Influence of Particulate Matter during Seasonal Smog on Quality of Life and Lung Function in Patients with Chronic Obstructive Pulmonary Disease

Chaicharn Pothirat,Theerakorn Theerakittikul,Athavudh Deesomchok,Chalerm Liwsrisakun,Pattraporn Tajaroenmuang,Warawut Chaiwong,Atikun Limsukon,Chaiwat Bumroongkit,Nittaya Phetsuk

doi:10.3390/ijerph16010106

Abstract

The impact of outdoor air pollution on the quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients, as measured by the COPD assessment test (CAT) questionnaire, is limited. The aim of this study was to determine the impact of a short-term increase in outdoor particulate matter in which the particles are less than 10 microns in diameter (PM10) during a seasonal smog period on QoL, symptoms, and lung function in COPD patients. This prospective observational study was conducted at Chiang Dao Hospital, Chiang Mai, Thailand between March and August 2016. Measurement of QoL, severity of dyspnea, forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1) were performed at both high and low PM10 periods. Fifty-nine patients met the inclusion criteria for enrollment into the study, with the mean age being 71.5 ± 8.0 years. Total CAT score, but not mMRC score, was statistically higher during the high PM10 period. The two lung function parameters, FVC and FEV1, were significantly lower at the high PM10 compared to the low PM10 period. We concluded that exposure to PM10 during the seasonal smog period resulted in short-term negative impact on the quality of life and lung function in COPD patients.

Highlights

Chronic obstructive pulmonary disease (COPD) is predicted to become the fourth leading cause of death worldwide by 2030 [1]
The recruitment criteria included: patients aged over 40 years with a diagnosis of chronic obstructive pulmonary disease (COPD) based on post-bronchodilator (BD) ratio of forced expiratory volume in the first second (FEV1 )/forced vital capacity (FVC)
Out of 90 patients assessed for eligibility, 31 were excluded due to current diagnosis of asthma (n = 14), diagnosis unmet for COPD following GOLD criteria (n = 15), and inability to perform spirometry (n = 2)

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is predicted to become the fourth leading cause of death worldwide by 2030 [1]. The most significant cause of COPD, after chronic cigarette smoking, is exposure to biomass smoke, especially in developing countries [2]. In Asia-Pacific countries and regions, the estimated prevalence of COPD ranges from 3.5% to 6.7% [3], and the prevalence of COPD in Chiang Dao was 6.8%, which was twice as high as that of Chiang Mai shown in a recent study [4]. Mai Province in Northern Thailand surrounded by high mountain ranges and covering an area of approximately 1882 km. Mai Province in Northern Thailand surrounded by high mountain ranges and covering an area of approximately 1882 km2 It has a population of around 87,992 people distributed among 7 sub-districts. Due to its geographical features, Chiang Dao has been exposed to air pollution, especially during the dry season, for many years. Agricultural burning and forest fires in Chiang Mai Province has contributed to the seasonal smog crisis between January and April each year since 2006 [5]

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