Recent evidence suggests that chronic exposure to high levels of ambient particulate matter (PM)
is associated with decreased pulmonary function and the development of chronic airflow obstruction.
To investigate the possible role of PM-induced abnormalities in the small airways in these
functional changes, we examined histologic sections from the lungs of 20 women from Mexico
City, a high PM locale. All subjects were lifelong residents of Mexico City, were never-smokers,
never had occupational dust exposure, and never used biomass fuel for cooking. Twenty neversmoking,
non–dust-exposed subjects from Vancouver, British Columbia, Canada, a low PM
region, were used as a control. By light microscopy, abnormal small airways with fibrotic walls
and excess muscle, many containing visible dust, were present in the Mexico City lungs. Formal
grading analysis confirmed the presence of significantly greater amounts of fibrous tissue and muscle
in the walls of the airways in the Mexico City compared with the Vancouver lungs. Electron
microscopic particle burden measurements on four cases from Mexico City showed that carbonaceous
aggregates of ultrafine particles, aggregates likely to be combustion products, were present
in the airway mucosa. We conclude that PM penetrates into and is retained in the walls of small
airways, and that, even in nonsmokers, long-term exposure to high levels of ambient particulate
pollutants is associated with small airway remodeling. This process may produce chronic airflow
obstruction.Occupational and Environmental Hygiene, School ofPathology and Laboratory Medicine, Department ofPopulation and Public Health (SPPH), School ofNon UBCMedicine, Faculty ofReviewedFacult