Associations of ambient air pollution with chronic obstructive pulmonary disease hospitalization and mortality.

Abstract

RATIONALE:

Ambient air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD). However, there is a lack of longitudinal studies to support this assertion.

OBJECTIVES:

To investigate the associations of long-term exposure to elevated traffic-related air pollution and woodsmoke pollution with the risk of COPD hospitalization and mortality.

METHODS:

This population-based cohort study included a 5-year exposure period and a 4-year follow-up period. All residents aged 45-85 years who resided in Metropolitan Vancouver, Canada, during the exposure period and did not have known COPD at baseline were included in this study (n = 467,994). Residential exposures to traffic-related air pollutants (black carbon, particulate matter <2.5 μm in aerodynamic diameter, nitrogen dioxide, and nitric oxide) and woodsmoke were estimated using land-use regression models and integrating changes in residences during the exposure period. COPD hospitalizations and deaths during the follow-up period were identified from provincial hospitalization and death registration databases.

MEASUREMENTS AND MAIN RESULTS:

An interquartile range elevation in black carbon concentrations (0.97 × 10(-5)/m, equivalent to 0.78 μg/m(3) elemental carbon) was associated with a 6% (95% confidence interval, 2-10%) increase in COPD hospitalizations and a 7% (0-13%) increase in COPD mortality after adjustment for covariates. Exposure to higher levels of woodsmoke pollution (tertile 3 vs. tertile 1) was associated with a 15% (2-29%) increase in COPD hospitalizations. There were positive exposure-response trends for these observed associations.

CONCLUSIONS:

Ambient air pollution, including traffic-related fine particulate pollution and woodsmoke pollution, is associated with an increased risk of COPD.

• Authors: Wen Qi Gan, J Mark FitzGerald, Chris Carlsten, Mohsen Sadatsafavi, Michael Brauer
• Journal: American journal of respiratory and critical care medicine (Am J Respir Crit Care Med) Vol. 187 Issue 7 Pg. 721-7 (Apr 01 2013) ISSN: 1535-4970 [Electronic] United States
• PMID: 23392442 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Particulate Matter
• Vehicle Emissions

Topics

• Aged
• Aged, 80 and over
• Air Pollution (adverse effects)
• Canada (epidemiology)
• Cohort Studies
• Environmental Exposure (adverse effects)
• Female
• Hospitalization (statistics & numerical data)
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Particulate Matter (adverse effects)
• Pulmonary Disease, Chronic Obstructive (epidemiology, mortality)
• Regression Analysis
• Risk Factors
• Vehicle Emissions (toxicity)