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Yang Y, Li X, Wang S, Lei Y, Xu W, Li Y, Yang L, Miao J, Wang W, Yin L. Assessing the impact of temperature on acute exacerbation of chronic obstructive pulmonary disease hospitalizations in residents of Panzhihua City: a multi-districts study using a distributed lag non-linear model. BMC Public Health 2024; 24:2151. [PMID: 39112974 PMCID: PMC11308688 DOI: 10.1186/s12889-024-19677-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 08/02/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Temperature fluctuations can impact the occurrence and progression of respiratory system diseases. However, the current understanding of the impact of temperature on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains limited. Therefore, our study aims to investigate the relationship between daily mean temperature (DMT) and the risk of AECOPD hospitalizations within Panzhihua City. METHODS We systematically collected data on AECOPD hospitalizations at Panzhihua Central Hospital from 2015 to 2020 and meteorological factors across Panzhihua City's districts. A two-stage analysis method was used to establish a distributed lag non-linear model to elucidate the influence of DMT on the frequency of admissions for AECOPD. Subgroup analyses were conducted by gender and age to identify populations potentially susceptible to the impact of DMT. RESULTS A total of 5299 AECOPD hospitalizations cases were included. The DMT and the risk of AECOPD hospitalization showed a non-linear exposure-response pattern, with low temperatures exacerbating the risk of hospitalizations. The lag effects of low temperature and relatively low temperature peaked at 2th day, with the lag effects disappearing at 16-17 days. Females and elders aged ≥ 65 years were more sensitive to effects of low and relatively low temperature at lag 0-4 days, while male AECOPD patients exhibited longer lasting lag effects. CONCLUSIONS Low temperatures are associated with an increased risk of AECOPD hospitalizations. Females or elders aged ≥ 65 years with chronic obstructive pulmonary disease should pay more attention to taking protective measures in cold environments. These findings are crucial for the formulation of public health policies, as they will help significantly alleviate the burden of AECOPD and improve respiratory health in the face of climate challenges.
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Affiliation(s)
- Yan Yang
- Department of Respiratory and Critical Care Medicine, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
| | - Xianzhi Li
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
- Clinical Research Center, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
| | - Shigong Wang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, 610225, China
| | - Yingchao Lei
- School of Health and Wellness, Panzhihua University, Panzhihua, Sichuan, 617000, China
| | - Wenhao Xu
- Discipline Construction Office, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
| | - Yongjun Li
- Panzhihua Meteorological Bureau, Panzhihua Meteorological Office, Panzhihua, Sichuan, 617000, China
| | - Lei Yang
- Department of Respiratory and Critical Care Medicine, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China
| | - Jinli Miao
- The Yangtze River Delta Biological Medicine Research and Development Center of Zhejiang Province, Yangtze Delta Region Institution of Tsinghua University, Hangzhou, Zhejiang, 314006, China
| | - Wenmin Wang
- The Yangtze River Delta Biological Medicine Research and Development Center of Zhejiang Province, Yangtze Delta Region Institution of Tsinghua University, Hangzhou, Zhejiang, 314006, China
| | - Li Yin
- Department of Respiratory and Critical Care Medicine, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China.
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, Sichuan, 617067, China.
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Qian Y, Cai C, Sun M, Lv D, Zhao Y. Analyses of Factors Associated with Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Review. Int J Chron Obstruct Pulmon Dis 2023; 18:2707-2723. [PMID: 38034468 PMCID: PMC10683659 DOI: 10.2147/copd.s433183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is the exacerbation of a range of respiratory symptoms during the stable phase of chronic obstructive pulmonary disease (COPD). AECOPD is thus a dangerous stage and key event in the course of COPD, as its deterioration and frequency seriously affects the quality of life of patients and shortens their survival. Acute exacerbations occur and develop due to many factors such as infection, tobacco smoke inhalation, air pollution, comorbidities, airflow limitation, various biomarkers, history of previous deterioration, natural killer cell abnormalities, immunoglobulin G deficiency, genetics, abnormal muscle and nutritional status, negative psychology, and seasonal temperature changes. There is relatively limited research on the impact of the role of standardized management on the alleviation of AECOPD. However, with the establishment of relevant prevention and management systems and the promotion of artificial intelligence technology and Internet medical approaches, long-term effective and standardized management of COPD patients may help to achieve the quality of life and disease prognosis in COPD patients and reduce the risk of AE.
