Harmful impact of air pollution on severe acute exacerbation of chronic obstructive pulmonary disease: particulate matter is hazardous

Int J Chron Obstruct Pulmon Dis. 2018 Mar 28:13:1053-1059. doi: 10.2147/COPD.S156617. eCollection 2018.

Abstract

Introduction: Particulate matter and air pollution in Korea are becoming worse. There is a lack of research regarding the impact of particulate matter on patients with COPD. Therefore, the purpose of this study was to investigate the effects of various air pollution factors, including particulate matter, on the incidence rate of severe acute exacerbations of COPD (AECOPD) events.

Methods: We analyzed the relationship between air pollutants and AECOPD events that required hospitalization at Guro Hospital in Korea from January 1, 2015 to May 31, 2017. We used general linear models with Poisson distribution and log-transformation to obtain adjusted relative risk (RR). We conducted further analysis through the Comprehensive Air-quality Index (CAI) that is used in Korea.

Results: Among various other air pollutants, particulate matter was identified as a major source of air pollution in Korea. When the CAI score was over 50, the incidence rate of severe AECOPD events was statistically significantly higher [RR 1.612, 95% CI, 1.065-2.440, P=0.024]. Additionally, the particulate matter levels 3 days before hospitalization were statistically significant [RR 1.003, 95% CI, 1.001-1.005, P=0.006].

Conclusion: Particulate matter and air pollution increase the incidence rate of severe AECOPD events. COPD patients should be cautioned against outdoor activities when particulate matter levels are high.

Keywords: COPD; acute exacerbation; air pollution; air quality index; particulate matter.

MeSH terms

  • Air Pollutants / adverse effects*
  • Air Pollution / adverse effects*
  • Disease Progression
  • Electronic Health Records
  • Hospitalization
  • Humans
  • Incidence
  • Inhalation Exposure / adverse effects*
  • Length of Stay
  • Linear Models
  • Odds Ratio
  • Particulate Matter / adverse effects*
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Retrospective Studies
  • Risk Factors
  • Seoul / epidemiology
  • Severity of Illness Index
  • Time Factors
  • Weather

Substances

  • Air Pollutants
  • Particulate Matter