Impact of Particulate Matter on Emergency Department admissions and hospitalizations for COPD Exacerbation

Abstract

Background: Short-term exposure to elevated Particulate Matter (PM) concentrations can cause a worsening of several respiratory conditions. Objectives: We evaluated the relationship between short-term exposure to PM10 – PM2.5 and COPD exacerbation, in terms of Emergency Department (ED) admissions and their outcomes observed at the university Hospital of Brescia, Italy, a city with high levels of air pollution. Methods: We collected data from patients admitted to the ED with diagnosis of COPD exacerbation, starting from January 2014 to January 2016. Daily PM levels were collected from the Environmental Protection Regional Agency (ARPA). We performed a time-series analysis, using the Poisson regression model with single and multiple day-lag. Results were expressed as Relative Risk (RR) and Excess of Relative Risk (ER) for COPD exacerbation-related ED admissions and hospitalizations, over a 10µg/m3 increase in PM concentration. Results: We included data from 431 patients. Both PM10 and PM2.5 were significantly associated with the risk of COPD exacerbation-related ED admission and hospitalization. Each increase of 10µg/m3 of PM10 and PM2.5 corresponded respectively to a RR(CI95%) for ED admissions of 1.06 and 1.08 in lag0-1; 1.06 and 1.09 in lag0-5 (p Conclusions: Our findings show that an increasing exposure to PM10-PM2.5 is associated to higher ED admission and increasing hospitalizations due to COPD exacerbation.