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Affiliation(s)
- Yang Qian
- The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Chenting Cai
- The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Mengqing Sun
- The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Dan Lv
- The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
| | - Yun Zhao
- The First Affiliated Hospital of Ningbo University, Ningbo, People’s Republic of China
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Chou CH, Chen YF, Peng HC, Chen CY, Cheng BW. Environmental pollutants increase the risks of acute exacerbation in patients with chronic airway disease. Front Public Health 2023; 11:1215224. [PMID: 38026400 PMCID: PMC10643209 DOI: 10.3389/fpubh.2023.1215224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Respiratory infections are a common cause of acute exacerbations in patients with chronic airway disease, however, environmental factors such as air pollution can also contribute to these exacerbations. The study aimed to determine the correlation between pollutant levels and exacerbation risks in areas exposed to environmental pollution sources. Methods From 2015 to 2016, a total of 788 patients with chronic airway diseases were enrolled in a study. Their medical records, including hospital visits due to acute exacerbations of varying severity were analyzed. Additionally, data on daily pollutant levels from the Air Quality Monitoring Network from 2014 to 2016 was also collected and analyzed. Results Patients with chronic airway disease and poor lung function (FEV1 < 50% or obstructive ventilatory defect) have a higher risk of severe acute exacerbations and are more likely to experience more than two severe acute exacerbations within a year. The study found that in areas exposed to environmental pollution sources, there is a significant correlation between NO2, O3, and humidity with the main causes of severe acute exacerbation. When the levels of NO2 were higher than 16.65 ppb, O3 higher than 35.65 ppb, or humidity higher than 76.95%, the risk of severe acute exacerbation in patients with chronic airway disease increased. Conclusion Acute exacerbations of chronic airway disease can be triggered by both the underlying disease state and the presence of air pollution. Computer simulations and early warning systems should be developed to predict acute exacerbations of chronic airway disease based on dynamic changes in air pollution.
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Affiliation(s)
- Chien-Hong Chou
- Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Fu Chen
- Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hung-Chueh Peng
- Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Chung-Yu Chen
- Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Bor-Wen Cheng
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
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Ross BA, Doiron D, Benedetti A, Aaron SD, Chapman K, Hernandez P, Maltais F, Marciniuk D, O'Donnell DE, Sin DD, Walker BL, Tan W, Bourbeau J. Short-term air pollution exposure and exacerbation events in mild to moderate COPD: a case-crossover study within the CanCOLD cohort. Thorax 2023; 78:974-982. [PMID: 37147124 DOI: 10.1136/thorax-2022-219619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/05/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Infections are considered as leading causes of acute exacerbations of chronic obstructive pulmonary disease (COPD). Non-infectious risk factors such as short-term air pollution exposure may play a clinically important role. We sought to estimate the relationship between short-term air pollutant exposure and exacerbations in Canadian adults living with mild to moderate COPD. METHODS In this case-crossover study, exacerbations ('symptom based': ≥48 hours of dyspnoea/sputum volume/purulence; 'event based': 'symptom based' plus requiring antibiotics/corticosteroids or healthcare use) were collected prospectively from 449 participants with spirometry-confirmed COPD within the Canadian Cohort Obstructive Lung Disease. Daily nitrogen dioxide (NO2), fine particulate matter (PM2.5), ground-level ozone (O3), composite of NO2 and O3 (Ox), mean temperature and relative humidity estimates were obtained from national databases. Time-stratified sampling of hazard and control periods on day '0' (day-of-event) and Lags ('-1' to '-6') were compared by fitting generalised estimating equation models. All data were dichotomised into 'warm' (May-October) and 'cool' (November-April) seasons. ORs and 95% CIs were estimated per IQR increase in pollutant concentrations. RESULTS Increased warm season ambient concentration of NO2 was associated with symptom-based exacerbations on Lag-3 (1.14 (1.01 to 1.29), per IQR), and increased cool season ambient PM2.5 was associated with symptom-based exacerbations on Lag-1 (1.11 (1.03 to 1.20), per IQR). There was a negative association between warm season ambient O3 and symptom-based events on Lag-3 (0.73 (0.52 to 1.00), per IQR). CONCLUSIONS Short-term ambient NO2 and PM2.5 exposure were associated with increased odds of exacerbations in Canadians with mild to moderate COPD, further heightening the awareness of non-infectious triggers of COPD exacerbations.
