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Smoking aggravates the impaired pulmonary function of officially acknowledged female victims of air pollution of 40 years ago.

Air pollution due to industrial waste and tobacco smoke is detrimental to pulmonary function. However, the combined effects of air pollution and smoking on pulmonary function have not been investigated. We examined the combined effect of air pollution of 40 years ago and concurrent smoking on the pulmonary function of officially acknowledged female victims in Japan, because females are more susceptible to the adverse effects of both irritants than males. The subjects comprised 655 female victims living in one of two areas with air pollution of 40 years ago and 572 females living in an area without air pollution. All victims have been prescribed standard respiratory medications. Pulmonary function was measured in 2000 for air-pollution groups (130 smokers and 525 non-smokers; mean age, 68.4 years) and during the period of 2004 to 2013 for non-air-pollution groups (113 smokers and 459 non-smokers; mean age, 69.0 years). The smokers included both current smokers and ex-smokers. The victims with a history of smoking had significantly lower forced expiratory volume in 1 second (FEV1 % predicted) (mean, 74%) and significantly lower FEV1/forced vital capacity (FVC) (mean, 70%) than the other groups (P<0.001). Thus, smoking aggravates the pulmonary function in officially acknowledged female victims, despite the improved air pollution and the continuous medical care provided by the government. In conclusion, exposure to air pollution of 40 years ago and cigarette smoking are associated with reduced pulmonary function. These results highlight the importance of measures aimed at smoking cessation and limiting air pollution.