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

Lin, Hualiang; Qian, Zhengmin; Guo, Yanfei; Zheng, Yang; Ai, Siqi; Hang, Jian; Wang, Xiaojie; Zhang, Lingli; Liu, Tao; Guan, Weijun; Li, Xing; Xiao, Jianpeng; Zeng, Weilin; Xian, Hong; Howard, Steven W.; Ma, Wenjun; Wu, Fan

doi:10.1016/j.envint.2018.01.029

Cited by 59 publications

(26 citation statements)

References 38 publications

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“…20 A smaller-scale study of 1872 older adults reported higher odds of COPD (OR 1·21, 95% CI 1·13-1·30) corresponding to 10 µg/m³ increments in PM 2·5 exposure. 13 Our results remained consistent in the non-linear restricted cubic spline models for COPD prevalence and predicted lung function. Adjusting for the confounding by greenness produced null effects.…”

Section: Discussionsupporting

confidence: 79%

“…We were able to rerun our models accounting for confounding effects of physical activity. Our results remained consistent and physical activity measured as metabolic equivalent of task h per week was beneficially associated with COPD (appendix pp [11][12][13].…”

Section: : Logistic Regression Models Of Association Between Copd Ansupporting

confidence: 81%

“…WHO's SAGE cohort reported positive associations between odds of self-reported doctor diagnosed COPD and PM 2·5 exposure. 13 Studies from China from 2018 and 2017 used spirometry to diagnose COPD and reported positive associations between exposure to PM 2·5 and COPD prevalence. 14,15 On the other hand, a Europe-wide study reported null associations between PM 2·5 exposure and both prevalent and incident COPD outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

Sarkar

Zhang

et al. 2019

The Lancet Planetary Health

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Background The role of environmental exposures in chronic obstructive pulmonary disease (COPD) remains inconclusive. We examined the association between environmental exposures (PM 2·5 , greenness, and urbanicity) and COPD prevalence using the UK Biobank cohort data to identify key built environment correlates of COPD. MethodsIn this cross-sectional, observational study we used baseline data for UK Biobank participants. Included participants were aged 39 years and older, white, had available spirometry data, and had complete data for phenotypes and exposures. COPD was defined by spirometry with the 2017 Global Initiative for Chronic Obstructive Lung Disease criteria. Environmental exposures were PM 2·5 derived from monitoring data and interpolated using land-use regression at the participants' geocoded residential addresses. Built environment metrics of residential greenness were modelled in terms of normalised difference vegetation index from remotely sensed colour infrared data within a 500 m residential catchment, and an urbanicity index derived from spatial analyses and measured with a 1 km buffer around each participant's residential address. Logistic regression models examined the associations between environmental exposures and COPD prevalence adjusting for a range of confounders. Subgroup analyses by urbanicity and effect modification by white blood cell count as an inflammatory marker were also done. FindingsWe assessed 96 779 participants recruited between April 4, 2006, and Oct 1, 2010, of which 5391 participants had COPD with a prevalence of 5·6%. Each 10 µg/m³ increment in ambient PM 2·5 exposure at a participant's residential location was associated with higher odds of COPD (odds ratio 1·55, 95% CI 1·14-2·10). Among the built environment metrics, urbanicity was associated with higher odds of COPD (1·05, 1·01-1·08 per interquartile increment), whereas residential greenness was protective, being associated with lower odds of COPD (0·89, 0·84-0·93 for each interquartile increment in greenness). The results remained consistent in models of COPD defined as per lower limit of normal criteria. The highest quartile of white blood cell count was associated with lower lung function and higher COPD risk with a significant interaction between PM 2·5 and white blood cell count only in the model of lung function (p=0·0003).Interpretation In this study of the built environment and COPD, to our knowledge the largest done in the UK, we found that exposure to ambient PM 2·5 and urbanicity were associated with a higher risk of COPD. Residing in greener areas, as measured by normalised difference vegetation index, was associated with lower odds of COPD, suggesting the potential value of urban planning and design in minimising or offsetting environmental risks for the prevention and management of COPD.

