A Comparison Analysis of Causative Impact of PM2.5 on Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) in Two Typical Cities in China

Xiaolin Xia,Wenlong Jing,Jiaying Lu,Yong Li,Ling Yao,Yangxiaoyue Liu

doi:10.3390/atmos12080970

Abstract

Chronic obstructive pulmonary disease (COPD) is a major and increasingly prevalent respiratory health problem worldwide and the fine particulate matter (PM2.5) is now becoming a rising health threat to it. This study aims to conduct a comparison analysis of health effect on acute exacerbation of COPD (AECOPD) associated with PM2.5 exposure in two typical cities (Beijing and Shenzhen) with different levels of PM2.5 pollution. Both correlational relationship and causal connection between PM2.5 exposure and AECOPD are investigated by adopting a time series analysis based on the generalized additive model (GAM) and convergent cross mapping (CCM). The results from GAM indicate that a 10 μg/m3 increase in PM2.5 concentration is associated with 2.43% (95% CI, 0.50–4.39%) increase in AECOPD on Lag0-2 in Beijing, compared with 6.65% (95% CI, 2.60–10.87%) on Lag0-14 in Shenzhen. The causality detection with CCM reveals similar significant causative impact of PM2.5 exposure on AECOPD in both two study areas. Findings from two methods agree that PM2.5 has non-negligible health effect on AECOPD in both two study areas, implying that air pollution can cause adverse consequences at much lower levels than common cognition. Our study highlights the adverse health effect of PM2.5 on people with COPD after exposure to different levels of PM2.5 and emphasizes that adverse effect in area with relative low pollution level cannot be overlooked. Governments in both high-pollution and low-pollution cities should attach importance to the adverse effects of PM2.5 on humans and take corresponding measures to control and reduce the related losses.

Highlights

Chronic obstructive pulmonary disease (COPD) is a major and increasingly prevalent respiratory health problem in the global, with a current estimate 700 million patients and 3.2 million deaths worldwide [1,2]
There are substantial evidences indicating that short-term exposure to PM2.5 can lead to acute exacerbation and even an increased risk of death in COPD patients [11,12,13,14]
A total of 712 and 3634 acute exacerbation of COPD (AECOPD) cases were recorded from the selected hospitals in Beijing and Shenzhen in 2013, respectively

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a major and increasingly prevalent respiratory health problem in the global, with a current estimate 700 million patients and 3.2 million deaths worldwide [1,2]. With the deterioration of air quality in recent decades, fine particulate matter (PM2.5) is becoming a rising health threat to human respiratory system [5]. There are substantial evidences indicating that short-term exposure to PM2.5 can lead to acute exacerbation and even an increased risk of death in COPD patients [11,12,13,14]. A panel study in Beijing [15] finds out that COPD patients are more susceptible to respiratory inflammation following PM2.5 exposure than individuals without COPD

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