The burden of COPD mortality due to ambient air pollution in Guangzhou, China.

Jun Yang,Yun-Feng Song,Chun-Quan Ou,Li Li,Ping-Yan Chen

doi:10.1038/srep25900

Abstract

Few studies have investigated the chronic obstructive pulmonary disease (COPD) mortality fraction attributable to air pollution and modification by individual characteristics of air pollution effects. We applied distributed lag non-linear models to assess the associations between air pollution and COPD mortality in 2007–2011 in Guangzhou, China, and the total COPD mortality fraction attributable to air pollution was calculated as well. We found that an increase of 10 μg/m3 in particulate matter with an aerodynamic diameter of 10 μm or less (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) was associated with a 1.58% (95% confidence interval (CI): 0.12–3.06%), 3.45% (95% CI: 1.30–5.66%) and 2.35% (95% CI: 0.42–4.32%) increase of COPD mortality over a lag of 0–15 days, respectively. Greater air pollution effects were observed in the elderly, males and residents with low educational attainment. The results showed 10.91% (95% CI: 1.02–9.58%), 12.71% (95% CI: 5.03–19.85%) and 13.38% (95% CI: 2.67–22.84%) COPD mortality was attributable to current PM10, SO2 and NO2 exposure, respectively. In conclusion, the associations between air pollution and COPD mortality differed by individual characteristics. There were remarkable COPD mortality burdens attributable to air pollution in Guangzhou.

Highlights

Worldwide, chronic obstructive pulmonary disease (COPD) affects 329 million people[1]
A few time-series studies[8,9,10,11,12] analyzed the short-term effects of air pollution on COPD mortality, which commonly assessed the effects within a week; our prior study[13] indicated that the associations between the Air Pollution Index (API) and mortality lasted for 15 days
The distributed lag surface reveals that COPD mortality risk was positively associated with air pollutant concentrations, with the strongest single-day association on the current day for all three air pollutants (Fig. 1)

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) affects 329 million people[1]. Regarding the associations between air pollution and COPD mortality, most previous studies used ratio measures, such as relative risk (RR) and odds ratio (OR), in the analysis. Compared with these indices, the attributable deaths (AD) and attributable fraction (AF) provide more information on the excess burden due to air pollution exposure, which are more suitable for estimating potential benefits from interventions aimed at reducing air pollution. The present study further assessed the burden of COPD mortality due to exposure to ambient air pollution using AF and examined the potential effect modification of air pollution by individual characteristics in Guangzhou, China, in 2007–2011

Methods

Results

Conclusion