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Affiliation(s)
- Bryan A Ross
- Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
- Medicine, McGill University Health Centre, Montreal, Québec, Canada
| | - Dany Doiron
- Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Andrea Benedetti
- Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Shawn D Aaron
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Kenneth Chapman
- Toronto General Hospital Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Paul Hernandez
- Medicine, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
| | - François Maltais
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Québec, Canada
| | - Darcy Marciniuk
- Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Wan Tan
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jean Bourbeau
- Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
- Medicine, McGill University Health Centre, Montreal, Québec, Canada
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Aranburu-Imatz A, Jiménez-Hornero JE, Morales-Cané I, López-Soto PJ. Environmental pollution in North-Eastern Italy and its influence on chronic obstructive pulmonary disease: time series modelling and analysis using visibility graphs. AIR QUALITY, ATMOSPHERE, & HEALTH 2023; 16:793-804. [PMID: 36714016 PMCID: PMC9875196 DOI: 10.1007/s11869-023-01310-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/16/2023] [Indexed: 06/01/2023]
Abstract
The impact on human health from environmental pollution is receiving increasing attention. In the case of respiratory diseases such as chronic obstructive pulmonary disease (COPD), the relationship is now well documented. However, few studies have been carried out in areas with low population density and low industrial production, such as the province of Belluno (North-Eastern Italy). The aim of the study was to analyze the effect of exposure to certain pollutants on the temporal dynamics of hospital admissions for COPD in the province of Belluno. Daily air pollution concentration, humidity, precipitations, and temperature were collected from the air monitoring stations in Belluno. Generalized additive mixed models (GAMM) and visibility graphs were used to determine the effects of the short-term exposure to environmental agents on hospital admissions associated to COPD. In the case of the city of Belluno, the GAMM showed that hospital admissions were associated with NO2, PM10, date, and temperature, while for the city of Feltre, GAMM produced no associated variables. Several visibility graph indices (average edge overlap and interlayer mutual information) showed a significant overlap between environmental agents and hospital admission for both cities. Our study has shown that visibility graphs can be useful in establishing associations between environmental agents and COPD hospitalization in sparsely populated areas.
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Affiliation(s)
- Alejandra Aranburu-Imatz
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Outpatient Clinic, Hospital Giovanni Paolo II, ULSS1 Dolomiti, Veneto, Italy
| | | | - Ignacio Morales-Cané
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Department of Nursing, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | - Pablo Jesús López-Soto
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Department of Nursing, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
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Partículas en suspensión PM10, NO2 y agudizaciones de enfermedad respiratoria crónica. Semergen 2022; 48:101819. [DOI: 10.1016/j.semerg.2022.101819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/12/2022] [Accepted: 07/27/2022] [Indexed: 11/15/2022]
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Chaipitakporn C, Athavale P, Kumar V, Sathiyakumar T, Budišić M, Sur S, Mondal S. COVID-19 in the U.S. during pre-vaccination period: Shifting impact of sociodemographic factors and air pollution. FRONTIERS IN EPIDEMIOLOGY 2022; 2:927189. [PMID: 38455291 PMCID: PMC10910972 DOI: 10.3389/fepid.2022.927189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/05/2022] [Indexed: 03/09/2024]
Abstract
Pandemic "wave" usually refers to the rise and fall of the infections with time, however, for a large country, the variations due to geographical location could be considerable. In this work, we investigated COVID-19 infection and fatality across the U.S. during the pandemic waves in the pre-vaccination period (January 2020-December 2020). Focusing on counties with a population ≥100,000, the data from the entire period were first segmented into two equal phases roughly corresponding to the first pandemic wave and subsequent surge, and each phase was further divided into two zones based on infection rate. We studied the potential influences of six sociodemographic variables (population density, age, poverty, education, and percentage of Hispanic and African American population) and four air pollutants (PM2.5, NO2, SO2, and O3) on the differences in infection and fatality observed among different phases and zones. We noticed a distinct difference in the overall impact of COVID-19 between the two phases of the pre-vaccination period with a substantial decrease in the fatality in the second phase despite an increase in the infection. Analysis using log-linear regression modeling further revealed a shift in the impact of several risk factors considered in this study. For example, population density and lesser education were found to be significant for infection during the first phase of the pandemic alone. Furthermore, population density and lesser education along with poverty and NO2 level had a significant contribution to fatality during the first phase of the pandemic, while age over 65 years was important in both phases. Interestingly, the effects of many of these factors were found to be significant only in the zones with higher infection rates. Our findings indicate that the impacts of several well-known sociodemographic and environmental risk factors for COVID-19 are not constant throughout the course of the pandemic, and therefore, careful considerations should be made about their role when developing preventative and mitigative measures.
