Contribution of air pollution to COPD and small airway dysfunction

Respirology. 2016 Feb;21(2):237-44. doi: 10.1111/resp.12644. Epub 2015 Sep 27.


Although in many Western countries levels of ambient air pollution have been improving with the setting of upper limits and better urban planning, air pollution in developing countries and particularly those with rapid industrialization has become a major global problem. Together with increased motor vehicle ownership and traffic congestion, there is a growing issue with airborne particles of respirable size. These particles are thought responsible for respiratory and cardiovascular effects and have also been implicated in cancer pathogenesis. The pathologic effects in the lung are mediated via inflammatory pathways and involve oxidative stress similar to cigarette smoking. These effects are seen in the peripheral airways where the smaller particle fractions are deposited and lead to airway remodelling. However, emphysema and loss of bronchioles seen with cigarette smoking have not been described with ambient air pollution, and there are few studies specifically looking at peripheral airway function. Definitive evidence of air pollution causing COPD is lacking and a different study design is required to link air pollution and COPD.

Keywords: air pollution; chronic obstructive pulmonary disease; peripheral airway; spirometry; study design.

Publication types

  • Review

MeSH terms

  • Air Pollutants* / adverse effects
  • Air Pollutants* / analysis
  • Air Pollution / adverse effects*
  • Airway Remodeling
  • Bronchioles* / drug effects
  • Bronchioles* / pathology
  • Bronchioles* / physiopathology
  • Humans
  • Oxidative Stress
  • Particulate Matter* / adverse effects
  • Particulate Matter* / analysis
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / etiology
  • Pulmonary Disease, Chronic Obstructive* / metabolism
  • Pulmonary Disease, Chronic Obstructive* / physiopathology


  • Air Pollutants
  • Particulate Matter