Department of Respiratory Disease and Critical Care Unit, University Hospital Center, Amiens-Picardie. 1, Rue du Professeur Christian Cabrol, Amiens-Cedex, 80054, France.
AGIR Unit - UR4294, University Picardie Jules Verne, 1, rue des Louvels, Amiens Cedex 1, 80037, France.
Environ Health. 2024 Nov 29;23(1):107. doi: 10.1186/s12940-024-01146-3.
Ambient air pollution is recognized as a major risk factor for chronic obstructive pulmonary disease (COPD) which is the third leading cause of death worldwide. We examined whether variations in daily outdoor air pollutants levels were associated with excess hospital emergency room visits (ERV) for acute exacerbation of COPD (AECOPD).
This two-center ecological cohort study was conducted in Amiens, France. We collected all consecutive ERV for AECOPD throughout 2017 and developed single pollutant models to assess the association between AECOPD and nitrogen dioxide (NO), ozone (O), or particulate matter (PM and PM) levels, while adjusting for temperature, hygrometry, influenza circulation and pollen allergy risk. For a subgroup of patients, we also applied geographical modeling to analyze annual exposure to outdoor air pollutants.
We recorded 240 ERV among 168 COPD patients in 2017 and identified 9 peaks of ERV. There was a statistically significant positive correlation between the daily ERV for AECOPD and the daily average concentrations of PM (RR = 1.06 (95%CI = [1.00-1.11]), p = 0.049), but no correlation with NO, O or PM (p = 0.073, p = 0.114 and p = 0.119, respectively). Our geographical modeling study revealed that long-term exposure to any of the four outdoor air pollutants was not associated with more frequent AECOPD.
Even though the pollution levels measured generally remained below or near the 2021 short-term air quality guidelines issued by the World Health Organization, significant aggregate-level associations were found between severe AECOPD leading to ERV and daily concentrations of PM.
NCT03079661.
空气污染被认为是慢性阻塞性肺疾病（COPD）的主要危险因素，COPD 是全球第三大致死原因。我们研究了每日户外空气污染物水平的变化是否与 COPD 急性加重（AECOPD）导致的急诊室就诊（ERV）过多有关。
这是一项在法国亚眠进行的两中心生态队列研究。我们收集了 2017 年所有 COPD 急性加重的连续 ERV，并开发了单污染物模型，以评估 AECOPD 与二氧化氮（NO）、臭氧（O）或颗粒物（PM 和 PM）水平之间的关系，同时调整了温度、湿度、流感循环和花粉过敏风险。对于亚组患者，我们还应用地理模型分析了户外空气污染物的年度暴露情况。
我们记录了 2017 年 168 例 COPD 患者中的 240 例 ERV，并确定了 9 个 ERV 高峰。AECOPD 的每日 ERV 与每日平均 PM 浓度之间存在统计学显著的正相关（RR=1.06[95%CI=1.00-1.11]，p=0.049），但与 NO、O 或 PM 无相关性（p=0.073，p=0.114 和 p=0.119，分别）。我们的地理模型研究表明，长期暴露于四种户外空气污染物中的任何一种都与更频繁的 AECOPD 无关。
尽管测量的污染水平通常低于或接近世界卫生组织 2021 年发布的短期空气质量指南，但严重 AECOPD 导致的 ERV 与每日 PM 浓度之间仍存在显著的聚集水平相关性。
NCT03079661。
