Application of artificial intelligence in quantifying lung deposition dose of black carbon in people with exposure to ambient combustion particles

Background Understanding lung deposition dose of black carbon is critical to fully reconcile epidemiological evidence of combustion particles induced health effects and inform the development of air quality metrics concerning black carbon. Macrophage carbon load (MaCL) is a novel cytology method that quantifies lung deposition dose of black carbon, however it has limited feasibility in large-scale epidemiological study due to the labor-intensive manual counting. Objective To assess the association between MaCL and episodic elevation of combustion particles; to develop artificial intelligence based counting algorithm for MaCL assay. Methods Sputum slides were collected during episodic elevation of ambient PM 2.5 ( n = 49, daily PM 2.5 > 10 µg/m 3 for over 2 weeks due to wildfire smoke intrusion in summer and local wood burning in winter) and low PM 2.5 period ( n = 39, 30-day average PM 2.5 < 4 µg/m 3 ) from the Lovelace Smokers cohort. Results Over 98% individual carbon particles in macrophages had diameter <1 µm. MaCL levels scored manually were highly responsive to episodic elevation of ambient PM 2.5 and also correlated with lung injury biomarker, plasma CC16. The association with CC16 became more robust when the assessment focused on macrophages with higher carbon load. A Mac hine- L earning algorithm for E ngulfed c A rbon P articles (MacLEAP) was developed based on the Mask Region-based Convolutional Neural Network. MacLEAP algorithm yielded excellent correlations with manual counting for number and area of the particles. The algorithm produced associations with ambient PM 2.5 and plasma CC16 that were nearly identical in magnitude to those obtained through manual counting. Impact statement Understanding lung black carbon deposition is crucial for comprehending health effects of combustion particles. We developed “Machine-Learning algorithm for Engulfed cArbon Particles (MacLEAP)”, the first artificial intelligence algorithm for quantifying airway macrophage black carbon. Our study bolstered the algorithm with more training images and its first use in air pollution epidemiology. We revealed macrophage carbon load as a sensitive biomarker for heightened ambient combustion particles due to wildfires and residential wood burning.