RT Journal Article
SR Electronic
T1 Personal exposure to air pollution and respiratory health of COPD patients in London
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2003432
DO 10.1183/13993003.03432-2020
A1 Dimitris Evangelopoulos
A1 Lia Chatzidiakou
A1 Heather Walton
A1 Klea Katsouyanni
A1 Frank J. Kelly
A1 Jennifer K Quint
A1 Roderic L. Jones
A1 Benjamin Barratt
YR 2021
UL http://erj.ersjournals.com/content/early/2020/12/17/13993003.03432-2020.abstract
AB 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.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Evangelopoulos has nothing to disclose.Conflict of interest: Dr. Chatzidiakou has nothing to disclose.Conflict of interest: Dr. Walton has nothing to disclose.Conflict of interest: Dr. Katsouyanni has nothing to disclose.Conflict of interest: Dr. Kelly has nothing to disclose.Conflict of interest: Dr. Quint reports grants from MRC, during the conduct of the study; grants from Asthma UK, grants and personal fees from AZ, grants from Chiesi, grants and personal fees from BI, grants and personal fees from Bayer, grants from MRC, grants from The Health Foundation, outside the submitted work;.Conflict of interest: Professor Jones has nothing to disclose.Conflict of interest: Dr. Barratt has nothing to disclose.