Air pollution, particularly fine particles of 2.5 μm or smaller in diameter (PM
2.5), is a known risk factor for asthma exacerbation.
1 Elevated PM
2.5 levels are found in polluted atmospheres throughout the world and numerous indoor environments where tobacco smoke is present or solid fuels are used for cooking or heating
2,3; PM
2.5 can penetrate the lung deeply to deposit in small airways
4-6 that have a physiology very important in asthma.
7 Anatomically defined as the airways with inner diameters smaller than 2 mm, the small airways cumulatively represent a substantially greater cross-sectional area than the large airways.
8 Compromised small airways contribute substantially to airflow obstruction
9-11 and airway inflammation
12-14 in asthma. Although PM
2.5 exposure has been associated with increased oxidative stress and pulmonary inflammation,
1,15,16 to our knowledge, no studies have examined whether reducing PM
2.5 exposure can be associated with improvements in small airway physiology in individuals with asthma.