Choi Juwhan, Oh Jee Youn, Lee Young Seok, Min Kyung Hoon, Hur Gyu Young, Lee Sung Yong, Kang Kyung Ho, Shim Jae Jeong
Division of Respiratory, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Int J Chron Obstruct Pulmon Dis. 2018 Mar 28;13:1053-1059. doi: 10.2147/COPD.S156617. eCollection 2018.
Particulate matter and air pollution in Korea are becoming worse. There is a lack of research regarding the impact of particulate matter on patients with COPD. Therefore, the purpose of this study was to investigate the effects of various air pollution factors, including particulate matter, on the incidence rate of severe acute exacerbations of COPD (AECOPD) events.
We analyzed the relationship between air pollutants and AECOPD events that required hospitalization at Guro Hospital in Korea from January 1, 2015 to May 31, 2017. We used general linear models with Poisson distribution and log-transformation to obtain adjusted relative risk (RR). We conducted further analysis through the Comprehensive Air-quality Index (CAI) that is used in Korea.
Among various other air pollutants, particulate matter was identified as a major source of air pollution in Korea. When the CAI score was over 50, the incidence rate of severe AECOPD events was statistically significantly higher [RR 1.612, 95% CI, 1.065-2.440, =0.024]. Additionally, the particulate matter levels 3 days before hospitalization were statistically significant [RR 1.003, 95% CI, 1.001-1.005, =0.006].
Particulate matter and air pollution increase the incidence rate of severe AECOPD events. COPD patients should be cautioned against outdoor activities when particulate matter levels are high.
韩国的颗粒物和空气污染状况日益恶化。关于颗粒物对慢性阻塞性肺疾病(COPD)患者影响的研究较少。因此,本研究旨在调查包括颗粒物在内的各种空气污染因素对COPD严重急性加重(AECOPD)事件发生率的影响。
我们分析了2015年1月1日至2017年5月31日期间韩国九老医院需要住院治疗的空气污染物与AECOPD事件之间的关系。我们使用具有泊松分布和对数变换的一般线性模型来获得调整后的相对风险(RR)。我们通过韩国使用的综合空气质量指数(CAI)进行了进一步分析。
在各种其他空气污染物中,颗粒物被确定为韩国空气污染的主要来源。当CAI评分超过50时,严重AECOPD事件的发生率在统计学上显著更高[RR 1.612,95%CI,1.065 - 2.440,P = 0.024]。此外,住院前3天的颗粒物水平具有统计学意义[RR 1.003,95%CI,1.001 - 1.005,P = 0.006]。
颗粒物和空气污染会增加严重AECOPD事件的发生率。当颗粒物水平较高时,应提醒COPD患者避免户外活动。