Schikowski Tamara, Sugiri Dorothea, Ranft Ulrich, Gehring Ulrike, Heinrich Joachim, Wichmann H-Erich, Krämer Ursula
Institut für Umweltmedizinische Forschung, Heinrich-Heine-University of Düsseldorf, Auf'm Hennekamp50, 40225 Düsseldorf, Germany.
Respir Res. 2005 Dec 22;6(1):152. doi: 10.1186/1465-9921-6-152.
Lung function and exacerbations of chronic obstructive pulmonary disease (COPD) have been associated with short-term exposure to air pollution. However, the effect of long-term exposure to particulate matter from industry and traffic on COPD as defined by lung function has not been evaluated so far. Our study was designed to investigate the influence of long-term exposure to air pollution on respiratory symptoms and pulmonary function in 55-year-old women. We especially focused on COPD as defined by GOLD criteria and additionally compared the effects of air pollution on respiratory symptoms by questionnaire data and by lung function measurements.
In consecutive cross sectional studies conducted between 1985-1994, we investigated 4757 women living in the Rhine-Ruhr Basin of Germany. NO2 and PM10 exposure was assessed by measurements done in an 8 km grid, and traffic exposure by distance from the residential address to the nearest major road using Geographic Information System data. Lung function was determined and COPD was defined by using the GOLD criteria. Chronic respiratory symptoms and possible confounders were defined by questionnaire data. Linear and logistic regressions, including random effects were used to account for confounding and clustering on city level.
The prevalence of COPD (GOLD stages 1-4) was 4.5%. COPD and pulmonary function were strongest affected by PM10 and traffic related exposure. A 7 microg/m3 increase in five year means of PM10 (interquartile range) was associated with a 5.1% (95% CI 2.5%-7.7%) decrease in FEV1, a 3.7% (95% CI 1.8%-5.5%) decrease in FVC and an odds ratio (OR) of 1.33 (95% CI 1.03-1.72) for COPD. Women living less than 100 m from a busy road also had a significantly decreased lung function and COPD was 1.79 times more likely (95% CI 1.06-3.02) than for those living farther away. Chronic symptoms as based on questionnaire information showed effects in the same direction, but less pronounced.
Chronic exposure to PM10, NO2 and living near a major road might increase the risk of developing COPD and can have a detrimental effect on lung function.
慢性阻塞性肺疾病（COPD）的肺功能及病情加重与短期暴露于空气污染有关。然而，长期暴露于来自工业和交通的颗粒物对基于肺功能定义的COPD的影响迄今尚未得到评估。我们的研究旨在调查长期暴露于空气污染对55岁女性的呼吸道症状和肺功能的影响。我们特别关注了根据全球慢性阻塞性肺疾病倡议（GOLD）标准定义的COPD，并另外通过问卷调查数据和肺功能测量比较了空气污染对呼吸道症状的影响。
在1985年至1994年期间进行的连续横断面研究中，我们调查了居住在德国莱茵-鲁尔区的4757名女性。通过在8公里网格内进行的测量评估二氧化氮（NO₂）和可吸入颗粒物（PM₁₀）暴露情况，并使用地理信息系统数据根据居住地址到最近主要道路的距离评估交通暴露情况。测定肺功能，并使用GOLD标准定义COPD。通过问卷调查数据定义慢性呼吸道症状和可能的混杂因素。使用包括随机效应的线性和逻辑回归来解释城市层面的混杂和聚类情况。
COPD（GOLD 1-4期）的患病率为4.5%。COPD和肺功能受PM₁₀及交通相关暴露的影响最大。PM₁₀五年平均浓度每增加7微克/立方米（四分位间距），第一秒用力呼气容积（FEV₁）下降5.1%（95%置信区间2.5%-7.7%），用力肺活量（FVC）下降3.7%（95%置信区间1.8%-5.5%），COPD的比值比（OR）为1.33（95%置信区间1.03-1.72）。居住在距离繁忙道路不到100米的女性肺功能也显著下降，患COPD的可能性是居住在较远位置女性的1.79倍（95%置信区间1.06-3.02）。基于问卷调查信息的慢性症状显示出相同方向的影响，但不太明显。
长期暴露于PM₁₀、NO₂以及居住在主要道路附近可能会增加患COPD的风险，并对肺功能产生有害影响。
