A full list of author affiliations can be found in the acknowledgements section. T. Schikowski, M. Adam and A. Marcon are equal first authors. T. Schikowski, A. Hansell, F. Kauffmann, J. Sunyer, N. Probst-Hensch, U. Krämer and N. Künzli are members of the Steering Committee ESCAPE Work Package 4, Respiratory Health in Adults
A full list of author affiliations can be found in the acknowledgements section. T. Schikowski, M. Adam and A. Marcon are equal first authors. T. Schikowski, A. Hansell, F. Kauffmann, J. Sunyer, N. Probst-Hensch, U. Krämer and N. Künzli are members of the Steering Committee ESCAPE Work Package 4, Respiratory Health in Adults.
Eur Respir J. 2014 Sep;44(3):614-26. doi: 10.1183/09031936.00132213. Epub 2014 Jan 31.
The role of air pollution in chronic obstructive pulmonary disease (COPD) remains uncertain. The aim was to assess the impact of chronic exposure to air pollution on COPD in four cohorts using the standardised ESCAPE exposure estimates. Annual average particulate matter (PM), nitrogen oxides (NOx) and road traffic exposure were assigned to home addresses using land-use regression models. COPD was defined by NHANES reference equation (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) less than the lower limit of normal) and the Global Initiative for Chronic Obstructive Lung Disease criterion (FEV1/FVC <0.70) and categorised by severity in non-asthmatics. We included 6550 subjects with assigned NOx and 3692 with PM measures. COPD was not associated with NO2 or PM10 in any individual cohort. In meta-analyses only NO2, NOx, PM10 and the traffic indicators were positively, although not significantly, associated with COPD. The only statistically significant associations were seen in females (COPD prevalence using GOLD: OR 1.57, 95% CI 1.11-2.23; and incidence: OR 1.79, 95% CI 1.21-2.68). None of the principal results were statistically significant, the weak positive associations of exposure with COPD and the significant subgroup findings need to be evaluated in further well standardised cohorts followed up for longer time, and with time-matched exposure assignments.
空气污染在慢性阻塞性肺疾病（COPD）中的作用仍不确定。本研究旨在使用标准化 ESCAPE 暴露评估，通过四个队列评估慢性暴露于空气污染对 COPD 的影响。使用基于土地利用的回归模型，将每年平均颗粒物（PM）、氮氧化物（NOx）和道路交通暴露值分配给家庭住址。COPD 采用 NHANES 参考方程（1 秒用力呼气量（FEV1）/用力肺活量（FVC）低于正常下限）和全球倡议慢性阻塞性肺疾病标准（FEV1/FVC<0.70）进行定义，并根据非哮喘患者的严重程度进行分类。我们纳入了 6550 名分配有 NOx 值的受试者和 3692 名分配有 PM 值的受试者。在任何单个队列中，COPD 均与 NO2 或 PM10 均无相关性。在荟萃分析中，仅 NO2、NOx、PM10 和交通指标与 COPD 呈正相关，尽管无统计学意义。只有在女性中观察到具有统计学意义的关联（使用 GOLD 标准的 COPD 患病率：OR1.57，95%CI1.11-2.23；发病率：OR1.79，95%CI1.21-2.68）。没有任何主要结果具有统计学意义，暴露与 COPD 之间的微弱正相关性以及有意义的亚组发现需要在进一步的标准化队列中进行评估，这些队列应随访时间更长，并进行时间匹配的暴露评估。