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Affiliation(s)
- Chaya Chaipitakporn
- David D. Reh School of Business, Clarkson University, Potsdam, NY, United States
| | - Prashant Athavale
- Department of Mathematics, Clarkson University, Potsdam, NY, United States
| | - Vijay Kumar
- Department of Mathematics, Clarkson University, Potsdam, NY, United States
| | | | - Marko Budišić
- Department of Mathematics, Clarkson University, Potsdam, NY, United States
| | - Shantanu Sur
- Department of Biology, Clarkson University, Potsdam, NY, United States
| | - Sumona Mondal
- Department of Mathematics, Clarkson University, Potsdam, NY, United States
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Bernasconi S, Angelucci A, Aliverti A. A Scoping Review on Wearable Devices for Environmental Monitoring and Their Application for Health and Wellness. SENSORS (BASEL, SWITZERLAND) 2022; 22:5994. [PMID: 36015755 PMCID: PMC9415849 DOI: 10.3390/s22165994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
This scoping review is focused on wearable devices for environmental monitoring. First, the main pollutants are presented, followed by sensing technologies that are used for the parameters of interest. Selected examples of wearables and portables are divided into commercially available and research-level projects. While many commercial products are in fact portable, there is an increasing interest in using a completely wearable technology. This allows us to correlate the pollution level to other personal information (performed activity, position, and respiratory parameters) and thus to estimate personal exposure to given pollutants. The fact that there are no univocal indices to estimate outdoor or indoor air quality is also an open problem. Finally, applications of wearables for environmental monitoring are discussed. Combining environmental monitoring with other devices would permit better choices of where to perform sports activities, especially in highly polluted areas, and provide detailed information on the living conditions of individuals.
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Silva Rodriguez ME, Silveyra P. Air Pollution Exposure as a Relevant Risk Factor for Chronic Obstructive Pulmonary Disease Exacerbations in Male and Female Patients. EUROPEAN MEDICAL JOURNAL 2022. [DOI: 10.33590/emj/21-00228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a multifactorial lung inflammatory disease that affects 174 million people worldwide, with a recently reported increased incidence in female patients. Patients with COPD are especially vulnerable to the detrimental effects of environmental exposures, especially from air particulate and gaseous pollutants; exposure to air pollution severely influences COPD outcomes, resulting in acute exacerbations, hospitalisations, and death. Here, a literature review of the recent work addressing air pollution-induced acute exacerbations of COPD (AECOPD) was conducted in order to determine whether sex was considered as a biological variable in these studies, and whether air pollution exposure affected patients with COPD in a sex-specific manner. It was found that, while the majority of studies enrolled both male and female patients, only a few reported results were disaggregated by sex. Most studies had a higher enrolment of male patients, only four compared AECOPD outcomes between sexes, and only one study identified sex differences in AECOPD, with females displaying higher rates. Overall, this analysis of the literature confirmed that air pollution exposure is a trigger for AECOPD hospitalisations and revealed a significant gap in the knowledge of sex-specific effects of air pollutants on COPD outcomes, highlighting the need for more studies to consider sex as a biological variable.
