Major threats causing AEs of pulmonary diseases include exposure to chemical air pollutants and biocontaminants, including allergens. The impact of chemical air pollutants on asthma attacks and COPD exacerbation is well established. The impact of airborne allergens is also well documented in the case of asthma and for rhinitis attacks and aggravation. Recently, an association has also been found between air pollution and IPF exacerbations. The modalities of action are different. The lag period (time between the exposure event and aggravation) is short (up to few hours or days) for both allergens and chemical air pollution in the case of asthma, and longer in the case of chemical pollutants for COPD and IPF. Whether a combination of air pollution and allergens is associated with a higher risk of pulmonary disease aggravation than exposure to each individually needs to be elucidated. The role of prevention has been promoted, but is often difficult in practice.

Cite as: Annesi-Maesano I. Chemical air pollution and allergen exposure. In: Burgel P-R, Contoli M, López-Campos JL, eds. Acute Exacerbations of Pulmonary Diseases (ERS Monograph). Sheffield, European Respiratory Society, 2017; pp. 66–75 [https://doi.org/10.1183/2312508X.10016016].