Association between exposure to ambient particulate matter and chronic obstructive pulmonary disease: results from a cross-sectional study in China

Thorax. 2017 Sep;72(9):788-795. doi: 10.1136/thoraxjnl-2016-208910. Epub 2016 Dec 9.

Abstract

Objective: The association between exposure to ambient particles with a median aerodynamic diameter less than 10/2.5 µm (particulate matter, PM10/2.5) and COPD remains unclear. Our study objective was to examine the association between ambient PM10/2.5 concentrations and lung functions in adults.

Methods: A cross-sectional study was conducted in southern China. Seven clusters were randomly selected from four cities across Guangdong province. Residents aged ≥20 years in the participating clusters were randomly recruited; all eligible participants were examined with a standardised questionnaire and spirometry. COPD was defined as a post-bronchodilator FEV1/FVC less than 70%. Atmosphere PM sampling was conducted across the clusters along with our survey.

Results: Of the subjects initially recruited, 84.4% (n=5993) were included for analysis. COPD prevalence and atmosphere PM concentration varied significantly among the seven clusters. COPD prevalence was significantly associated with elevated PM concentration levels: adjusted OR 2.416 (95% CI 1.417 to 4.118) for >35 and ≤75 µg/m3 and 2.530 (1.280 to 5.001) for >75 µg/m3 compared with the level of ≤35 µg/m3 for PM2.5; adjusted OR 2.442 (95% CI 1.449 to 4.117) for >50 and ≤150 µg/m3 compared with the level of ≤50 µg/m3 for PM1. A 10 µg/m3 increase in PM2.5 concentrations was associated with a 26 mL (95% CI -43 to -9) decrease in FEV1, a 28 mL (-49 to -8) decrease in FVC and a 0.09% decrease (-0.170 to -0.010) in FEV1/FVC ratio. The associations of COPD with PM10 were consistent with PM2.5 but slightly weaker.

Conclusions: Exposure to higher PM concentrations was strongly associated with increased COPD prevalence and declined respiratory function.

Trial registration number: ChiCTR-OO-14004264; Post-results.

Keywords: COPD epidemiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollutants / adverse effects*
  • Air Pollutants / analysis
  • China / epidemiology
  • Cross-Sectional Studies
  • Environmental Exposure / adverse effects
  • Environmental Exposure / analysis
  • Environmental Monitoring / methods
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Male
  • Middle Aged
  • Particulate Matter / adverse effects*
  • Particulate Matter / analysis
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / etiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Risk Factors
  • Spirometry / methods
  • Surveys and Questionnaires
  • Vital Capacity / physiology

Substances

  • Air Pollutants
  • Particulate Matter

Associated data

  • ChiCTR/ChiCTR-OO-14004264