Various air pollutants, meteorological factors associated with COPD exacerbations
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Researchers reported nine air pollutants and meteorological factors are associated with an increase in the incidence of COPD exacerbations, for a lag time of up to 10 days.
The analysis evaluated 551,535 patients with COPD in the National Health Insurance Service from 2013 to 2018. The data were merged with 24-hour average air pollutant and meteorological factors values from national databases. All patients lived in eight metropolitan cities in South Korea with densely located observatory stations.
“While Korea is located in East Asia between China and the Pacific Ocean, it does experience dynamic changes in weather, atmosphere and air pollutant levels,” Jin-Young Huh, MD, from the department of pulmonology and critical care medicine at the University of Ulsan College of Medicine at Asan Medical Center, Seoul, South Korea, and colleagues wrote in the Annals of the American Thoracic Society.
A total of 15,282 COPD exacerbations led to either hospitalization or an ED visit.
Fine particulate matter (PM)2.5, PM10, nitrogen dioxide, sulfur dioxide, carbon monoxide, ozone, humidity, average temperature and diurnal temperature range were all associated with the incidence of COPD exacerbations.
An elevation of 10 g/m3 in PM2.5 increased the risk for COPD exacerbations by 1.1% on lag day 0 during 2015-2016 in the multivariate analysis. In addition, an increase of 10 g/m3 in PM2.5 on lag day 0 and an increase of 1 degree Celsius in diurnal temperature range was associated with a 1% and 3% higher risk for COPD exacerbations. Researchers also noted the largest effect sizes of a 10 g/m3 increase in PM2.5 and PM10 on lag day 4 in 2017-2018, which increased acute COPD exacerbation occurrence by 1.3% and 1.4%. However, excess COPD exacerbation risk was highest on lag day 3 for average temperature with an increase of 1 degree Celsius increasing the risk by 1.1%.
“The effects of air pollutants and meteorological factors cannot be simplified such by the use of a linear model, and identification of these diverse associations can be an important basis to understand their effects and to predict COPD exacerbations,” the researchers wrote.