Association between acute exacerbation of chronic obstructive pulmonary disease and short-term exposure to ambient air pollutants in France

Abstract Background 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 ro...

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Main Authors: Damien Basille, Lola Soriot, Florence Weppe, Peggy Desmettres, Paulo Henriques, Nicolas Benoit, Stéphanie Devaux, Momar Diouf, Vincent Jounieaux, Claire Andrejak
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Environmental Health
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Online Access:https://doi.org/10.1186/s12940-024-01146-3
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author Damien Basille
Lola Soriot
Florence Weppe
Peggy Desmettres
Paulo Henriques
Nicolas Benoit
Stéphanie Devaux
Momar Diouf
Vincent Jounieaux
Claire Andrejak
author_facet Damien Basille
Lola Soriot
Florence Weppe
Peggy Desmettres
Paulo Henriques
Nicolas Benoit
Stéphanie Devaux
Momar Diouf
Vincent Jounieaux
Claire Andrejak
author_sort Damien Basille
collection DOAJ
description Abstract Background 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). Methods 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 (NO2), ozone (O3), or particulate matter (PM2.5 and PM10) 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. Results 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 PM2.5 (RR = 1.06 (95%CI = [1.00–1.11]), p = 0.049), but no correlation with NO2, O3 or PM10 (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. Conclusion 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 PM2.5. Clinical trial registration NCT03079661.
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spelling doaj-art-4fad2db6ffc04e31bb51e23bcbf9692e2025-08-20T02:38:35ZengBMCEnvironmental Health1476-069X2024-11-012311910.1186/s12940-024-01146-3Association between acute exacerbation of chronic obstructive pulmonary disease and short-term exposure to ambient air pollutants in FranceDamien Basille0Lola Soriot1Florence Weppe2Peggy Desmettres3Paulo Henriques4Nicolas Benoit5Stéphanie Devaux6Momar Diouf7Vincent Jounieaux8Claire Andrejak9Department of Respiratory Disease and Critical Care Unit, University Hospital CenterDepartment of Respiratory Disease and Critical Care Unit, University Hospital CenterDepartment of Respiratory Disease and Critical Care Unit, University Hospital CenterAtmo Hauts-de-FranceDepartment of Emergency Medicine, University Hospital Center Amiens-PicardieDepartment of Respiratory DiseaseDepartment of Respiratory Disease and Critical Care Unit, University Hospital CenterDirection de la Recherche Clinique et de l’Innovation, University Hospital CenterDepartment of Respiratory Disease and Critical Care Unit, University Hospital CenterDepartment of Respiratory Disease and Critical Care Unit, University Hospital CenterAbstract Background 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). Methods 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 (NO2), ozone (O3), or particulate matter (PM2.5 and PM10) 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. Results 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 PM2.5 (RR = 1.06 (95%CI = [1.00–1.11]), p = 0.049), but no correlation with NO2, O3 or PM10 (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. Conclusion 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 PM2.5. Clinical trial registration NCT03079661.https://doi.org/10.1186/s12940-024-01146-3Nitrogen dioxideOzoneParticulate matterChronic obstructive pulmonary diseaseMorbidity
spellingShingle Damien Basille
Lola Soriot
Florence Weppe
Peggy Desmettres
Paulo Henriques
Nicolas Benoit
Stéphanie Devaux
Momar Diouf
Vincent Jounieaux
Claire Andrejak
Association between acute exacerbation of chronic obstructive pulmonary disease and short-term exposure to ambient air pollutants in France
Environmental Health
Nitrogen dioxide
Ozone
Particulate matter
Chronic obstructive pulmonary disease
Morbidity
title Association between acute exacerbation of chronic obstructive pulmonary disease and short-term exposure to ambient air pollutants in France
title_full Association between acute exacerbation of chronic obstructive pulmonary disease and short-term exposure to ambient air pollutants in France
title_fullStr Association between acute exacerbation of chronic obstructive pulmonary disease and short-term exposure to ambient air pollutants in France
title_full_unstemmed Association between acute exacerbation of chronic obstructive pulmonary disease and short-term exposure to ambient air pollutants in France
title_short Association between acute exacerbation of chronic obstructive pulmonary disease and short-term exposure to ambient air pollutants in France
title_sort association between acute exacerbation of chronic obstructive pulmonary disease and short term exposure to ambient air pollutants in france
topic Nitrogen dioxide
Ozone
Particulate matter
Chronic obstructive pulmonary disease
Morbidity
url https://doi.org/10.1186/s12940-024-01146-3
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