Jo Yong Suk, Lim Myoung Nam, Han Young-Ji, Kim Woo Jin
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Medical Center, Seoul.
Data Analysis Center.
Int J Chron Obstruct Pulmon Dis. 2018 Jan 12;13:299-307. doi: 10.2147/COPD.S149469. eCollection 2018.
Aside from smoking, which is already recognized as a strong risk factor for COPD, interest in the impact of particulate matter (PM) on COPD is increasing. This study aimed to investigate the effect of PM, especially with an aerodynamic diameter ≤2.5 µm (PM), and its chemical constituents on the exacerbation of COPD.
Data on hospital visits including admission and outpatient clinic visits for exacerbation of COPD in Chuncheon, Korea, between 2006 and 2012 were extracted from the National Health Insurance Service database. PM and its chemical constituents were measured on the roof of the four-story Kangwon National University Natural Sciences building once every 3 days. Meteorological data were provided by the Korean Meteorological Administration.
During the study period, the mean level of PM was 35.0±25.2 µg/m, and the number of daily hospital visits were 6.42±4.28 and 2.07±1.93 for males and females, respectively. The number of COPD-related hospital visits increased with increasing PM after adjusting for meteorological covariates and females tended to be more affected sooner than males. Among the PM constituents, Al, Si, and elemental carbon were associated with increased hospital visits and there was a difference according to sex. In males, some constituents of PM were related to an increased risk of a hospital visit, mainly on the first and second days of measurement (Lag1 and Lag2). In contrast, there was no significant increase in the risk of hospital visits due to any of the PM constituents in females.
Concentrations of PM mass and some of the PM constituents were associated with increased COPD-related hospital visits in Chuncheon.
除了已被公认为慢性阻塞性肺疾病(COPD)强风险因素的吸烟外,颗粒物(PM)对COPD影响的关注度日益增加。本研究旨在调查PM,尤其是空气动力学直径≤2.5μm的颗粒物(PM₂.₅)及其化学成分对COPD急性加重的影响。
从韩国国民健康保险服务数据库中提取2006年至2012年期间韩国春川市因COPD急性加重而住院及门诊就诊的数据。每隔3天在江原国立大学自然科学楼四层楼顶测量一次PM及其化学成分。气象数据由韩国气象厅提供。
研究期间,PM的平均水平为35.0±25.2μg/m³,男性和女性的每日就诊次数分别为6.42±4.28次和2.07±1.93次。在调整气象协变量后,与COPD相关的就诊次数随PM增加而增多,且女性比男性更早受到影响。在PM成分中,铝、硅和元素碳与就诊次数增加有关,且存在性别差异。在男性中,PM的一些成分与就诊风险增加有关,主要在测量的第一天和第二天(滞后1天和滞后2天)。相比之下,女性中任何PM成分导致的就诊风险均无显著增加。
春川市PM质量浓度及部分PM成分与COPD相关就诊次数增加有关。