Seposo Xerxes, Arcilla Audrey Lynn A, De Guzman Jose Guillermo N, Dizon Enrico Miguel S, Figuracion Andrea Nova R, Morales Christina Micaela M, Tugonon Pauleena Katriona A, Apostol Geminn Louis C
School of Medicine and Public Health, Ateneo de Manila University, Don Eugenio Lopez Sr. Medical Complex Ortigas Avenue 1604, Pasig City, Philippines.
School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamot1-12-4 Sakamotoo, Nagasaki, 852-8523, Japan.
Chronic Dis Transl Med. 2021 Feb 23;7(2):117-124. doi: 10.1016/j.cdtm.2021.01.002. eCollection 2021 Jun.
Air pollution and poor ambient air quality are significantly related to multiple health risks. One associated disease is chronic obstructive pulmonary disease (COPD), a preventable disease with several contributing factors and one of the leading causes of morbidity/mortality locally and globally. A potentially high-risk population are traffic enforcers who are constantly exposed to air pollution. In the Philippines, the MMDA has the widest coverage in traffic management. The study determined the risk of COPD among Metro Manila Development Authority (MMDA) traffic enforcers in relation to ambient air quality level, as well as identified other factors that increase the risk of developing COPD.
Fifty-two MMDA traffic enforcers deployed in PM air quality sensor areas in Metro Manila from 2016 to 2018 were recruited through stratified sampling. The International Primary Airways Guidelines (IPAG) questionnaire was utilized to measure risk of COPD. Respiratory health and working history were obtained through questionnaires. Department of environment and natural resources provided PM ambient air quality data which aided in the construction of the Exposure-Month Index. Ordinal logistic regression was used to examine the association of PM together with the relevant factors and the risk of COPD.
We found statistically significant associations between PM and COPD among high risk category [odds risk (OR): 1.24, 95% confidence interval (CI): 1.07-1.44]. Age (Moderate, OR: 1.16, 95% CI: 0.98-1.38 and High, OR: 10.06, 95% CI: 4.02-25.17) and chest pain (Moderate, OR: 68.65, 95% CI: 1.71-2.75 × 10) were potential risk factors, whereas body mass index (BMI) (OR: 0.05, 95% CI: 0.01-0.53) exhibited protective effect.
Exposure to PM was associated with an increased risk of COPD among high-risk category MMDA traffic enforcers. Age and chest pain were potential risk factors to risk of COPD, whereas BMI exhibited a potential protective effect. Results of this study can be used for clinical management of high-risk populations, such that of MMDA traffic enforcers.
空气污染和恶劣的环境空气质量与多种健康风险显著相关。一种相关疾病是慢性阻塞性肺疾病（COPD），这是一种可预防的疾病，有多种促成因素，是当地和全球发病/死亡的主要原因之一。一个潜在的高危人群是经常暴露于空气污染中的交通执法人员。在菲律宾，马尼拉大都会发展管理局（MMDA）在交通管理方面的覆盖范围最广。该研究确定了马尼拉大都会发展管理局（MMDA）交通执法人员患慢性阻塞性肺疾病（COPD）的风险与环境空气质量水平的关系，并确定了其他增加患慢性阻塞性肺疾病风险的因素。
通过分层抽样招募了2016年至2018年部署在马尼拉大都会PM空气质量传感器区域的52名MMDA交通执法人员。采用国际初级气道指南（IPAG）问卷来测量患慢性阻塞性肺疾病（COPD）的风险。通过问卷获取呼吸健康和工作史。环境和自然资源部提供了PM环境空气质量数据，这有助于构建暴露月指数。采用有序逻辑回归分析来检验PM与相关因素以及慢性阻塞性肺疾病（COPD）风险之间的关联。
我们发现高风险类别中PM与慢性阻塞性肺疾病（COPD）之间存在统计学上的显著关联[优势风险（OR）：1.24，95%置信区间（CI）：1.07 - 1.44]。年龄（中度，OR：1.16，95% CI：0.98 - 1.38；高度，OR：10.06，95% CI：4.02 - 25.17）和胸痛（中度，OR：68.65，95% CI：1.71 - 2.75×10）是潜在风险因素，而体重指数（BMI）（OR：0.05，95% CI：0.01 - 0.53）显示出保护作用。
在高风险类别的MMDA交通执法人员中，暴露于PM与患慢性阻塞性肺疾病（COPD）的风险增加有关。年龄和胸痛是患慢性阻塞性肺疾病（COPD）风险的潜在因素，而BMI显示出潜在的保护作用。本研究结果可用于高危人群（如MMDA交通执法人员）的临床管理。
