Association of high PM_2.5 levels with short-term and medium-term lung function recovery in patients with pulmonary lobectomy

The association between exposure to ambient fine particulate matter with an aerodynamic diameter of ≤ 2.5 μm (PM_2.5) and short- and medium-term lung function recovery (LFR) in patients undergoing lobectomy remains uncertain. This study investigated the associations between PM_2.5 concentrations and LFR in adult patients (n = 526) who underwent video-assisted thoracoscopic (VATS) lobectomy in Guangzhou, China between January 2018 and June 2021. All patients underwent at least two spirometry tests. Environmental PM_2.5 concentrations in the same period were collected from the nearest monitoring station. A multiple linear regression (MLR) model was employed to investigate the associations between changes in PM_2.5 concentrations and LFR in patients who underwent lobectomy after adjusting for potential confounders. We assessed short- and medium-term LFR in patients who underwent lobectomy. The three- and 6-month average PM_2.5 concentrations in each patient's residential area were divided into regional mild pollution (PM_2.5 <25 μg/m³), moderate pollution (25 μg/m³ ≤ PM_2.5 <35 μg/m³), and severe pollution (35 μg/m³ ≤ PM_2.5) periods. The MLR model confirmed that PM_2.5 was an independent risk factor affecting short-term forced lung capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximum expiratory flow at 50% vital capacity (MEF₅₀) recovery (adjusted P = 0.041, 0.014, 0.016, respectively). The MLR model confirmed that PM_2.5 was an independent risk factor affecting medium-term MEF₅₀ recovery (adjusted P = 0.046). Compared with the moderate and severe pollution periods, the short- and medium-term LFR (FVC, FEV1, MEF₅₀) of patients in the mild pollution period were faster and better (P < 0.001, P < 0.001, P < 0.001, P = 0.048, P = 0.010, P = 0.013, respectively). Thus, exposure to high PM_2.5 levels was associated with significantly reduced speed and degree of short- and medium-term LFR in patients who underwent lobectomy.