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Affiliation(s)
| | - Patricia Silveyra
- School of Public Health, Indiana University Bloomington, Indiana, USA
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10
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The Impact of Air Pollutants and Meteorological Factors on Chronic Obstructive Pulmonary Disease Exacerbations: A Nationwide Study. Ann Am Thorac Soc 2021; 19:214-226. [PMID: 34499589 DOI: 10.1513/annalsats.202103-298oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Chronic obstructive lung disease (COPD) is a chronic progressive disease. Although smoking is the most important risk factor, 30% of COPD patients are never smokers, and environmental agents are also influential. The effects of air pollutants and meteorological factors on COPD exacerbations have not been studied extensively. OBJECTIVE We aimed to investigate the air pollutants and meteorological factors that impact the incidence of COPD exacerbations. METHODS We obtained clinical data of COPD exacerbation cases from The National Health Insurance Service (NHIS) and merged it with 24-hour average values of air pollutants and meteorological factors from national databases. Patients who reside in eight metropolitan cities, where observatory stations are densely located, were selected for analysis. RESULTS In 1,404,505 COPD patients between 2013 and 2018, 15,282 COPD exacerbations leading to hospitalization or emergency room visits were identified. Among the various air pollutants and meteorological factors, particulate matter (PM)2.5, PM10, NO2, SO2, CO, O3, average temperature and diurnal temperature range (DTR) were associated with COPD exacerbations. GAM model analysis with cubic splines showed an inverted U-shaped relationship with PM2.5, PM10, CO, NO2, SO2, O3, DTR and humidity, while it displayed a U-shaped pattern with the average temperature. Distinct patterns were found from 2015-2016 to 2017-2018. CONCLUSIONS PM2.5, PM10, CO, NO2, O3, SO2, average temperature, humidity, and DTR affected the incidence of COPD exacerbations in various patterns, up to 10 lag days.
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Jo EJ, Choi MH, Kim CH, Won KM, Kim YK, Jeong JH, An HY, Hwang MK, Park HK. Patterns of medical care utilization according to environmental factors in asthma and chronic obstructive pulmonary disease patients. Korean J Intern Med 2021; 36:1146-1156. [PMID: 33561336 PMCID: PMC8435499 DOI: 10.3904/kjim.2020.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/02/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Weather and air pollution are associated with the exacerbation of respiratory diseases. We investigated patterns of medical care use according to meteorological factors and air pollution in patients with asthma or chronic obstructive pulmonary disease (COPD). METHODS We analyzed the medical care utilization patterns of patients with asthma or COPD registered in the Korea Health Insurance Review and Assessment database for the period 2007 to 2013. The patterns were divided into hospitalization and emergency department (ED) use. RESULTS The medical care use of patients with asthma or COPD increased when the mean temperature and relative humidity were lower, and the temperature difference and atmospheric pressure were greater. Medical care use increased with the concentrations of particulate matter and ozone. Among age groups, sensitivity to pollutants was greatest in patients aged ≥ 65 years. The effect of being elderly was greater for asthma than for COPD, with a higher hospitalization rate. ED utilization affected by environmental factors was significantly greater for females and hospitalization was significantly more common for males. CONCLUSION Meteorological factors and air pollutants were shown to contribute to increased medical care utilization by patients with asthma and COPD, particularly elderly patients. The overall effect was greater for COPD, but the effect in elderly patients was greater for asthma. In addition, the patterns of change in medical care use due to environmental factors differed according to sex.
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Affiliation(s)
- Eun-Jung Jo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Min-Hyeok Choi
- Department of Preventive and Occupational Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Chang-Hoon Kim
- Department of Preventive and Occupational Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kyung-Mi Won
- The Institute of Environmental Studies, Pusan National University, Busan, Korea
| | - Yoo-Keun Kim
- Division of Earth Environmental System, Pusan National University, Busan, Korea
| | - Ju-Hee Jeong
- The Institute of Environmental Studies, Pusan National University, Busan, Korea
| | - Hye Yeon An
- Division of Earth Environmental System, Pusan National University, Busan, Korea
| | - Mi-Kyoung Hwang
- The Institute of Environmental Studies, Pusan National University, Busan, Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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12
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Wu DW, Chen SC, Tu HP, Wang CW, Hung CH, Chen HC, Kuo TY, Wang CF, Lai BC, Chen PS, Kuo CH. The Impact of the Synergistic Effect of Temperature and Air Pollutants on Chronic Lung Diseases in Subtropical Taiwan. J Pers Med 2021; 11:jpm11080819. [PMID: 34442463 PMCID: PMC8401456 DOI: 10.3390/jpm11080819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 12/11/2022] Open
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.
