Environmental Substances Associated with Chronic Obstructive Pulmonary Disease—A Scoping Review

Abstract

Chronic obstructive pulmonary disease (COPD) is a slowly developing non-communicable disease (NCD), causing non-reversible obstruction and leading to marked morbidity and mortality. Besides traditional risk factors such as smoking, some environmental substances can augment the risk of COPD. The European Human Biomonitoring Initiative (HBM4EU) is a program evaluating citizens’ exposure to various environmental substances and their possible health impacts. Within the HBM4EU, eighteen priority substances or substance groups were chosen. In this scoping review, seven of these substances or substance groups are reported to have an association or a possible association with COPD. Main exposure routes, vulnerable and high-exposure risk groups, and matrices where these substances are measured are described. Pesticides in general and especially organophosphate and carbamate insecticides, and some herbicides, lead (Pb), and polycyclic aromatic hydrocarbons (PAHs) showed an association, and cadmium (Cd), chromium (Cr and CrVI), arsenic (As), and diisocyanates, a possible association with COPD and/or decreased lung function. Due to long latency in COPD’s disease process, the role of chemical exposure as a risk factor for COPD is probably underestimated. More research is needed to support evidence-based conclusions. Generally, chemical exposure is a growing issue of concern, and prompt action is needed to safeguard public health.

Metal Exposure, Smoking, and the Risk of COPD: A Nested Case–Control Study in a Chinese Occupational Population

“…A study on the relationship between occupational exposure and the clinical features of COPD showed that those with COPD reported more symptoms associated with occupational exposure, even if they had a history of smoking [ 40 ]. The European Human Biomonitoring Initiative (HBM4EU) review of the scope of COPD and environmental substances reported that exposure to Pb was associated with COPD, while Cd, Cr, and As may be associated with COPD and/or decreased lung function [ 41 ]. In this study, we did not determine which specific metals may lead to an increased risk of COPD.…”

“…At present, patients with COPD are not exposed to one single substance in the environment, and it is particularly important to study the interaction between exposed substances [ 41 ]. Boggia et al confirmed a significant interaction ( p < 0.001) between smoking and occupational exposure on the risk of COPD and increased risk among workers exposed to both risk factors (ExpB:2.51) [ 42 ].…”

Exposure to Environmental Toxins: Potential Implications for Stroke Risk via the Gut– and Lung–Brain Axis

“…PM10 can penetrate deeper into the lungs, targeting the lung bronchioles and resulting in remodeling of lung tissue and the upregulation of immune cells [140]. Damage to lung architecture and altered immune response elevate the likelihood of lung diseases such as chronic obstructive pulmonary disease (COPD), chronic bronchitis, and respiratory tract infections due to resulting lung impairment and dysfunction post-exposure to environmental toxins [43,141,142].…”

HPLC Analysis and Risk Assessment of 15 Priority PAHs in Human Blood Serum of COPD Patient from Urban and Rural Areas, Iasi (Romania)

“…The mechanisms implicated in the induction or exacerbation of airway inflammatory responses by PAHs were studied over the years, while several are described in some review studies. When fine particles like PAHs are breathed into the lungs, they cause inflammation, which is one of the mechanisms implicated in the development, and also the exacerbation, of many respiratory diseases [ 11 ]. Research in the field of pollution is focused mostly on the urban environment [ 12 ] because it was found that most of the pollution is transmitted from outside to inside, while smoking and cooking contribute to internal pollution in a relatively stable interval [ 12 ].…”