Environmental Risk Factors for Acute Respiratory Distress Syndrome

Several environmental exposures increase susceptibility to the acute respiratory distress syndrome (ARDS). Specifically, chronic exposure to ambient air pollution, cigarette smoke, and alcohol "prime" the lung via epithelial injury, endothelial dysfunction, and immunomodulatory mechanisms, increasing the risk and severity of ARDS following an array of acute insults. Future research of these pathways may reveal therapeutic targets. Relevant emerging threats, such as electronic cigarettes and vaping, wildfire smoke, and the environmental hazards associated with climate change, may also be associated with ARDS. Building upon existing public policy interventions can prevent substantial morbidity and mortality from ARDS.