Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
BMC Public Health. 2023 Nov 13;23(1):2229. doi: 10.1186/s12889-023-17093-6.
Short-term exposure to PM2.5 has been associated with human health risks. However, evidence on the association between short-term exposure to PM and the risk of chronic obstructive pulmonary disease (COPD) remains limited and controversial. This study aimed to specifically assess the relationship between exposure to PM and the risk of hospitalization due to COPD.
A systematic search was conducted in PubMed, Web of Science, and Google Scholar databases from January 1, 2010 to May 1, 2022. The odds ratio (OR) statistic was calculated as a common measure of effect size. Publication bias was also examined in all eligible studies on COPD hospitalization using funnel plots and Egger's test, as well as trim-and-fill method for missing studies on COPD hospitalization.
A total of 19 studies were included in this meta-analysis. Random-effects models were plotted to calculate the pooled effect size by measuring OR (χ = 349.95; df = 18; I = 94.86%; P = 0.007; Z = 2.68; P < 0.001). A 10-mg/m daily increase in PM concentration was associated with a 1.6% (95% CI: 0.4-2.9%) increase in COPD hospitalization. There was no publication bias regarding the association between COPD hospitalization and PM (bias = 1.508; 95% CI: -1.475, 4.491; t = 1.066; P = 0.301). The subgroups of age ≥ 65 years and Asian countries were associated with an increased risk of COPD hospitalization. Besides, higher risks were estimated in the subgroups of studies performed in the warm season, case-crossover studies, studies with three lag days, and studies without adjustments for humidity and temperature confounders, with very small heterogeneity.
Evidence suggests that short-term exposure to PM increases COPD hospitalization. Further studies are needed to understand the mechanism of the association between PM and COPD for reducing air pollution, which can be beneficial for COPD patients.
短期暴露于 PM2.5 与人类健康风险有关。然而，关于短期暴露于 PM 与慢性阻塞性肺疾病（COPD）风险之间的关联证据仍然有限且存在争议。本研究旨在专门评估 PM 暴露与 COPD 住院风险之间的关系。
从 2010 年 1 月 1 日至 2022 年 5 月 1 日，在 PubMed、Web of Science 和 Google Scholar 数据库中进行了系统搜索。计算了比值比（OR）统计量作为衡量效应大小的常用指标。还使用漏斗图和 Egger 检验以及 COPD 住院缺失研究的修剪和填充方法，对所有 COPD 住院研究的发表偏倚进行了检查。
共有 19 项研究纳入了本荟萃分析。使用随机效应模型绘制了汇总效应大小，通过测量 OR（χ=349.95；df=18；I=94.86%；P=0.007；Z=2.68；P<0.001）进行计算。PM 浓度每天增加 10 毫克/立方米，与 COPD 住院率增加 1.6%（95%CI：0.4-2.9%）相关。关于 COPD 住院与 PM 之间的关联，没有发表偏倚（偏倚=1.508；95%CI：-1.475,4.491；t=1.066；P=0.301）。年龄≥65 岁和亚洲国家的亚组与 COPD 住院风险增加相关。此外，在温暖季节进行的研究、病例交叉研究、滞后 3 天的研究以及未调整湿度和温度混杂因素的研究中，估计风险更高，且存在非常小的异质性。
有证据表明，短期暴露于 PM 会增加 COPD 住院的风险。需要进一步研究以了解 PM 与 COPD 之间关联的机制，以减少空气污染，这对 COPD 患者有益。