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Section: Discussionsupporting

confidence: 79%

Section: : Logistic Regression Models Of Association Between Copd Ansupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

Sarkar

Zhang

et al. 2019

The Lancet Planetary Health

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show abstract

“…Some studies have found a significant relationship between air pollution and COPD. 23,24 We found that those lived in the areas with PM 2.5 concentration of 50 to 65 µg/m 3 had a substantially higher prevalence of COPD among adults aged 60 or older, while the classification tree did not identify PM 2.5 as an important risk factor for COPD among adults aged 40 to 59. This implies that the effect of PM 2.5 on COPD may be more pronounced in the elderly and there may be a non-linear relationship between PM 2.5 and COPD.…”

Section: Discussionmentioning

confidence: 77%

<p>Geographical Disparity and Associated Factors of COPD Prevalence in China: A Spatial Analysis of National Cross-Sectional Study</p>

Wang¹,

Cong²,

Fan³

et al. 2020

COPD

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Purpose: COPD prevalence has rapidly increased in China, but the geographical disparities in COPD prevalence remain largely unknown. This study aimed to assess city-level disparities in COPD prevalence and identify the relative importance of COPD related risk factors in mainland China. Patients and Methods: A nationwide cross-sectional study of COPD recruited 66,752 adults across the mainland China between 2014 and 2015. Patients with COPD were ascertained by a post-bronchodilator pulmonary function test. We estimated the cityspecific prevalence of COPD by spatial kriging interpolation method. We detected spatial clusters with a significantly higher prevalence of COPD by spatial scan statistics. We determined the relative importance of COPD associated risk factors by a nonparametric and nonlinear classification and regression tree (CART) model. Results: The three spatial clusters with the highest prevalence of COPD were located in parts of Sichuan, Gansu, and Shaanxi, etc. (relative risks (RRs)) ranging from 1.55 (95% CI 1.55-1.56) to 1.33 (95% CI 1.33-1.33)). CART showed that advanced age (≥60 years) was the most important factor associated with COPD in the overall population, followed by smoking. We estimated that there were about 28.5 million potentially avoidable cases of COPD among people aged 40 or older if they never smoked. PM 2.5 was an important associated risk factor for COPD in the north, northeast, and southwest of China. After adjusting for age and smoking, the spatial cluster with the highest prevalence shifted to most of Sichuan, Gansu, Qinghai, and Ningxia, etc. (RR 1.65 (95% CI 1.63-1.67)). Conclusion: The spatial clusters of COPD at the city level and regionally varied important risk factors for COPD would help develop tailored interventions for COPD in China. After adjusting for the main risk factors, the spatial clusters of COPD shifted, indicating that there would be other potential risk factors for the remaining clusters which call for further studies.

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“…A multiple-region cooperative study among China, Ghana, India, Mexico, Russia, and South Africa, showed that per 10 µg/m 3 increase in PM 2.5 , enhanced the number of COPD patients aged over 50 years old by 1.21%. In Shanghai, every 10 µg/m 3 increment in the concentration of PM 2.5 increased the relative risk of COPD by 9.0% [11].…”

Section: Introductionmentioning

confidence: 97%

Association Between Consecutive Ambient Air Pollution and Chronic Obstructive Pulmonary Disease Hospitalization: Time Series Study During 2015-2017 in Chengdu China

Zhang

Wang

et al. 2020

2020 42nd Annual International Conference of the IEEE Engineering in Medicine &Amp; Biology Society (EMBC)

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This paper investigates the association between consecutive ambient air pollution and Chronic Obstructive Pulmonary Disease (COPD) hospitalization in Chengdu China. The three-year (2015-2017) time series data for both ambient air pollutant concentrations and COPD hospitalizations in Chengdu are approved for the study. The big data statistic analysis shows that Air Quality Index (AQI) exceeded the lighted air polluted level in Chengdu region are mainly attributed to particulate matters (i.e., PM 2.5 and PM 10). The time series study for consecutive ambient air pollutant concentrations reveal that AQI, PM 2.5 , and PM 10 are significantly positive correlated, especially when the number of consecutive polluted days is greater than nine days. The daily COPD hospitalizations for every 10 µg/m 3 increase in PM 2.5 and PM 10 indicate that consecutive ambient air pollution can lead to an appearance of an elevation of COPD admissions, and also present that dynamic responses before and after the peak admission are different. Support Vector Regression (SVR) is then used to describe the dynamics of COPD hospitalizations to consecutive ambient air pollution. These findings will be further developed for region specific, hospital early notifications of COPD in responses to consecutive ambient air pollution.

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

Cited by 59 publications

References 38 publications

Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

<p>Geographical Disparity and Associated Factors of COPD Prevalence in China: A Spatial Analysis of National Cross-Sectional Study</p>

Association Between Consecutive Ambient Air Pollution and Chronic Obstructive Pulmonary Disease Hospitalization: Time Series Study During 2015-2017 in Chengdu China

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