Air pollution exposure—the (in)visible risk factor for respiratory diseases

AbstractThere is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.

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Chronic Obstructive Pulmonary Disease (COPD) and Air Pollution: A Review

Jundishapur Journal of Chronic Disease Care ◽

10.5812/jjcdc.110273 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Noorollah Tahery ◽

Kourosh Zarea ◽

Maria Cheraghi ◽

Nasser Hatamzadeh ◽

Majid Farhadi ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Air Pollution ◽

Pulmonary Disease ◽

Air Pollutants ◽

Pollutant Emissions ◽

Public Health Issue ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Air Pollution Exposure ◽

Pollution Exposure

: Air pollution exposure is one of the main risk factors for respiratory system diseases, including airway diseases, Chronic Obstructive Pulmonary Disease (COPD), and lung cancer. Few studies have been done concerning Interstitial Lung Disease (ILD) and its relationship with air pollution. Particulate Matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), Polyaromatic Hydrocarbons (PAHs), and Heavy Metals (HM) are the most important air pollutants found to exert harmful effects on the human and environment. This review aimed to study the health effects of air pollution on respiratory systems, especially COPD. A narrative review of the literature was done from 1978 to 2020 in various databases, including Google Scholar, Science Direct, Web of Science, Springer, PubMed, NCBI, and BMJ. The results indicated that air pollution exposure could increase respiratory diseases, especially COPD. According to the results, COPD is caused by poor airflow and long-term breathing problems due to disrupted lung tissue. Based on the results, hazardous air pollutants induce destructive effects on the lung and result in COPD. Thus, COPD is a critical public health issue in Iran and the world. To decrease the rate of COPD attributed to air pollutants, we should use policies to decrease pollutant emissions.

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Long-term air pollution and road traffic noise exposure and COPD: the Danish Nurse Cohort

European Respiratory Journal ◽

10.1183/13993003.04594-2020 ◽

2021 ◽

pp. 2004594

Author(s):

Shuo Liu ◽

Youn-Hee Lim ◽

Marie Pedersen ◽

Jeanette T. Jørgensen ◽

Heresh Amini ◽

...

Keyword(s):

Air Pollution ◽

Noise Exposure ◽

Cox Regression ◽

Road Traffic ◽

Traffic Noise ◽

Potential Interaction ◽

Chronic Obstructive ◽

Road Traffic Noise ◽

Obstructive Pulmonary Disease

BackgroundWhile air pollution has been linked to the development of chronic obstructive pulmonary disease (COPD), evidence on the role of environmental noise is just emerging. We examined the associations of long-term exposure to air pollution and road traffic noise with COPD incidence.MethodsWe defined COPD incidence for 24 538 female nurses from the Danish Nurse Cohort (age>44 years) as the first hospital contact between baseline (1993 or 1999) and 2015. We estimated residential annual mean concentrations of particulate matter with diameter<2.5 µm (PM2.5) since 1990 and nitrogen dioxide (NO2) since 1970 by the Danish DEHM/UBM/AirGIS modeling system, and road traffic noise (Lden) since 1970 by the Nord2000 model. Time-varying Cox regression models were applied to assess the associations of air pollution and road traffic noise with COPD incidence.Results977 nurses developed COPD during 18.6 years’ mean follow-up. We observed associations with COPD for all three exposures with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.19 (1.01, 1.41) per 6.26 µg·m−3 for PM2.5, 1.13 (1.05, 1.20) per 8.19 µg·m−3 for NO2, and 1.15 (1.06, 1.25) per 10 dB for Lden. Associations with NO2 and Lden attenuated slightly after mutual adjustment, but were robust to adjustment for PM2.5. Associations with PM2.5 were attenuated to null after adjustment for either NO2 or Lden. No potential interaction effect was observed between air pollutants and noise.ConclusionsLong-term exposure to air pollution, especially traffic-related NO2, and road traffic noise were independently associated with COPD.

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Bronchiectasis and increased mortality in patients with corticosteroid-dependent severe asthma: a nationwide population study

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753466620963030 ◽

2020 ◽

Vol 14 ◽

pp. 175346662096303

Author(s):

Hayoung Choi ◽

Hyun Lee ◽

Jiin Ryu ◽

Sung Jun Chung ◽

Dong Won Park ◽

...

