Current Environmental Health Reports

, Volume 5, Issue 1, pp 70–76 | Cite as

COPD Patients as Vulnerable Subpopulation for Exposure to Ambient Air Pollution

  • Joachim Heinrich
  • Tamara Schikowski
Susceptibility Factors in Environmental Health (B Ritz and Z Liew, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Susceptibility Factors in Environmental Health


Purpose of Review

The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide with no known cure and an increasing number of triggers that exacerbate symptoms and speed up progression. This review aims to summarize the evidence for COPD patients being more vulnerable to air pollution exposure assessed as acute effects.

Recent Findings

Several recent systematic reviews show consistently increased risks for COPD mortality and COPD hospital admission, ranging between 2 and 3% with increasing PM2.5 or PM10. Similar adverse impacts were shown for NO2. Also, adverse health effects among COPD patients were also found for other gaseous pollutants such as ozone and SO2; most of these studies could not be included in the meta-analysis we reviewed. Data from ten panel studies of COPD patients reported a small but statistically significant decline of FEV1 [− 3.38 mL (95% CI − 6.39 to − 0.37)] per increment of 10 μg/m3 PM10, supporting an impact on respiratory health with increasing PM10 exposure.


The combined information from systematic reviews and more recent findings lead us to conclude that COPD patients are more vulnerable to ambient air pollution than healthier people.


COPD COPD exacerbation Ambient air pollution PM2.5 NO2 SO2 CO Ozone Vulnerability 



We thank Dr. Carlana Ramlochansingh for the final editing of the manuscript.

Author Contributions

JH drafted the manuscript. TS added comments. Both authors critical interpreted the findings and derived the main conclusions.

Compliance with Ethical Standards

Conflict of Interest

Joachim Heinrich and Tamara Schikowski declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Supplementary material

40572_2018_178_MOESM1_ESM.docx (30 kb)
Supplementary Table 1 (DOCX 29 kb)


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Joachim Heinrich
    • 1
    • 2
    • 3
  • Tamara Schikowski
    • 4
  1. 1.Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Centre Munich, German Centre for Lung Research. (DZL)University Hospital Munich of Ludwig Maximillians University MunichMunichGermany
  2. 2.Institute of Epidemiology IHelmholtz Zentrum München—German Research Center for Environmental HealthNeuherbergGermany
  3. 3.Allergy and Lung Health Unit, Melbourne School of Population HealthUniversity of MelbourneMelbourneAustralia
  4. 4.Leibniz Institute for Environmental MedicineDüsseldorfGermany

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