The attributable risk of chronic obstructive pulmonary disease due to ambient fine particulate pollution among older adults.

BACKGROUND The linkage between ambient fine particle pollution (PM2.5) and chronic obstructive pulmonary disease (COPD) and the attributable risk remained largely unknown. This study determined the cross-sectional association between ambient PM2.5 and prevalence of COPD among adults ≥50 years of age. METHODS We surveyed 29,290 participants aged 50 years and above in this study. The annual average concentrations of PM2.5 derived from satellite data were used as the exposure indicator. A mixed effect model was applied to determine the associations and the burden of COPD attributable to PM2.5. RESULTS: Among the participants, 1872 (6.39%) were classified as COPD cases. Our analysis observed a threshold concentration of 30 μg/m3 in the PM2.5-COPD association, above which we found a linear positive exposure-response association between ambient PM2.5 and COPD. The odds ratio (OR) for each 10 μg/m3 increase in ambient PM2.5 was 1.21(95% CI: 1.13, 1.30). Stratified analyses suggested that males, older subjects (65 years and older) and those with lower education attainment might be the vulnerable subpopulations. We further estimated that about 13.79% (95% CI: 7.82%, 21.62%) of the COPD cases could be attributable to PM2.5 levels higher than 30 μg/m3 in the study population. CONCLUSION Our analysis indicates that ambient PM2.5 exposure could increase the risk of COPD and accounts for a substantial fraction of COPD among the study population.

[1]  R. Devlin,et al.  Concentrated ambient air particles induce mild pulmonary inflammation in healthy human volunteers. , 2000, American journal of respiratory and critical care medicine.

[2]  Tao Liu,et al.  Long-Term Effects of Ambient PM2.5 on Hypertension and Blood Pressure and Attributable Risk Among Older Chinese Adults , 2017, Hypertension.

[3]  F. Kelly,et al.  Oxidative stress: its role in air pollution and adverse health effects , 2003, Occupational and environmental medicine.

[4]  Hualiang Lin,et al.  Short-term effects of meteorological factors on hand, foot and mouth disease among children in Shenzhen, China: Non-linearity, threshold and interaction. , 2016, The Science of the total environment.

[5]  Thomas Ferkol,et al.  The global burden of respiratory disease. , 2014, Annals of the American Thoracic Society.

[6]  Joachim Heinrich,et al.  Long-term air pollution exposure and living close to busy roads are associated with COPD in women , 2005, Respiratory research.

[7]  R. Burnett,et al.  Long-term exposure to ambient air pollution and risk of hospitalization with community-acquired pneumonia in older adults. , 2010, American journal of respiratory and critical care medicine.

[8]  C. Ou,et al.  The burden of COPD mortality due to ambient air pollution in Guangzhou, China , 2016, Scientific Reports.

[9]  Weifeng Zou,et al.  Association between exposure to ambient particulate matter and chronic obstructive pulmonary disease: results from a cross-sectional study in China , 2016, Thorax.

[10]  Wenjun Ma,et al.  Ambient fine and coarse particulate matter pollution and respiratory morbidity in Dongguan, China. , 2017, Environmental pollution.

[11]  Jon G Ayres,et al.  COPD and chronic bronchitis risk of indoor air pollution from solid fuel: a systematic review and meta-analysis , 2010, Thorax.

[12]  Geir Aamodt,et al.  Relation between concentration of air pollution and cause-specific mortality: four-year exposures to nitrogen dioxide and particulate matter pollutants in 470 neighborhoods in Oslo, Norway. , 2007, American journal of epidemiology.

[13]  M. Brauer,et al.  Use of Satellite Observations for Long-Term Exposure Assessment of Global Concentrations of Fine Particulate Matter , 2014, Environmental health perspectives.

[14]  F. Clavel-Chapelon,et al.  Environmental tobacco smoke and risk of respiratory cancer and chronic obstructive pulmonary disease in former smokers and never smokers in the EPIC prospective study , 2005, BMJ : British Medical Journal.

[15]  Michael Brauer,et al.  Associations of ambient air pollution with chronic obstructive pulmonary disease hospitalization and mortality. , 2013, American journal of respiratory and critical care medicine.

[16]  Aziz Sheikh,et al.  Global and regional estimates of COPD prevalence: Systematic review and meta–analysis , 2015, Journal of global health.

