Liu Y, Lee K, Perez-Padilla R, Hudson N L, Mannino D M
Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington, Kentucky 40536, USA.
Int J Tuberc Lung Dis. 2008 Feb;12(2):115-27.
Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality in both high- and low-income countries. While active cigarette smoking is the most important preventable risk factor globally, outdoor and indoor air pollutants can cause or exacerbate COPD. In high-income countries, historic air pollution events provide clear evidence that exposure to high levels of outdoor air pollutants is associated with increased mortality and morbidity due to COPD and related cardiorespiratory diseases. Studies in the last 20 years continue to show increased risk associated mainly with particulate matters, even at much lower levels. Populations in low-income countries are largely exposed to indoor air pollutants from the combustion of solid fuels, which contributes significantly to the burden of COPD-related diseases, particularly in non-smoking women. Effective preventive strategies for COPD may vary between countries, and include continued improvements in air cleaning technology, air quality legislation and dissemination of improved cooking stoves. A joint effort from both society and governments is needed for these endeavors.
慢性阻塞性肺疾病（COPD）在高收入国家和低收入国家都是发病和死亡的重要原因。虽然主动吸烟是全球最重要的可预防风险因素，但室外和室内空气污染物可导致COPD或使其加重。在高收入国家，历史上的空气污染事件提供了明确证据，即暴露于高水平的室外空气污染物与因COPD及相关心肺疾病导致的死亡率和发病率增加有关。过去20年的研究继续表明，即使在低得多的水平下，主要与颗粒物相关的风险也在增加。低收入国家的人群很大程度上暴露于固体燃料燃烧产生的室内空气污染物中，这对COPD相关疾病的负担有很大影响，尤其是在不吸烟的女性中。COPD的有效预防策略在不同国家可能有所不同，包括持续改进空气净化技术、空气质量立法以及推广改良炉灶。社会和政府需要共同努力来开展这些工作。
