Joachim Heinrich1,2,3, Tamara Schikowski4. 1. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Centre Munich, German Centre for Lung Research. (DZL), University Hospital Munich of Ludwig Maximillians University Munich, Munich, Germany. joachim.heinrich@med.uni-muenchen.de. 2. Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany. joachim.heinrich@med.uni-muenchen.de. 3. Allergy and Lung Health Unit, Melbourne School of Population Health, University of Melbourne, Melbourne, Australia. joachim.heinrich@med.uni-muenchen.de. 4. Leibniz Institute for Environmental Medicine, Düsseldorf, Germany.
Abstract
PURPOSE OF REVIEW: The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide with no known cure and an increasing number of triggers that exacerbate symptoms and speed up progression. This review aims to summarize the evidence for COPD patients being more vulnerable to air pollution exposure assessed as acute effects. RECENT FINDINGS: Several recent systematic reviews show consistently increased risks for COPD mortality and COPD hospital admission, ranging between 2 and 3% with increasing PM2.5 or PM10. Similar adverse impacts were shown for NO2. Also, adverse health effects among COPD patients were also found for other gaseous pollutants such as ozone and SO2; most of these studies could not be included in the meta-analysis we reviewed. Data from ten panel studies of COPD patients reported a small but statistically significant decline of FEV1 [- 3.38 mL (95% CI - 6.39 to - 0.37)] per increment of 10 μg/m3 PM10, supporting an impact on respiratory health with increasing PM10 exposure. The combined information from systematic reviews and more recent findings lead us to conclude that COPD patients are more vulnerable to ambient air pollution than healthier people.
PURPOSE OF REVIEW: The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide with no known cure and an increasing number of triggers that exacerbate symptoms and speed up progression. This review aims to summarize the evidence for COPDpatients being more vulnerable to air pollution exposure assessed as acute effects. RECENT FINDINGS: Several recent systematic reviews show consistently increased risks for COPD mortality and COPD hospital admission, ranging between 2 and 3% with increasing PM2.5 or PM10. Similar adverse impacts were shown for NO2. Also, adverse health effects among COPDpatients were also found for other gaseous pollutants such as ozone and SO2; most of these studies could not be included in the meta-analysis we reviewed. Data from ten panel studies of COPDpatients reported a small but statistically significant decline of FEV1 [- 3.38 mL (95% CI - 6.39 to - 0.37)] per increment of 10 μg/m3 PM10, supporting an impact on respiratory health with increasing PM10 exposure. The combined information from systematic reviews and more recent findings lead us to conclude that COPDpatients are more vulnerable to ambient air pollution than healthier people.
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