Letter to the Director
Tobacco as a Source of Microplastics and Respiratory Health
Carlos Baeza-Martineza,
, Sandra Ruiz-Alcaraza, María J. Soler-Semperea,b, Eduardo Garcia-Pachona, Luis Hernandez-Blascob, Javier Bayoc
Corresponding author
a Section of Respiratory Medicine, Hospital General Universitario de Elche, Elche, Alicante, Spain
b Department of Clinical Medicine, Universidad Miguel Hernandez de Elche, Elche, Alicante, Spain
c Department of Chemical and Environmental Engineering, Technical University of Cartagena, Cartagena, Spain
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As baseline FVC declines, the difference between the relative and absolute percentage value increases. The relative method is more sensitive for detecting decline and this parameter is more marked in patients with reduced baseline FVC values. <span class="elsevierStyleItalic">Absolute FVC</span><span class="elsevierStyleItalic">decline</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>baseline FVC<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>final FVC; <span class="elsevierStyleItalic">relative decline:</span> (baseline FVC<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>final FVC)/baseline FVC; <span class="elsevierStyleItalic">FVC:</span> forced vital capacity; L: liters; <span class="elsevierStyleItalic">Δ</span>: Delta of change between a relative and absolute FVC decline of 5%.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Horacio Matías Castro, Joaquin Maritano Furcada, Juan Ignacio Enghelmayer" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Horacio Matías" "apellidos" => "Castro" ] 1 => array:2 [ "nombre" => "Joaquin" "apellidos" => "Maritano Furcada" ] 2 => array:2 [ "nombre" => "Juan Ignacio" "apellidos" => "Enghelmayer" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289622004896?idApp=UINPBA00003Z" "url" => "/03002896/0000005800000012/v2_202305072241/S0300289622004896/v2_202305072241/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Director</span>" "titulo" => "Tobacco as a Source of Microplastics and Respiratory Health" "tieneTextoCompleto" => true "saludo" => "To the Director," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "845" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos Baeza-Martinez, Sandra Ruiz-Alcaraz, María J. Soler-Sempere, Eduardo Garcia-Pachon, Luis Hernandez-Blasco, Javier Bayo" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Carlos" "apellidos" => "Baeza-Martinez" "email" => array:1 [ 0 => "baezamartinez.c@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Sandra" "apellidos" => "Ruiz-Alcaraz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "María J." "apellidos" => "Soler-Sempere" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Eduardo" "apellidos" => "Garcia-Pachon" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Luis" "apellidos" => "Hernandez-Blasco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Javier" "apellidos" => "Bayo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Section of Respiratory Medicine, Hospital General Universitario de Elche, Elche, Alicante, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Clinical Medicine, Universidad Miguel Hernandez de Elche, Elche, Alicante, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Chemical and Environmental Engineering, Technical University of Cartagena, Cartagena, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read with great interest the editorial by De Granda Orive et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> entitled “Tobacco as a Source of Microplastics (MPs). Tobacco and Environment: World No Tobacco Day 2022”. The article stresses the importance of cigarette filters as a source of MPs. Environmental pollution from MPs in air is a matter of growing concern because of human health implications. Airborne MPs can be directly and continuously inhaled in air environments.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> It has been estimated that about 0.3 million tons of potential small microfibers might reach the environment from cigarette filters.</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is reasonable to suspect that smokers may be exposed to inhalation of a greater number of MPs that could reach the lower airway. This could occur because of the deep inhalations they take but also because of the presence of the MPs in cigarettes.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We consider interesting to comment on our experience in this area. We have very recently studied the presence of MPs in the lower airway by bronchoalveolar lavage (BAL) in 44 individuals.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Of these, 23 (52%) were smokers, 15 (34%) former smokers and 6 (14%) had never smoked. Smokers and former smokers have an average value for cumulative tobacco consumption of 41<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4 pack-years. We have found statistically significant differences in MPs concentration in BAL samples according to smoking habits (<span class="elsevierStyleItalic">F</span>-value<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8.131, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001): active smokers had higher MPs concentrations (5.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.52<span class="elsevierStyleHsp" style=""></span>items/100<span class="elsevierStyleHsp" style=""></span>mL BAL) compared to former smokers (3.88<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.18<span class="elsevierStyleHsp" style=""></span>items/100<span class="elsevierStyleHsp" style=""></span>mL BAL) (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.008), and non-smokers (3.14<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.21<span class="elsevierStyleHsp" style=""></span>items/100<span class="elsevierStyleHsp" style=""></span>mL BAL) (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001). The clinical significance of our finding remains to be determined, but initial data indicate that the presence of MPs is associated with increased respiratory impairment.</p><p id="par0020" class="elsevierStylePara elsevierViewall">There is limited data about the presence of MPs in the human respiratory tract. Huang et al. found, in sputum samples, that smokers had more types of MPs compared to non-smokers.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Chen et al. analyzed the presence of MPs in ground glass nodules from surgical samples; these authors observed that in tumor lesions of patients with exposure risk factors such as smoking, the presence of these microfibers was detected more frequently compared to samples of unexposed patients (72% vs. 42%).<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> All these findings indicate the importance of MPs in cigarettes, not only in environmental pollution, but also in respiratory health.</p><p id="par0025" class="elsevierStylePara elsevierViewall">De Granda et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> have warned about these little known and potentially serious risks of tobacco use in their excellent editorial. We consider that our findings reinforce the editorial's comments and provide objective information on tobacco risks that until now may not be taken into account.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0030" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">None to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tobacco as a source of microplastics. 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Zeng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1021/acs.est.1c03859" "Revista" => array:6 [ "tituloSerie" => "Environ Sci Technol" "fecha" => "2022" "volumen" => "56" "paginaInicial" => "2476" "paginaFinal" => "2486" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35073488" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An emerging role of microplastics in the etiology of lung ground glass nodules" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Q. Chen" 1 => "J. Gao" 2 => "H. Yu" 3 => "H. Su" 4 => "Y. Yang" 5 => "Y. Cao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12302-022-00605-3" "Revista" => array:4 [ "tituloSerie" => "Environ Sci Eur" "fecha" => "2022" "volumen" => "34" "paginaInicial" => "25" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000005800000012/v2_202305072241/S0300289622005063/v2_202305072241/en/main.assets" "Apartado" => array:4 [ "identificador" => "93867" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005800000012/v2_202305072241/S0300289622005063/v2_202305072241/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289622005063?idApp=UINPBA00003Z" ]
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