The global contribution of outdoor air pollution to the incidence, prevalence, mortality and hospital admission for chronic obstructive pulmonary disease: a systematic review and meta-analysis.

Qingkun Song,Jun Ren,Xiaorongwang Xiaorongwang,David Christiani

doi:10.3390/ijerph111111822

Abstract

Objective: This study aimed to investigate the quantitative effects of outdoor air pollution, represented by 10 µg/m3 increment of PM10, on chronic obstructive pulmonary disease in China, United States and European Union through systematic review and meta-analysis. Methods: Publications in English and Chinese from PubMed and EMBASE were selected. The Cochrane Review Handbook of Generic Inverse Variance was used to synthesize the pooled effects on incidence, prevalence, mortality and hospital admission. Results: Outdoor air pollution contributed to higher incidence and prevalence of COPD. Short-term exposure was associated with COPD mortality increased by 6%, 1% and 1% in the European Union, the United States and China, respectively (p < 0.05). Chronic PM exposure produced a 10% increase in mortality. In a short-term exposure to 10 µg/m3 PM10 increment COPD mortality was elevated by 1% in China (p < 0.05) and hospital admission enrollment was increased by 1% in China, 2% in United States and 1% in European Union (p < 0.05). Conclusions: Outdoor air pollution contributes to the increasing burdens of COPD.10 µg/m3 increase of PM10 produced significant condition of COPD death and exacerbation in China, United States and European Union. Controlling air pollution will have substantial benefit to COPD morbidity and mortality.

Highlights

Chronic obstructive pulmonary disease (COPD) is one of the leading health burdens worldwide, accounting for 3.0 million deaths annually [1]
From some systematic reviews, exposing to indoor air pollution introduced a more than 2-fold risk of COPD, tobacco smoking definitely increased the risk of chronic respiratory diseases and smoking cessation was an effective strategy for COPD treatment [7,8,9,10]
Among the studies on mortality, the cohort and cross-sectional study assessed the chronic effect of particulate matter (PM), and the case crossover and time-series studies analyzed the acute effect of PM

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is one of the leading health burdens worldwide, accounting for 3.0 million deaths annually [1]. From some systematic reviews, exposing to indoor air pollution introduced a more than 2-fold risk of COPD, tobacco smoking definitely increased the risk of chronic respiratory diseases and smoking cessation was an effective strategy for COPD treatment [7,8,9,10]. The effects from outdoor air pollution on COPD burdens and exacerbation were seldom reported from systematic reviews. Verifying the efficacy of air quality improvement on COPD burdens, especially significant reductions of particulate matter (PM), is meaningful to Chinese policymakers. This study aimed to quantitatively assess the contribution from outdoor air pollution to COPD burdens, in order to present a goal and evidence of improving air quality

Results

Discussion

Conclusion