scholarly journals Personal exposure to air pollution and respiratory health of COPD patients in London

2021 ◽  
pp. 2003432
Author(s):  
Dimitris Evangelopoulos ◽  
Lia Chatzidiakou ◽  
Heather Walton ◽  
Klea Katsouyanni ◽  
Frank J. Kelly ◽  
...  

Previous studies have investigated the effects of air pollution on chronic obstructive pulmonary disease (COPD) patients using either fixed site measurements or a limited number of personal measurements, usually for one pollutant and a short time period. These limitations may introduce bias and distort the epidemiological associations as they do not account for all the potential sources or the temporal variability of pollution.We used detailed information on individuals’ exposure to various pollutants measured at fine spatio-temporal scale to obtain more reliable effect estimates. A panel of 115 patients was followed up for an average continuous period of 128 days carrying a personal monitor specifically designed for this project that measured temperature, PM10, PM2.5, NO2, NO, CO and O3 at one-minute time resolution. Each patient recorded daily information on respiratory symptoms and measured peak expiratory flow (PEF). A pulmonologist combined related data to define a binary variable denoting an “exacerbation”. The exposure-response associations were assessed with mixed-effects models.We found that gaseous pollutants were associated with a deterioration in patients’ health. We observed an increase of 16.4% (95% confidence interval: 8.6–24.6%), 9.4% (5.4–13.6%) and 7.6% (3.0–12.4%) in the odds of exacerbation for an interquartile range increase in NO2, NO and CO respectively. Similar results were obtained for cough and sputum. O3 was found to have adverse associations with PEF and breathlessness. No association was observed between particles and any outcome.Our findings suggest that, when considering total personal exposure to air pollutants, mainly the gaseous pollutants affect COPD patients’ health.

2018 ◽  
Vol 7 (11) ◽  
pp. 432 ◽  
Author(s):  
Lukas Marek ◽  
Malcolm Campbell ◽  
Michael Epton ◽  
Simon Kingham ◽  
Malina Storer

Chronic Obstructive Pulmonary Disease is a progressive lung disease affecting the respiratory function of every sixth New Zealander and over 300 million people worldwide. In this paper, we explored how the combination of social, demographical and environmental conditions (represented by increased winter air pollution) affected hospital admissions due to COPD in an urban area of Christchurch (NZ). We juxtaposed the hospitalisation data with dynamic air pollution data and census data to investigate the spatiotemporal patterns of hospital admissions. Spatial analysis identified high-risk health hot spots both overall and season specific, exhibiting higher rates in winter months not solely due to air pollution, but rather as a result of its combination with other factors that initiate deterioration of breathing, increasing impairments and lead to the hospitalisation of COPD patients. From this we found that socioeconomic deprivation and air pollution, followed by the age and ethnicity structure contribute the most to the increased winter hospital admissions. This research shows the continued importance of including both individual (composition) and area level (composition) factors when examining and analysing disease patterns.


2015 ◽  
Vol 46 (6) ◽  
pp. 1605-1614 ◽  
Author(s):  
Floor Borlée ◽  
C. Joris Yzermans ◽  
Christel E. van Dijk ◽  
Dick Heederik ◽  
Lidwien A.M. Smit

Several studies have investigated the effect of livestock farm emissions on the respiratory health of local residents, but results are inconsistent. This study aims to explore associations between the presence of livestock farms and respiratory health in an area of high-density livestock farming in the Netherlands. We focused especially on associations between farm exposures and respiratory symptoms within subgroups of potentially susceptible patients with a pre-existing lung disease.In total, 14 875 adults (response rate 53.4%) completed a questionnaire concerning respiratory health, smoking habits and personal characteristics. Different indicators of livestock farm exposures relative to the home address were computed using a geographic information system.Prevalence of chronic obstructive pulmonary disease (COPD) and asthma was lower among residents living within 100 m of a farm (OR 0.47, 95% CI 0.24–0.91 and OR 0.65, 95% CI 0.45–0.93, respectively). However, >11 farms in 1000 m compared to fewer than four farms in 1000 m (fourth quartileversusfirst quartile) was associated with wheezing among COPD patients (OR 1.71, 95% CI 1.01–2.89). Using general practitioners' electronic medical records, we demonstrated that selection bias did not affect the observed associations.Our data suggest a protective effect of livestock farm emissions on the respiratory health of residents. Nonetheless, COPD patients living near livestock farms reported more respiratory symptoms, suggesting an increased risk of exacerbations.


