Impact of ambient air pollution on the differential white blood cell count in patients with chronic pulmonary disease

Inhal Toxicol. 2010 Feb;22(3):245-52. doi: 10.3109/08958370903207274.


Epidemiologic studies report associations between particulate air pollution and increased mortality from pulmonary diseases. This study was performed to examine whether the exposure to ambient gaseous and particulate air pollution leads to an alteration of the differential white blood cell count in patients with chronic pulmonary diseases like chronic bronchitis, chronic obstructive pulmonary disease, and asthma. A prospective panel study was conducted in Erfurt, Eastern Germany, with 12 repeated differential white blood cell counts in 38 males with chronic pulmonary diseases. Hourly particulate and gaseous air pollutants and meteorological data were acquired. Mixed models with a random intercept adjusting for trend, meteorology, weekday, and other risk variables were used. In this explorative analysis, we found an immediate decrease of polymorphonuclear leukocytes in response to an increase of most gaseous and particulate pollutants. Lymphocytes increased within 24 h in association with all gaseous pollutants but showed only minor effects in regard to particulate air pollution. Monocytes showed an increase associated with ultrafine particles, and nitrogen monoxide. The effect had two peaks in time, one 0-23 h before blood withdrawal and a second one with a time lag of 48-71 h. The increase of particulate and gaseous air pollution was associated with multiple changes in the differential white blood cell count in patients with chronic pulmonary diseases.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Air Pollutants / adverse effects
  • Air Pollutants / analysis
  • Air Pollution / adverse effects*
  • Air Pollution / analysis
  • Animals
  • C-Reactive Protein / metabolism
  • Carbon Monoxide / adverse effects
  • Carbon Monoxide / analysis
  • Environmental Monitoring
  • Germany
  • Humans
  • Leukocyte Count*
  • Linear Models
  • Longitudinal Studies
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Nitrogen Dioxide / adverse effects
  • Nitrogen Dioxide / analysis
  • Oxidants, Photochemical / adverse effects
  • Oxidants, Photochemical / analysis
  • Particle Size
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / blood*
  • Rabbits
  • Respiratory Function Tests


  • Air Pollutants
  • Oxidants, Photochemical
  • Carbon Monoxide
  • C-Reactive Protein
  • Nitrogen Dioxide