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Affiliation(s)
- Da-Wei Wu
- Doctoral Degree Program, Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Chih-Wen Wang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chih-Hsing Hung
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Huang-Chi Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Tzu-Yu Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chen-Feng Wang
- Department of Electronics Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan; (C.-F.W.); (B.-C.L.)
| | - Bo-Cheng Lai
- Department of Electronics Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan; (C.-F.W.); (B.-C.L.)
| | - Pei-Shih Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Institute of Environmental Engineering, College of Engineering, National Sun Yat-Sen University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101 (ext. 2141-34); Fax: +886-7-311-0811
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Sahoo MM. Significance between air pollutants, meteorological factors, and COVID-19 infections: probable evidences in India. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:40474-40495. [PMID: 33638789 PMCID: PMC7912974 DOI: 10.1007/s11356-021-12709-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/25/2021] [Indexed: 04/15/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease represents the causative agent with a potentially fatal risk which is having great global human health concern. Earlier studies suggested that air pollutants and meteorological factors were considered as the risk factors for acute respiratory infection, which carries harmful pathogens and affects the immunity. The study intended to explore the correlation between air pollutants, meteorological factors, and the daily reported infected cases caused by novel coronavirus in India. The daily positive infected cases, concentrations of air pollutants, and meteorological factors in 288 districts were collected from January 30, 2020, to April 23, 2020, in India. Spearman's correlation and generalized additive model (GAM) were applied to investigate the correlations of four air pollutants (PM2.5, PM10, NO2, and SO2) and eight meteorological factors (Temp, DTR, RH, AH, AP, RF, WS, and WD) with COVID-19-infected cases. The study indicated that a 10 μg/m3 increase during (Lag0-14) in PM2.5, PM10, and NO2 resulted in 2.21% (95%CI: 1.13 to 3.29), 2.67% (95% CI: 0.33 to 5.01), and 4.56 (95% CI: 2.22 to 6.90) increase in daily counts of Coronavirus Disease 2019 (COVID 19)-infected cases respectively. However, only 1 unit increase in meteorological factor levels in case of daily mean temperature and DTR during (Lag0-14) associated with 3.78% (95%CI: 1.81 to 5.75) and 1.82% (95% CI: -1.74 to 5.38) rise of COVID-19-infected cases respectively. In addition, SO2 and relative humidity were negatively associated with COVID-19-infected cases at Lag0-14 with decrease of 7.23% (95% CI: -10.99 to -3.47) and 1.11% (95% CI: -3.45 to 1.23) for SO2 and for relative humidity respectively. The study recommended that there are significant correlations between air pollutants and meteorological factors with COVID-19-infected cases, which substantially explain the effect of national lockdown and suggested positive implications for control and prevention of the spread of SARS-CoV-2 disease.
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Affiliation(s)
- Mrunmayee Manjari Sahoo
- Domain of Environmental and Water Resources Engg, SCE, Lovely Professional University, Phagwara, 144411, India.
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Relationship between Air Pollution and Hospital Admissions for Chronic Obstructive Pulmonary Disease in Changchun, China: A Season-Stratified Case-Cross Study. Can Respir J 2021; 2021:3240785. [PMID: 34326908 PMCID: PMC8302390 DOI: 10.1155/2021/3240785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/16/2021] [Accepted: 07/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to explore the relationship between air pollution and hospital admissions for COPD in Changchun, a northeast city of China, in different seasons. Methods The data on a total of 1,733 hospitalized patients living in Changchun with acute exacerbation of COPD from September 2013 to April 2018 were collected from a comprehensive 3A hospital of Changchun. Daily average concentrations of PM2.5, PM10, SO2, NO2, CO, and O3 were collected from the Department of Ecology and Environment of Jilin Province. The conditional logistic regression model was adopted to analyze the effect of air pollutant concentration on the number of hospitalized patients with COPD in different seasons. Results The maximum OR value for most air pollutants emitted in spring was on lag day 4, in summer and autumn on lag day 3, and in winter on lag day 2. In spring, SO2 and NO2 were entered into the regression equation, and the OR (95%CI) was 0.992 (0.986-0.998) and 1.009 (1.002-1.017); in autumn, PM2.5, PM10, and SO2 were entered into the regression equation, and the OR (95%CI) was 1.005 (1.000-1.011), 0.995 (0.991-1.000), and 1.006 (1.001-1.011), respectively; and in winter, PM2.5 and PM10 were entered into the regression equation, and the OR (95%CI) was 1.008 (1.002-1.015) and 0.994 (0.988-0.999), respectively. Conclusion The relationship between air pollution and hospital admission for COPD in Northeast China varies with different seasons. In spring, NO2 is likely to be the major risk factor for hospital admissions for COPD; in autumn, PM2.5 and SO2 are the major risk factors; and in winter, PM2.5 is the major risk factor.
