Satellite-Based Estimates of Long-Term Exposure to PM2.5 and its Association with Chronic Obstruct Pulmonary Disease in Taiwan Adults

Abstract

Background/Aim: Previous studies have shown the short-term effects of fine particulate matter (PM2.5) on lung function. However, the effects of long-term exposure to PM2.5 on lung function and chronic obstructive pulmonary disease (COPD) are not well-documented. This study aimed to investigate the satellite-based estimates of long-term exposure to PM2.5 and its association with lung function and COPD in a large prospective Taiwan cohort. Methods: A total of 366,756 participants aged 20 years or older were recruited with 1,031,849 spirometry tests in Taiwan in 2001-2014. We performed generalized linear mixed models to examine the associations between PM2.5 and lung function adjusting for a wide range of confounders. For the 125,475 participants who were free of COPD in baseline, we used cox proportional hazard regression models to investigate the PM2.5 effects on COPD development. Results: PM2.5 was associated with lower lung function. After adjusting for confounders, participants with 4th quantile of PM2.5 had a decrease of 3.61% (95% confidence interval (CI): -3.76 to -3.47), 4.35% (95%CI: -4.36 to -4.34), and 7.75% (95%CI: -7.96 to -7.55) in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximum mid-expiratory flow (MMEF), respectively. They also had a faster decline of 0.24%, 0.64%, and 1.62% in FVC, FEV1, and MMEF, respectively. Compared to the participants with 1st quantile of PM2.5, participants with the 4th, 3rd and 2nd quantiles of PM2.5 had a hazard risk of 1.10 (1.00, 1.22), 1.15 (1.03, 1.27) and 1.24 (1.12, 1.37) in COPD development, respectively. Conclusions: Long-term exposure to ambient PM2.5 is associated with decrease in pulmonary function and increased risk of COPD incident in Taiwan adults.