Particulate matter, NO2, and O3 are the culprit pollutants leading to respiratory diseases.

HP: The proportion of HP cases increased with higher levels of air pollution in several Indian cities.

IPF: Air pollution has been associated with lower FVC, accelerated decline of FVC, and acute exacerbations in patients with IPF.

ILA: Also associated with increased risk of having ILA in both adults and children.

Possible mechanism: Air pollution → oxidant stress, inflammatory response and telomere shortening → fibrotic pathway.

Exposome should be evaluated to ascertain the cause of pulmonary fibrosis.

Patients with ILD should avoid strenuous exercise during bad-quality air days and use facemasks.