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The effect of nitrogen dioxide and atmospheric pressure on hospitalization risk for chronic obstructive pulmonary disease in Guangzhou, China. Respir Med 2021; 182:106424. [PMID: 33932714 DOI: 10.1016/j.rmed.2021.106424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The relationship between air pollution and meteorological factors on diseases has become a research hotspot recently. Nevertheless, few studies have touched the inferences of nitrogen dioxide (NO2) and atmospheric pressure (AP) on hospitalization risk for chronic obstructive pulmonary disease (COPD). OBJECTIVES To investigate the short-term impact of particulate air pollutants and meteorology factors on hospitalizations for COPD and quantify the corresponding risk burden of hospital admission. METHODS In our study, COPD cases were collected from Guangzhou Panyu Central Hospital (n = 11,979) from Dec of 2013 to Jun 2019. The 24-h average temperature, relative humidity (RH), wind speed (V), AP and other meteorological data were obtained from Guangzhou Meteorological Bureau. Air pollution data were collected from Guangzhou Air Monitoring Station. The influence of different NO2 and AP values on COPD risk was quantified by a distributed lag nonlinear model (DLNM) combined with Poisson Regression and Time Series analysis. RESULTS We found that NO2 had a non-linear relationship with the incidence of COPD, with an approximate "M" type, appearing at the peaks of 126 μg/m³ (RR = 1.32, 95%CI, 1.07 to 1.64) and 168 μg/m³ (RR = 1.21, 95%CI, 0.94 to 1.55), respectively. And the association between AP and COPD incidence exhibited an approximate J-shape with a peak occurring at 1035 hPa (RR = 1.16, 95% CI, 1.02 to 1.31). CONCLUSIONS The nonlinear relationship of NO2 and AP on COPD admission risk in different periods of lag can be used to establish an early warning system for diseases and reduce the possible outbreaks and burdens of COPD in a sensitive population.
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What Are the Effects of Meteorological Factors on Exacerbations of Chronic Obstructive Pulmonary Disease? ATMOSPHERE 2021. [DOI: 10.3390/atmos12040442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the greatest global public health challenges. Acute exacerbations of COPD lead to the accelerated deterioration of lung function, reduced quality of life, a higher number of hospitalizations, and increased mortality. The factor causing the exacerbation is usually an infectious agent, but the impact of environmental factors is being studied more thoroughly. Among them, meteorological factors are the least examined. Multiple studies have shown that lower temperatures during the cold season, as well as sudden temperature changes regardless of the season, have the most significant negative effect on patients with COPD. However, higher temperatures, especially during summer heatwaves, can also cause COPD exacerbation and it is expected that this will be an even more important health problem in the future considering climate changes. The effects of other meteorological factors on acute exacerbation of COPD, such as atmospheric pressure, solar radiation, rainfall, wind speed, and humidity are far less investigated and opposing results have been obtained in different studies. Thus, there is a need for further research in this area that would result in clinical recommendations and public health interventions that could decrease the global burden of COPD.
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Gayle AV, Quint JK, Fuertes EI. Understanding the relationships between environmental factors and exacerbations of COPD. Expert Rev Respir Med 2021; 15:39-50. [PMID: 32713218 DOI: 10.1080/17476348.2020.1801426] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with a significant health burden both for patients and healthcare systems. Exposure to various environmental factors increases the risk of exacerbations. AREAS COVERED We searched PubMed and assessed literature published within the last 10 years to include epidemiological evidence on the relationships between air pollution, temperature and COPD exacerbation risk as well as the implications of extreme weather events on exacerbations. EXPERT OPINION Ongoing climate change is expected to increase air pollution levels, global temperature and the frequency and severity of extreme weather events, all of which are associated with COPD exacerbations. Further research is needed using patient-focused methodological approaches to better understand and quantify these relationships, so that effective mitigation strategies that decrease the risk of exacerbations can be developed.
