[Short term effect of urban air pollution on respiratory insufficiency due to chronic obstructive pulmonary disease. Synthesis of studies published from 1962 to January 2000].

This review presents a synthesis of studies published from 1962 to 2000 on the relations between air pollution and chronic obstructive pulmonary disease (COPD): 12 ecological epidemiological studies, 6 epidemiological panel studies, and 11 controlled human exposure trials. The controlled trials, ecological time-based epidemiological studies and panels are examined successively followed by a discussion of their methodology and results. The controlled trials either do no highlight effects or show effects having no clinical significance since variations are similar to physiological variability. For epidemiological studies reporting individual data, the results point to a particle effect (two studies). This effect of particles is found in ecological studies which also describe an impact of ozone, sometimes of sulfur dioxide and less often of nitrogen dioxide. In conclusion, patients suffering from COPD are generally regarded as a group sensitive to air pollution, as suggested by the results of numerous ecological epidemiological studies. Rare individual studies provide a few arguments supporting this assumption.