Keyword(s):

Confidence Interval ◽

Respiratory Diseases ◽

Chronic Obstructive ◽

Study Cohort ◽

Limited Information ◽

Term Survival ◽

Obstructive Pulmonary Disease ◽

All Cause Mortality ◽

The Impact

Background: Long-term corticosteroid (CS) use is associated with increased mortality in patients with asthma, and comorbid bronchiectasis is also associated with frequent asthma exacerbation and increased healthcare use. However, there is limited information on whether bronchiectasis further increases mortality in patients with CS-dependent asthma. This study examined the impact of bronchiectasis on mortality in patients with CS-dependent asthma. Methods: A retrospective cohort of patients with CS-dependent asthma ⩾18 years old was established using records from the Korean National Health Insurance Service database from 2005 to 2015. Patients with CS-dependent asthma with and without bronchiectasis were matched by age, sex, type of insurance, and Charlson comorbidity index. We evaluated the hazard ratio (HR) for all-cause mortality in patients with bronchiectasis compared with those without bronchiectasis. Results: The study cohort included 754 patients with CS-dependent asthma with bronchiectasis and 3016 patients with CS-dependent asthma without bronchiectasis. Patients with CS-dependent asthma with bronchiectasis had a higher all-cause mortality than those without bronchiectasis (8429/100,000 versus 6962/100,000 person-years, p < 0.001). The adjusted HR for mortality in patients with CS-dependent asthma with bronchiectasis relative to those without bronchiectasis was 1.33 (95% confidence interval, 1.18–1.50), and the association was primarily significant for respiratory diseases (subdistribution HR = 1.65, 95% confidence interval, 1.42–1.92). Conclusions: Bronchiectasis further increases all-cause mortality in patients with CS-dependent asthma, a trend that was especially associated with respiratory diseases including chronic obstructive pulmonary disease. Strategies to improve treatment outcomes in patients with CS-dependent asthma with bronchiectasis are urgently needed to improve long-term survival. The reviews of this paper are available via the supplemental material section.

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Health effects of long-term exposure to air pollution: An overview of major respiratory and cardiovascular diseases and diabetes

Chemical Industry and Chemical Engineering Quarterly ◽

10.2298/ciceq120110112j ◽

2012 ◽

Vol 18 (4-2) ◽

pp. 617-622 ◽

Cited By ~ 7

Author(s):

Zorana Jovanovic-Andersen

Keyword(s):

Air Pollution ◽

Human Health ◽

Health Effects ◽

Convincing Evidence ◽

Urban Setting ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Limit Values ◽

Public Health Burden

Large number of studies provided convincing evidence for adverse effects of exposure to outdoor air pollution on human health, and served as basis for current USA and EU Air Quality Standards and limit values. Still, new knowledge is emerging, expanding our understanding of vast effects of exposure to air pollution on human health of this ubiquitous exposure affecting millions of people in urban setting. This paper focuses on the studies of health effects of long-term (chronic) exposures to air pollution, and includes major chronic and acute diseases in adults and especially elderly, which will present increasing public health burden, due to improving longevity and projected increasing numbers of elderly. The paper gives overview over the most relevant and latest literature presented by different health outcomes: chronic obstructive pulmonary disease, asthma, pneumonia, cardiovascular disease, and diabetes.

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Association Between Air Pollution and Lung Lobar Emphysema in COPD

Frontiers in Medicine ◽

10.3389/fmed.2021.705792 ◽

2021 ◽

Vol 8 ◽

Author(s):

Nguyen Thanh Tung ◽

Shu-Chuan Ho ◽

Yueh-Hsun Lu ◽

Tzu-Tao Chen ◽

Kang-Yun Lee ◽

...

Keyword(s):

Air Pollution ◽

Exercise Capacity ◽

Reference Group ◽

Lower Lobe ◽

Chronic Obstructive ◽

Crude Odds Ratio ◽

Obstructive Pulmonary Disease ◽

Emphysema Severity ◽

Lobar Emphysema ◽

Pollution Exposure

The development of emphysema has been linked to air pollution; however, the association of air pollution with the extent of lobar emphysema remains unclear. This study examined the association of particulate matter <2.5 μm in aerodynamic diameters (PM2.5) (≤2.5 μm), nitrogen dioxide (NO2), and ozone (O3) level of exposure with the presence of emphysema in 86 patients with chronic obstructive pulmonary disease (COPD). Exposure to the air pollution estimated using the land-use regression model was associated with lung function, BODE (a body mass index, degree of obstruction, dyspnea severity, and exercise capacity index) quartiles, and emphysema measured as low-attenuation areas on high-resolution CT (HR-CT) lung scans. Using paraseptal emphysema as the reference group, we observed that a 1 ppb increase in O3 was associated with a 1.798-fold increased crude odds ratio of panlobular emphysema (p < 0.05). We observed that PM2.5 was associated with BODE quartiles, modified Medical Research Council (mMRC) dyspnea score, and exercise capacity (all p < 0.05). We found that PM2.5, NO2, and O3 were associated with an increased degree of upper lobe emphysema and lower lobe emphysema (all p < 0.05). Furthermore, we observed that an increase in PM2.5, NO2, and O3 was associated with greater increases in upper lobe emphysema than in lower lobe emphysema. In conclusion, exposure to O3 can be associated with a higher risk of panlobular emphysema than paraseptal emphysema in patients with COPD. Emphysema severity in lung lobes, especially the upper lobes, may be linked to air pollution exposure in COPD.

