Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Environ Res. 2024 Sep 15;257:119240. doi: 10.1016/j.envres.2024.119240. Epub 2024 May 29.
Prolonged exposure to air pollution has been linked to adverse respiratory health, yet the evidence concerning its association with chronic obstructive pulmonary disease (COPD) is inconsistent. The evidence of a greenness effect on chronic respiratory diseases is limited.
This study aimed to investigate the association between long-term exposure to particulate matter (PM and PM), black carbon (BC), nitrogen dioxide (NO), ozone (O) and greenness (as measured by the normalized difference vegetation index - NDVI) and incidence of self-reported chronic bronchitis or COPD (CB/COPD).
We analyzed data from 5355 adults from 7 centers participating in the Respiratory Health in Northern Europe (RHINE) study. Mean exposures to air pollution and greenness were assessed at available residential addresses in 1990, 2000 and 2010 using air dispersion models and satellite data, respectively. Poisson regression with log person-time as an offset was employed to analyze the association between air pollution, greenness, and CB/COPD incidence, adjusting for confounders.
Overall, there were 328 incident cases of CB/COPD during 2010-2023. Despite wide statistical uncertainty, we found a trend for a positive association between NO exposure and CB/COPD incidence, with incidence rate ratios (IRRs) per 10 μg/m³ difference ranging between 1.13 (95% CI: 0.90-1.41) in 1990 and 1.18 (95% CI: 0.96-1.45) in 2000. O showed a tendency for inverse association with CB/COPD incidence (IRR from 0.84 (95% CI: 0.66-1.07) in 2000 to 0.88 (95% CI: 0.69-1.14) in 2010. No consistent association was found between PM, BC and greenness with CB/COPD incidence across different exposure time windows.
Consistent with prior research, our study suggests that individuals exposed to higher concentrations of NO may face an elevated risk of developing COPD, although evidence remains inconclusive. Greenness was not associated with CB/COPD incidence, while O showed a tendency for an inverse association with the outcome.
长期暴露在空气污染中与不良的呼吸道健康有关，但关于其与慢性阻塞性肺疾病（COPD）的关联的证据并不一致。关于绿色环境对慢性呼吸道疾病影响的证据有限。
本研究旨在探讨长期暴露于颗粒物（PM 和 PM）、黑碳（BC）、二氧化氮（NO）、臭氧（O）和绿色植被（用归一化差异植被指数 - NDVI 衡量）与慢性支气管炎或 COPD（CB/COPD）发病的关系。
我们分析了来自 7 个中心的 5355 名成年人参加的北欧呼吸健康研究（RHINE）的数据。使用空气扩散模型和卫星数据分别在 1990 年、2000 年和 2010 年评估了空气污染和绿色植被的平均暴露水平。使用泊松回归模型，以对数个人时间作为偏移量，调整混杂因素后分析空气污染、绿色植被与 CB/COPD 发病的关系。
2010 年至 2023 年期间，共有 328 例 CB/COPD 发病病例。尽管存在广泛的统计不确定性，但我们发现 NO 暴露与 CB/COPD 发病之间存在正相关趋势，1990 年和 2000 年每增加 10μg/m³的发病率比（IRR）分别为 1.13（95% CI：0.90-1.41）和 1.18（95% CI：0.96-1.45）。O 与 CB/COPD 发病呈负相关趋势（2000 年的 IRR 为 0.84（95% CI：0.66-1.07），2010 年的 IRR 为 0.88（95% CI：0.69-1.14））。在不同的暴露时间窗口内，PM、BC 和绿色植被与 CB/COPD 发病之间没有一致的关联。
与之前的研究一致，本研究表明，暴露于较高浓度 NO 的个体可能面临更高的 COPD 发病风险，尽管证据仍不明确。绿色植被与 CB/COPD 发病无关，而 O 与发病呈负相关趋势。
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