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Affiliation(s)
- Alicia V Gayle
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
- Global Real World Evidence, AstraZeneca Plc , Cambridge, UK
| | - Jennifer K Quint
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
| | - Elaine I Fuertes
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
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Angelucci A, Aliverti A. Telemonitoring systems for respiratory patients: technological aspects. Pulmonology 2020; 26:221-232. [DOI: 10.1016/j.pulmoe.2019.11.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 12/29/2022] Open
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Di Ciaula A, Portincasa P. The environment as a determinant of successful aging or frailty. Mech Ageing Dev 2020; 188:111244. [PMID: 32335099 DOI: 10.1016/j.mad.2020.111244] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 02/07/2023]
Abstract
The number of elderly persons is rising rapidly, and healthspan is a key factor in determining the well-being of individuals and the sustainability of national health systems. Environmental health is crucial for a "successful aging". Complex relationships between environmental factors and non-communicable diseases play a major role, causing or accelerating disabilities. Besides genetic factors, aging results from the concurrence of several environmental factors starting from early (i.e. in utero) life, able to increase susceptibility to diseases in adulthood, and to promote frailty in the elderly. In aged people, an unhealthy environment contributes to a fast and early decline and increases vulnerability. Exposure to pollutants facilitates the onset and progression of cardiovascular, respiratory, metabolic and neurologic diseases through direct effects and epigenetic mechanisms negatively affecting biological age. Healthy diet, healthy environment and constant physical activity could counteract, at least in part, the negative effects of environmental stressors. Almost all environmental factors generating detrimental effects on aging are modifiable, with relevant implications in terms of primary prevention measures potentially leading to decreased frailty, to an increase in the number of years lived without diseases or disability, and to a significant reduction in health expenditure.
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Affiliation(s)
- Agostino Di Ciaula
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy; Division of Internal Medicine, Hospital of Bisceglie (ASL BAT), Bisceglie, Italy; International Society of Doctors for Environment (ISDE).
| | - Piero Portincasa
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
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Ho SC, Chuang KJ, Lee KY, Chen JK, Wu SM, Chen TT, Lee CN, Chang CC, Feng PH, Chen KY, Su CL, Tsai CY, Chuang HC. Chronic obstructive pulmonary disease patients have a higher risk of occurrence of pneumonia by air pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 677:524-529. [PMID: 31063895 DOI: 10.1016/j.scitotenv.2019.04.358] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/24/2019] [Accepted: 04/24/2019] [Indexed: 05/24/2023]
Abstract
Epidemiological evidence has shown that air pollution is associated with chronic obstructive pulmonary disease (COPD). The objective of this study was to investigate the effects of air pollution on patients with COPD and pneumonia. A case-control study of patients who had undergone thoracentesis for pleural effusion drainage in a hospital was recruited for this study. COPD and non-COPD patients with pneumonia respectively served as the case and control groups. Increases in particulate matter of <2.5 μm in aerodynamic diameter (PM2.5) and NO2 increased the risk of pneumonia in COPD patients (adjusted odd ratio (OR) = 4.136, 95% confidence interval (CI) = 1.740-9.832 for PM2.5; adjusted OR = 1.841, 95% CI = 1.117-3.036 for NO2). COPD patients with pneumonia had higher levels of CD14 in pleural effusion than did non-COPD with pneumonia (p < 0.05). An increase in CD14 of the pleural effusion increased the risk of pneumonia in COPD patients (adjusted OR = 1.126, 95% CI = 1.009-1.256). We further observed that an increase in Cu and a decrease in Zn in the pleural effusion increased the risk of pneumonia in COPD patients (adjusted OR = 1.005, 95% CI = 1.000-1.010 for Cu; adjusted OR = 0.988, 95% CI = 0.978-0.997 for Zn). In conclusion, our results suggest that COPD patients had a high risk of pneumonia occurring due to air pollution exposure.
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Affiliation(s)
- Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jen-Kun Chen
- Institute of Biomedical Engineering & Nanomedicine, National Health Research Institutes, Miaoli, Taiwan; Graduate Institute of Life Sciences and School of Dentistry, National Defense Medical Center, Taipei, Taiwan.
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Chun-Nin Lee
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Chih-Cheng Chang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chein-Ling Su
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Cheng-Yu Tsai
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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