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(Chest. 1998;113:1312-1318.)
© 1998 American College of Chest Physicians

Respiratory Changes due to Long-term Exposure to Urban Levels of Air Pollution

A Histopathologic Study in Humans

Marcelo B. Souza MD1; Paulo H. N. Saldiva MD, PhD, FCCP1; C. Arden Pope III PhD2; and Vera Luiza Capelozzi MD, PhD1

1 From the Laboratory of Experimental Air Pollution, Brigham Young University, Provo, Utah
2 From the Faculty of Medicine, University of São Paulo, Brazil, and the Department of Economics, Brigham Young University, Provo, Utah

Study objectives: To evaluate the potential associations between long-term exposure to air pollution and histopathologic evidence of damage to the lungs in humans.

Design: Lung tissue samples were collected during necropsies of individuals who died due to violent causes, selected on the basis of their exposure background.

Patients: The exposed group was composed of individuals who lived in Guarulhos, an area with high mean levels of inhalable particles. The control group was composed of individuals who lived in two cities with economies based on agricultural activities: Ribeirão Preto and Ourinhos.

Interventions: Information about cigarette smoking and occupational exposure was obtained from family members.

Measurements and results: Morphometric evaluation of the main bronchus was conducted to determine the volume ratio of submucosal glands. Histopathologic alterations of the bronchioli were evaluated by scoring the presence of inflammatory reaction, wall thickening, and secretory hyperplasia. The number of spots of carbon deposition was counted along the regions of lymphatic drainage (visceral pleura and axial connective tissue around bronchi and blood vessels). Statistical analysis was done by means of regression models controlled for age, smoking, and occupational exposure. Lungs collected from the high pollution area presented evidence of more histopathologic damage in comparison to those from the clean environments. These effects were observed even after controlling for individual differences in age, sex, and cigarette smoking levels.

Conclusions: These results suggest that long-term exposure to air pollution may contribute to the pathogenesis of airway disease, and that urban levels of air pollution have adverse effects on the respiratory tract.

Key Words: air pollution • morphometry • necropsy • respiratory pathology

Submitted on June 20, 1997
Accepted on October 22, 1997




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