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Effects of Air Pollutants on Airway Diseases

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189905 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9905

Author(s):

Yun-Gi Lee ◽

Pureun-Haneul Lee ◽

Seon-Muk Choi ◽

Min-Hyeok An ◽

An-Soo Jang

Keyword(s):

Urban Areas ◽

Air Pollutants ◽

Respiratory Diseases ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Airway Diseases ◽

Biological Contaminants ◽

Underlying Mechanisms ◽

The Impact

Air pollutants include toxic particles and gases emitted in large quantities from many different combustible materials. They also include particulate matter (PM) and ozone, and biological contaminants, such as viruses and bacteria, which can penetrate the human airway and reach the bloodstream, triggering airway inflammation, dysfunction, and fibrosis. Pollutants that accumulate in the lungs exacerbate symptoms of respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). Asthma, a heterogeneous disease with complex pathological mechanisms, is characterized by particular symptoms such as shortness of breath, a tight chest, coughing, and wheezing. Patients with COPD often experience exacerbations and worsening of symptoms, which may result in hospitalization and disease progression. PM varies in terms of composition, and can include solid and liquid particles of various sizes. PM concentrations are higher in urban areas. Ozone is one of the most toxic photochemical air pollutants. In general, air pollution decreases quality of life and life expectancy. It exacerbates acute and chronic respiratory symptoms in patients with chronic airway diseases, and increases the morbidity and risk of hospitalization associated with respiratory diseases. However, the mechanisms underlying these effects remain unclear. Therefore, we reviewed the impact of air pollutants on airway diseases such as asthma and COPD, focusing on their underlying mechanisms.

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The short term burden of ambient gaseous air pollution on chronic obstructive pulmonary disease in Pudong New Area, China: A time-stratified case-crossover study with a distributed lag nonlinear model

10.21203/rs.3.rs-109352/v1 ◽

2020 ◽

Author(s):

Yichen Chen ◽

Xiaopan Li ◽

Hanyi Chen ◽

Lianghong Sun ◽

Tao Lin ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Air Pollution ◽

Air Pollutants ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Distributed Lag ◽

Case Crossover ◽

Distributed Lag Nonlinear Model ◽

Pudong New Area ◽

The Impact

Abstract Background: Air pollution is a severe and dangerous public health problem. However, the effect of ambient gaseous air pollution exposure on years of life lost (YLL) attributable to chronic obstructive pulmonary disease (COPD) mortality has not been quantitatively verified.Methods: We collected the data of 12,781 COPD deaths and ambient gaseous air pollutants, including sulfur dioxide (SO2), nitrogen dioxide (NO2), Carbon monoxide (CO), and ozone (O3), during the years 2013-2019 in the Shanghai Pudong New Area (PNA). Then we performed a time-stratified case-crossover study combined with a distributed lag nonlinear model (DLNM) to estimate the impact of those air pollutants on daily COPD deaths counts and YLL. The confounders including long-term trend and meteorological factors have been controlled for, and effects of age and educational attainment as effect modifiers have also been evaluated.Results: During the 2013-2019 time frame, increases of 10μg/m3 in SO2 and NO2 were associated with a 4.93% (95% CI: 1.47%, 8.50%) and 1.47% (95% CI: 0.14%, 2.82%) in daily COPD death counts at lag0-1day, respectively, a 2.52 (95% CI: 0.31, 4.72) YLL increase and 0.85 (95% CI: 0.01, 1.68) YLL increase at lag0-1day, respectively. A 1mg/m3 increase in CO was associated with a 9.46% (95% CI: 0.40%, 19.35%) at lag0 increase in daily COPD death counts. No significant impact from O3 on both daily COPD deaths counts and YLL (P>0.05). The impact of gaseous air pollutants on the daily COPD death count and YLL were significant in populations of older adults and the lower educated population, while an insignificant effect was observed in the younger population and higher educated population. The YLL due to COPD related to SO2 and CO for the lower educated population was significantly higher than those for the higher educated population.Conclusion: Reducing specific gaseous air pollutants will help to control COPD deaths and improve the population’s life expectancy.

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