The Global Burden of Disease Study has estimated that over 500 million subjects, around 7% of the global population, are affected by chronic respiratory diseases, with substantial individual and societal costs concerning morbidity, disability and mortality.1 Identifying and mitigating potentially modifiable risk factors are crucial in preventing the associated public health burden. Extensive literature has provided compelling evidence that air pollution, especially fine particulate matter (PM)2.5 (diameter <2.5 µm), is a leading risk factor for the incidence and mortality of acute and chronic respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD).2 3 In addition, in 2013, the International Agency for Research on Cancer classified outdoor air pollution as a known carcinogen for the lung.4 The recent large multicentre project ‘Effects of Low-Level Air Pollution: A Study in Europe’ has shown that adverse respiratory effects, including incidence of asthma in adults5 and COPD,6 occur even at exposure levels below the current European Union air quality limit values. Furthermore, the new 2021 WHO Air Quality Guidelines have halved from 10 mg/m3 to 5 mg/m3 the recommended annual average outdoor concentrations of PM2.5.7 Although the vast literature on air pollution and respiratory effects, important unanswered queries remain on the aetiopathogenetic mechanisms and dynamics underlying the progression from a lung disease-free status to subsequent chronic lung diseases and, ultimately, death. To elucidate, these deadly trajectories would inform and guide focused preventive strategies in agreement with a modern precision public health approach. In the study of Wang et al , the Authors …

中文翻译：

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空气污染对呼吸系统的影响：是时候停止这种致命的轨迹了

全球疾病负担研究估计，超过 5 亿受试者（约占全球人口的 7%）受到慢性呼吸道疾病的影响，在发病率、残疾和死亡率方面造成巨大的个人和社会成本。 1 识别和减轻潜在可改变的风险因素对预防相关的公共卫生负担至关重要。大量文献提供了令人信服的证据，表明空气污染，尤其是细颗粒物 (PM)2.5（直径 <2.5 µm），是急性和慢性呼吸系统疾病（包括哮喘和慢性阻塞性肺病）发病率和死亡率的主要危险因素（ COPD).2 3 此外，2013 年，国际癌症研究机构将室外空气污染列为已知的肺部致癌物。4 最近的大型多中心项目“低水平空气污染的影响：欧洲的一项研究”表明，即使暴露水平低于欧盟目前的空气质量限值，也会出现不良呼吸系统影响，包括成人哮喘5和慢性阻塞性肺病6的发病率值。此外，新的 2021 年世卫组织空气质量指南已将建议的 PM2.5.7 年平均室外浓度从 10 mg/m3 减半至 5 mg/m3 尽管关于空气污染和呼吸系统影响的大量文献，但关于病原体机制的重要悬而未决的问题仍然存在以及从无肺病状态发展为随后的慢性肺病并最终死亡的动态机制。为了阐明，这些致命的轨迹将为符合现代精确公共卫生方法的重点预防策略提供信息和指导。在 Wang 等人的研究中，作者……