Sunyer J
Unitat de Recerca Respiratòria i Ambiental, Institut Municipal d'Investigació Médica, Barcelona, Spain.
Eur Respir J. 2001 May;17(5):1024-33. doi: 10.1183/09031936.01.17510240.
There is consistency in the findings that relate the acute increases in urban air pollution (mainly the particulate matter) and the short-term health effects (i.e. mortality and hospital admissions) on patients suffering from chronic obstructive pulmonary disease (COPD). Beyond the acute effects, a relevant public health and scientific question is to what extent chronic exposure to air pollution is related with lung function impairment and development of COPD. The few cross-sectional studies showed an increase of self-reported diagnosis of chronic bronchitis and emphysema, breathlessness and mucus hypersecretion and lower levels of lung function in the more polluted areas. The two cohort studies in children have found a retardation of pulmonary function growth, and the only cohort in adults a faster decline of lung function. Given the intrinsic limitations of cross-sectional studies to separate the timing between exposure and effects, and the weaknesses of the cohorts (ie. few areas, short follow-up, only one retest, lack of individual weighting of air pollution measure) there is a need for new prospective studies. These should be performed in a large number of geographical areas and with a long follow-up to asses the impact of long-term air pollution on lung function growth and decline, and on incidence, duration, severity and survival of chronic obstructive pulmonary disease.
有关城市空气污染（主要是颗粒物）的急性增加与慢性阻塞性肺疾病（COPD）患者短期健康影响（即死亡率和住院率）之间关系的研究结果具有一致性。除了急性影响外，一个相关的公共卫生和科学问题是，长期接触空气污染在多大程度上与肺功能损害和COPD的发展有关。少数横断面研究表明，在污染更严重的地区，自我报告的慢性支气管炎、肺气肿、呼吸急促和黏液分泌过多的诊断增加，肺功能水平降低。两项针对儿童的队列研究发现肺功能生长迟缓，而唯一一项针对成年人的队列研究发现肺功能下降更快。鉴于横断面研究在区分暴露与影响的时间方面存在固有局限性，以及队列研究的弱点（即地区少、随访短、仅一次重新测试、缺乏空气污染测量的个体权重），需要开展新的前瞻性研究。这些研究应在大量地理区域进行，并进行长期随访，以评估长期空气污染对肺功能生长和下降以及慢性阻塞性肺疾病的发病率、病程、严重程度和生存率的影响。
