Aglan Amro, Synn Andrew J, Nurhussien Lina, Chen Kelly, Scheerens Charlotte, Koutrakis Petros, Coull Brent, Rice Mary B
Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America.
Department of Public Health and Primary Care, Faculty of Medicine, Ghent University, Ghent, Belgium.
Hyg Environ Health Adv. 2023 Jun;6. doi: 10.1016/j.heha.2023.100052. Epub 2023 Mar 31.
Air pollution exposure is associated with hospital admissions for Chronic Obstructive Pulmonary Disease (COPD). Few studies have investigated whether daily personal exposure to air pollutants affects respiratory symptoms and oxygenation among COPD patients.
We followed 30 former smokers with COPD for up to 4 non-consecutive 30-day periods in different seasons. Participants recorded worsening of respiratory symptoms (sub-categorized as breathing or bronchitis symptoms) by daily questionnaire, and oxygen saturation by pulse oximeter. Personal and community-level exposure to fine particulate matter (PM), nitrogen dioxide (NO), and ozone (O) were measured by portable air quality monitors and stationary monitors in the Boston area. We used generalized and multi-level linear mixed-effects models to estimate associations of the 24-hour average of each pollutant in the previous day with changes in respiratory symptoms and oxygen saturation.
Higher community-level exposure to air pollutants was associated with worsening respiratory symptoms. An interquartile range (IQR) higher community-level O was associated with a 1.35 (95%CI: 1.07-1.70) higher odds of worsening respiratory symptoms. The corresponding ORs for community-level PM and NO were 1.18 (95%CI: 1.02-1.37) and 1.06 (95%CI: 0.90-1.25), respectively. Community-level NO was associated with worsening bronchitis symptoms (OR=1.25, 95%CI: 1.00-1.56), but not breathing symptoms. Personal PM exposure was associated with lower odds of worsening respiratory symptoms (OR=0.91; 95%CI: 0.81-1.01). Personal exposure to NO was associated with 0.11% lower oxygen saturation (95%CI: -0.22, 0.00) per IQR.
In this COPD population, there was a pattern of worsening respiratory symptoms associated with community-level exposure to O and PM, and worsening oxygenation associated with personal exposure to NO.
暴露于空气污染与慢性阻塞性肺疾病（COPD）的住院治疗相关。很少有研究调查COPD患者每日个人暴露于空气污染物是否会影响呼吸道症状和氧合作用。
我们对30名患有COPD的 former smokers 进行了跟踪，在不同季节进行了长达4个不连续的30天周期的研究。参与者通过每日问卷记录呼吸道症状的恶化情况（细分为呼吸或支气管炎症状），并通过脉搏血氧仪记录血氧饱和度。通过便携式空气质量监测仪和波士顿地区的固定监测仪测量个人和社区层面的细颗粒物（PM）、二氧化氮（NO）和臭氧（O）暴露情况。我们使用广义和多层次线性混合效应模型来估计前一天每种污染物的24小时平均值与呼吸道症状和血氧饱和度变化之间的关联。
社区层面更高的空气污染物暴露与呼吸道症状恶化相关。社区层面O每升高一个四分位数间距（IQR），呼吸道症状恶化的几率就高出1.35倍（95%置信区间：1.07 - 1.70）。社区层面PM和NO的相应比值比分别为1.18（95%置信区间：1.02 - 1.37）和1.06（95%置信区间：0.90 - 1.25）。社区层面的NO与支气管炎症状恶化相关（比值比 = 1.25，95%置信区间：1.00 - 1.56），但与呼吸症状无关。个人PM暴露与呼吸道症状恶化几率较低相关（比值比 = 0.91；95%置信区间：0.81 - 1.01）。个人暴露于NO与每IQR血氧饱和度降低0.11%相关（95%置信区间：-0.22，0.00）。
在这个COPD人群中，存在一种模式，即社区层面暴露于O和PM与呼吸道症状恶化相关，而个人暴露于NO与氧合作用恶化相关。
