Introduction: Obstructive airway diseases are important contributors to the global burden of disease. Air pollution has been shown to play a significant role in acute exacerbations (AE) of these diseases. However, non-invasive markers to monitor lung damage induced by air pollution are lacking.

Goal: The ALERT study aims to monitor the impact of in- and outdoor air pollution exposure on respiratory functioning in healthy individuals and patients with chronic airway disease (asthma and COPD), by combining air pollution monitoring with patient reported outcomes and exhaled breath analysis of volatile organic components (VOCs).

Methods: Patients with Chronic Obstructive Pulmonary Disease (COPD), asthma, and healthy controls are included. Based upon historical exposure data from the ?Airbezen study?, exposure to NO2, PM10, PM2.5 will be correlated to symptoms assessed by questionnaires (ACQ, CAT). Next, in and outdoor air pollution (NOx, PM10) will be measured with 3 months interval at the participants residence with subsequent lung health evaluation and breath sample collection [figure 1A]. Individual VOCs will be identified and quantified to establish a breath print for lung damage.

Results: Preliminary analysis of the first included patients shows that historical PM levels differ significantly between COPD and asthma patients and correlate with reported CAT scores in COPD indicating disease impact [figure 1B,C].

Conclusion: Our preliminary results indicate that air pollution contributes to chronic respiratory disease and symptoms. First results of breath analyses are expected in June 2023.