Document Detail

Short-term effects of air pollution in a cohort of patients with chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  23018970     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although damage to the respiratory system from air pollutants has been recognized, research on susceptibility to air pollution in patients with chronic obstructive respiratory disease (COPD) has produced contradictory results. We studied the short-term effects of particulate matter (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3) on cardiac and respiratory mortality in a COPD cohort. We assessed age, sex, and previous diseases as effect modifiers.
METHODS: Using hospital data (1998-2009) and pharmaceutical data (2005-2009), we enrolled 145,681 COPD subjects, aged 35+ years and residents of Rome, and followed them from 2005 to 2009. A comparison group of people without COPD (1,710,557 subjects) was also studied. We analyzed deaths due to all natural causes (International Classification of Diseases - Ninth Revision codes 1-799). Statistical analyses were carried out using Poisson regression and a case-crossover approach.
RESULTS: PM10, PM2.5, and NO2 (0- to 5-day lag) were associated with daily mortality, with stronger effects in people with COPD. The mortality associated with PM10 (per interquartile range [IQR] = 16 μg/m) was five times more in COPD patients (3.5% [95% confidence interval = -0.1% to 7.2%]) than in other subjects (0.7% [-0.8% to 2.2%]). Effects on respiratory mortality among COPD subjects were particularly elevated from PM2.5 (IQR = 11 μg/m) (11.6% [2.0% to 22.2%]) and NO2 (IQR = 24 μg/m) (19.6% [3.5% to 38.2%]). Older age, male sex, preexisting heart conduction disorders, and cerebrovascular diseases were associated with stronger effects in COPD subjects.
CONCLUSIONS: COPD patients are more susceptible to air pollutants, especially PM10 and NO2. These results suggest a need for more protective air pollution standards for susceptible groups.
Annunziata Faustini; Massimo Stafoggia; Giovanna Cappai; Francesco Forastiere
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epidemiology (Cambridge, Mass.)     Volume:  23     ISSN:  1531-5487     ISO Abbreviation:  Epidemiology     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-08     Completed Date:  2013-02-14     Revised Date:  2013-03-06    
Medline Journal Info:
Nlm Unique ID:  9009644     Medline TA:  Epidemiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  861-79     Citation Subset:  IM    
Department of Epidemiology, Regional Health Service of Lazio, Rome, Italy.
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MeSH Terms
Age Distribution
Aged, 80 and over
Air Pollution / adverse effects,  analysis*,  statistics & numerical data*
Cardiovascular Diseases / epidemiology
Cause of Death
Cohort Studies
Environmental Monitoring / statistics & numerical data*
Italy / epidemiology
Middle Aged
Nitrogen Dioxide / analysis*
Ozone / analysis*
Pulmonary Disease, Chronic Obstructive / mortality*
Risk Factors
Sex Distribution
Survival Rate
Reg. No./Substance:
10028-15-6/Ozone; 10102-44-0/Nitrogen Dioxide
Erratum In:
Epidemiology. 2013 Jan;24(1):177

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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