School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, UK.
J Epidemiol Community Health. 2009 Apr;63(4):324-8. doi: 10.1136/jech.2008.077024. Epub 2009 Feb 10.
Chronic obstructive pulmonary disease (COPD) is a major global cause of morbidity and mortality. Studies in urban areas have shown associations between air pollutants and hospital admissions for COPD. Whether temporal variations in air quality are associated with hospital admissions for COPD in a rural region with lower concentrations of air pollutants than previously studied was investigated.
Daily COPD admissions were recorded for patients attending three hospitals in the county of Norfolk, UK, between January 2006 and February 2007. Records were combined with daily information on concentrations of six air pollutants (carbon monoxide, nitric oxide, nitrogen dioxide, oxides of nitrogen, ozone and fine particulates), airborne pollens, temperature and influenza incidence. A case-crossover analysis was used to examine the association between air pollution and daily admissions.
There were 1050 admissions for COPD over the study period. After adjustment for temperature, pollen and respiratory infections, each 10 microg/m(3) increase in CO was associated with a 2% increase in the odds of admission. Values of 17%, 22% and 9% were observed for NO, NO(2) and oxides of nitrogen respectively. No associations were observed with O(3) or particulates.
Among a population of a less urbanised area than previously investigated, this study found evidence that ambient pollutant concentrations were still associated with the risks of hospital admission for COPD.
慢性阻塞性肺疾病（COPD）是一个主要的全球性发病和死亡原因。城市地区的研究表明，空气污染物与 COPD 住院之间存在关联。在一个空气污染物浓度低于以往研究的农村地区，空气质量的时间变化是否与 COPD 住院有关，这一点尚未得到研究。
在 2006 年 1 月至 2007 年 2 月期间，英国诺福克郡的三家医院记录了 COPD 每日住院人数。记录与每日六类空气污染物（一氧化碳、一氧化氮、二氧化氮、氮氧化物、臭氧和细颗粒物）浓度、空气花粉、温度和流感发病率的信息相结合。采用病例交叉分析来研究空气污染与每日住院之间的关系。
在研究期间，共有 1050 例 COPD 住院。在调整温度、花粉和呼吸道感染后，每增加 10μg/m³的 CO，住院的几率增加 2%。NO、NO₂和氮氧化物的增加率分别为 17%、22%和 9%。未观察到与 O₃或颗粒物的关联。
在一个比以往研究更城市化程度较低的人群中，本研究发现了证据表明，环境污染物浓度仍与 COPD 住院风险相关。
