The Impact of Air Pollutants and Meteorological Factors on Chronic Obstructive Pulmonary Disease Exacerbations: A Nationwide Study.

Jin-Young Huh; Jinwook Hong; Dong-Woo Han; Young-Jun Park; Jaehun Jung; and Sei Won Lee; Huh, Jin-Young; Hong, Jinwook; Han, Dong-Woo; Park, Young-Jun; Jung, Jaehun; Lee, Sei Won

Rationale: Chronic obstructive lung disease (COPD) is a chronic progressive disease. Although smoking is the most important risk factor, 30% of patients with COPD are never-smokers, and environmental agents are also influential. The effects of air pollutants and meteorological factors on COPD exacerbations have not been studied extensively. Objectives: We aimed to investigate the air pollutants and meteorological factors that impact the incidence of COPD exacerbations. Methods: We obtained clinical data of COPD exacerbation cases from The National Health Insurance Service and merged it with 24-hour average values of air pollutants and meteorological factors from national databases. Patients who reside in eight metropolitan cities, where observatory stations are densely located, were selected for analysis. Results: In 1,404,505 patients with COPD between 2013 and 2018, 15,282 COPD exacerbations leading to hospitalization or emergency room visits were identified. Among the various air pollutants and meteorological factors, particulate matter ⩽2.5 μm in aerodynamic diameter (PM2.5), particulate matter ⩽10 μm in aerodynamic diameter (PM10), NO2, SO2, CO, O3, average temperature, and diurnal temperature range (DTR) were associated with COPD exacerbations. Generalized additive mode model analysis with cubic splines showed an inverted U-shaped relationship with PM2.5, PM10, CO, NO2, SO2, O3, DTR, and humidity, whereas it displayed a U-shaped pattern with the average temperature. Distinct patterns were found from 2015-2016 to 2017-2018. Conclusions: PM2.5, PM10, CO, NO2, O3, SO2, average temperature, humidity, and DTR affected the incidence of COPD exacerbations in various patterns, up to 10 lag days.

CHINA; AIR pollutants; OBSTRUCTIVE lung diseases; CHRONIC diseases; SMOKING; DISEASE risk factors; PARTICULATE matter; DISEASE incidence; DISEASE exacerbation; AIR pollution; RESEARCH; RESEARCH methodology; ECOLOGY; EVALUATION research; COMPARATIVE studies; RESEARCH funding; METROPOLITAN areas

Annals of the American Thoracic Society, 2022, Vol 19, Issue 2, p214

2329-6933

Academic Journal

10.1513/AnnalsATS.202103-298OC