[17]  Hualiang Lin,et al.  Emergency Cardiovascular Hospitalization Risk Attributable to Cold Temperatures in Hong Kong , 2016, Circulation. Cardiovascular quality and outcomes.

[18]  Tao Liu,et al.  Quantifying short-term and long-term health benefits of attaining ambient fine particulate pollution standards in Guangzhou, China , 2016 .

[19]  Michael Brauer,et al.  Risk estimates of mortality attributed to low concentrations of ambient fine particulate matter in the Canadian community health survey cohort , 2016, Environmental Health.

[20]  H. R. Anderson,et al.  Long-term exposure to outdoor air pollution and the incidence of chronic obstructive pulmonary disease in a national English cohort , 2014, Occupational and Environmental Medicine.

[21]  João Paulo Souza,et al.  Outdoor Air Pollution, Preterm Birth, and Low Birth Weight: Analysis of the World Health Organization Global Survey on Maternal and Perinatal Health , 2014, Environmental health perspectives.

[22]  Chaoyang Li,et al.  Ozone, Fine Particulate Matter, and Chronic Lower Respiratory Disease Mortality in the United States. , 2015, American journal of respiratory and critical care medicine.

[23]  Michael Brauer,et al.  An Integrated Risk Function for Estimating the Global Burden of Disease Attributable to Ambient Fine Particulate Matter Exposure , 2014, Environmental health perspectives.

[24]  Paolo Vineis,et al.  Air pollution and nonmalignant respiratory mortality in 16 cohorts within the ESCAPE project. , 2014, American journal of respiratory and critical care medicine.

[25]  P. Kowal,et al.  Ambient PM2.5 and Stroke: Effect Modifiers and Population Attributable Risk in Six Low- and Middle-Income Countries , 2017, Stroke.

[26]  U Ackermann-Liebrich,et al.  Lung function and long term exposure to air pollutants in Switzerland. Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) Team. , 1997, American journal of respiratory and critical care medicine.

[27]  Tai Hing Lam,et al.  Satellite-Based Estimates of Long-Term Exposure to Fine Particles and Association with Mortality in Elderly Hong Kong Residents , 2015, Environmental health perspectives.

[28]  Joel Schwartz,et al.  Long-term exposure to traffic emissions and fine particulate matter and lung function decline in the Framingham heart study. , 2015, American journal of respiratory and critical care medicine.

[29]  H. Leufkens,et al.  Essential medicines for COPD and asthma in low and middle-income countries , 2014, Thorax.

[30]  Shengming Liu,et al.  Prevalence of chronic obstructive pulmonary disease in China: a large, population-based survey. , 2007, American journal of respiratory and critical care medicine.

[31]  Hualiang Lin,et al.  The effect of meteorological factors on adolescent hand, foot, and mouth disease and associated effect modifiers , 2014, Global health action.

[32]  F Kauffmann,et al.  Twenty five year mortality and air pollution: results from the French PAARC survey , 2005, Occupational and Environmental Medicine.

[33]  S. Salvi.  Tobacco smoking and environmental risk factors for chronic obstructive pulmonary disease. , 2014, Clinics in chest medicine.

[34]  S. Chatterji,et al.  Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1 , 2015, BMC Public Health.

[35]  S T Holgate,et al.  Acute inflammatory responses in the airways and peripheral blood after short-term exposure to diesel exhaust in healthy human volunteers. , 1999, American journal of respiratory and critical care medicine.

[36]  H. R. Anderson,et al.  Long-term exposure to outdoor air pollution and the prevalence of asthma: meta-analysis of multi-community prevalence studies , 2013, Air Quality, Atmosphere & Health.

[37]  J. Hewitt,et al.  Genetic and environmental influences on substance initiation, use, and problem use in adolescents. , 2003, Archives of general psychiatry.

[38]  S T Holgate,et al.  Acute exposure to diesel exhaust increases IL-8 and GRO-alpha production in healthy human airways. , 2000, American journal of respiratory and critical care medicine.

[39]  R. Keller.  [Air pollution and lung diseases in adults]. , 1986, Sozial- und Praventivmedizin.

[40]  Thomas Kuhlbusch,et al.  Association of ambient air pollution with the prevalence and incidence of COPD , 2014, European Respiratory Journal.