COPD Patients as Vulnerable Subpopulation for Exposure to Ambient Air Pollution

The prevalence of chronic obstructive pulmonary disease (COPD) is increasing worldwide with no known cure and an increasing number of triggers that exacerbate symptoms and speed up progression. This review aims to summarize the evidence for COPD patients being more vulnerable to air pollution exposure assessed as acute effects.

Several recent systematic reviews show consistently increased risks for COPD mortality and COPD hospital admission, ranging between 2 and 3% with increasing PM_2.5 or PM₁₀. Similar adverse impacts were shown for NO_2. Also_, adverse health effects among COPD patients were also found for other gaseous pollutants such as ozone and SO₂; most of these studies could not be included in the meta-analysis we reviewed. Data from ten panel studies of COPD patients reported a small but statistically significant decline of FEV1 [- 3.38 mL (95% CI - 6.39 to - 0.37)] per increment of 10 μg/m³ PM₁₀, supporting an impact on respiratory health with increasing PM₁₀ exposure. The combined information from systematic reviews and more recent findings lead us to conclude that COPD patients are more vulnerable to ambient air pollution than healthier people.