Abstract
Previous studies have suggested an association between air pollution and lung disease. However, few studies have explored the relationship between chronic lung diseases classified by lung function and environmental parameters. This study aimed to comprehensively investigate the relationship between chronic lung diseases, air pollution, meteorological factors, and anthropometric indices. We conducted a cross-sectional study using the Taiwan Biobank and the Taiwan Air Quality Monitoring Database. A total of 2889 participants were included. We found a V/U-shaped relationship between temperature and air pollutants, with significant effects at both high and low temperatures. In addition, at lower temperatures (<24.6 °C), air pollutants including carbon monoxide (CO) (adjusted OR (aOR):1.78/Log 1 ppb, 95% CI 0.98–3.25; aOR:5.35/Log 1 ppb, 95% CI 2.88–9.94), nitrogen monoxide (NO) (aOR:1.05/ppm, 95% CI 1.01–1.09; aOR:1.11/ppm, 95% CI 1.07–1.15), nitrogen oxides (NOx) (aOR:1.02/ppm, 95% CI 1.00–1.05; aOR:1.06/ppm, 95% CI 1.04–1.08), and sulfur dioxide (SO2) (aOR:1.29/ppm, 95% CI 1.01–1.65; aOR:1.77/ppm, 95% CI 1.36–2.30) were associated with restrictive and mixed lung diseases, respectively. Exposure to CO, NO, NO2, NOx and SO2 significantly affected obstructive and mixed lung disease in southern Taiwan. In conclusion, temperature and air pollution should be considered together when evaluating the impact on chronic lung diseases.
Highlights
Chronic lung diseases, including obstructive lung diseases (such as asthma, chronic obstructive pulmonary disease (COPD), and bronchiectasis), restrictive lung diseases, and mixed lung disease are diagnosed by spirometry according to the standardized European Respiratory Society/American Thoracic Society guidelines [1]
Data for carbon monoxide (CO) were skewed and log transformed for analysis. In this analysis of 2889 participants registered in the TWB, we found that factors associated with higher risk of chronic lung diseases include elderly age (>60 years), female gender, lower body height and weight, higher body adiposity index and body roundness index, lower haematocrit, higher glycohemoglobin, and lower albumin level
The results showed a V/U-shaped relationship between temperature and air pollutants, and both lower and higher temperatures increased the risk of air pollution, but this effect was more obvious at lower temperatures and in southern Taiwan
Summary
Chronic lung diseases, including obstructive lung diseases (such as asthma, chronic obstructive pulmonary disease (COPD), and bronchiectasis), restrictive lung diseases (such as interstitial lung disease, pulmonary fibrosis and neuromuscular disease), and mixed (obstructive and restrictive) lung disease are diagnosed by spirometry according to the standardized European Respiratory Society/American Thoracic Society guidelines [1]. Acute and chronic air pollution exposure had been associated with an increased risk of cardiovascular and respiratory morbidity and mortality [7,8,9]. A study reported that exposure to PM2.5 was associated with a higher risk of acute exacerbations of COPD, especially in females and elderly patients (age > 75 years old), and that this effect was restricted to the cold season (November to April) [18]. Dynamic changes in air pollutants and meteorological factors coexist simultaneously [20] Studies from both Northeast Asia and Europe reported that a synergistic effect between high temperature and air pollution may be associated with a higher risk of mortality [21,22]. We investigated association among air pollutants, meteorological factors, and chronic lung diseases, and explored the interactions and synergic effects between various air pollutants
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