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Review
. 2020 Jul;14(7):737-748.
doi: 10.1080/17476348.2020.1753507. Epub 2020 Apr 26.

Influences of environmental exposures on individuals living with cystic fibrosis

Rhonda Szczesniak  1   2 , Jessica L Rice  3 , Cole Brokamp  1   2 , Patrick Ryan  1   2 , Teresa Pestian  1 , Yizhao Ni  2   4 , Eleni-Rosalina Andrinopoulou  5 , Ruth H Keogh  6 , Emrah Gecili  1 , Rui Huang  1   7 , John P Clancy  2   8 , Joseph M Collaco  3
Affiliations
Review

Influences of environmental exposures on individuals living with cystic fibrosis

Rhonda Szczesniak et al. Expert Rev Respir Med. 2020 Jul.

Abstract

Introduction: Natural, social, and constructed environments play a critical role in the development and exacerbation of respiratory diseases. However, less is known regarding the influence of these environmental/community risk factors on the health of individuals living with cystic fibrosis (CF), compared to other pulmonary disorders.

Areas covered: Here, we review current knowledge of environmental exposures related to CF, which suggests that environmental/community risk factors do interact with the respiratory tract to affect outcomes. Studies discussed in this review were identified in PubMed between March 2019 and March 2020. Although the limited data available do not suggest that avoiding potentially detrimental exposures other than secondhand smoke could improve outcomes, additional research incorporating novel markers of environmental exposures and community characteristics obtained at localized levels is needed.

Expert opinion: As we outline, some environmental exposures and community characteristics are modifiable; if not by the individual, then by policy. We recommend a variety of strategies to advance understanding of environmental influences on CF disease progression.

Keywords: Cystic fibrosis; air pollution; climate; environment; geocoding; geographic; geomarker; secondhand smoke; socioeconomic status; stressors.

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Figures

Figure 1:
Figure 1:. Conceptual framework outlining CF environmental health epidemiology*
*See Section 2 for full description of key environmental domains (geographic, community and healthcare access) and exposures therein. Bi-directional arrows and dashed lines indicate reciprocal relationships.
Figure 2:
Figure 2:. Potential strategies to enhance CF environmental health decision making
See this image and copyright information in PMC

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