2020 ◽  
Vol 99 (2) ◽  
pp. 140-144
Author(s):  
T. I. Vitkina ◽  
Karolina A. Sidletskaya

Introduction. The prevalence and gain in the incidence of chronic obstructive pulmonary disease (COPD) is a reason to search for new approaches to the diagnosis of its progression. Air pollution causes an additional burden on COPD patients, contributing to the progression of this pathology. The study of mechanisms of its impact on the inflammatory response in COPD is an urgent task. The aim is to establish the dynamics of expression of interleukin-4 (IL-4), IL-6 and their membrane receptors (IL-4R, IL-6R) in blood T-helpers during COPD progression in patients living in areas with the high technogenic load. Material and methods. Vladivostok was chosen as a region with significant technogenic air pollution - the amount of air pollutants is 59.9 thousand tons per year, with 80% related to vehicle emissions; the surface layer of air is characterized by a predominance of particles less than 10 µm, which are the most pathogenic for the respiratory system. Patients with stable mild (36), moderate (52 ) and severe COPD (24) patients living in Vladivostok for at least 5 years were examined. The control group consisted of healthy volunteers living in the same area (32cases). The levels of IL-4, IL-6 in plasma and the number of T-helper cells expressing IL-4R and IL-6R were determined by flow cytometry. Results. A decline in serum IL-4 concentration and an increase in serum IL-6 level in COPD patients living under constant air pollution has been found. A decrease in IL-4R expression in blood T-helpers at all COPD stages and the gain in IL-6R synthesis in blood T-helpers during the progression of COPD were established. Conclusion. Data on the expression of IL-6R and IL-4R on circulating T-helpers can be used to diagnose the progression of COPD in patients living in urbanized areas.


2021 ◽  
Vol 06 (01) ◽  
pp. 15-21
Author(s):  
Pranav Ish ◽  

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of morbidity and mortality worldwide and is expected to increase in the coming decades due to increasing air pollution. In a country like India, it is a challenge to control the growing incidence of COPD. For this, it is imperative to understand the various risk factors that lead to the development of COPD including smoking and the ever-worsening environmental air pollution levels. Material and Methods: This prospective case-control study was carried out at the out-patient clinic of pulmonary medicine at our tertiary care centre. Clinical severity data, demographic characteristics, smoking history, and particulate matter (PM) 2.5 levels at the residence of the patients were recorded. A total of 182 cases of COPD and 365 controls were taken. Result: COPD was found to be common among males (69.2%), among the factory workers, drivers and roadside vendors and in elderly age groups. COPD was found to be associated with exposure to active and passive smoking (p < 0.05). Exposure to dust, fumes, and smoke at the workplace was significantly more prevalent among the COPD patients (13.2%) than the control group (2.7%). Besides, 61.5% of the COPD patients were residing in the area with PM 2.5 levels > 60μg/m3 which was significantly greater than the controls (44.9%). Conclusion: The main risk factor for COPD is exposure to active and passive tobacco smoking. Other environmental factors such as exposure to dust, fumes at the workplace and home are also associated with COPD. Level of PM 2.5 > 60 μg/m3 is associated with an increased risk of COPD. Thus, the environmental history of residence in Delhi or a city with high AQI is significant in evaluating a COPD patient. It is important to understand the contribution of these risk factors as curbing and curtailing them can help prevent and control the growing burden of COPD.


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.


Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.


2020 ◽  
Vol 24 (4) ◽  
pp. 80-86
Author(s):  
V. I. Trofimov ◽  
D. Z. Baranov

BACKGROUND: a comparative analysis of laboratory and instrumental tests at patients with bronchial obstructive diseases seems very actual due to the wide prevalence of these diseases. THE AIM: to evaluate characteristics of spirometry as well as allergic (total IgE, sputum eosinophils) and infectious (blood and sputum leucocytes, ESR, CRP, fibrinogen) inflammation markers at patients with bronchial obstructive diseases. PATIENTS AND METHODS: 104 case histories of patients with bronchial asthma, chronic obstructive pulmonary disease and overlap were analyzed including age, duration of smoking (pack-years), laboratory (clinical blood test, biochemical blood test, general sputum analysis, sputum culture) and instrumental (spirometry, body plethysmography, echocardiography) tests. Data were processed statistically with non-parametric methods. RESULTS: COPD patients were older than other groups’ patients, had the highest pack-years index. ACO patients were marked with maximal TLC and Raw, minimal FEV1, FEF25-75, FEV1/FVC. Patients with COPD had the highest inflammation markers (leucocyte count, CRP, fibrinogen). CONCLUSION: high active inflammation may cause severe lower airways possibility disorders at patients with COPD. Data related to a possible role of K. pneumoniaе in the pathogenesis of eosinophilic inflammation in lower airways are of significant interest. Patients with ACO occupy an intermediate position between asthma and COPD patients based on clinical and functional features.


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