COPD Patients as Vulnerable Subpopulation for Exposure to Ambient Air Pollution
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.
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.
KeywordsCOPD COPD exacerbation Ambient air pollution PM2.5 NO2 SO2 CO Ozone Vulnerability
We thank Dr. Carlana Ramlochansingh for the final editing of the manuscript.
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.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance.
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