Air pollution and COPD: GOLD 2023 committee report

Area of Science:

• Environmental Health
• Pulmonology
• Public Health

Background:

• Air pollution is a primary driver in the development of Chronic Obstructive Pulmonary Disease (COPD), accounting for a substantial portion of the global attributable risk.
• Recent evidence indicates that both gaseous and particulate air pollutants contribute to COPD pathogenesis, with no safe exposure levels identified.

Approach:

• The Global Initiative for Chronic Obstructive Lung Disease (GOLD) Scientific Committee conducted a comprehensive review of existing evidence on air pollution and COPD.
• A qualitative synthesis of the evidence was performed to inform recommendations for risk mitigation.

Key Points:

• The relationship between air pollution levels and respiratory events is supra-linear, meaning risks increase disproportionately with higher pollution.
• Climate change-related events like wildfires and heat waves pose significant threats, increasing morbidity and mortality in COPD patients.
• Childhood exposure to air pollution can impede lung development, potentially leading to developmental COPD.

Conclusions:

• GOLD strongly recommends robust public health policies worldwide to decrease ambient air pollution levels.
• Implementation of public warning systems, advisories, and personalized apps is advised to alert individuals, especially COPD patients, to hazardous air quality.
• For household air pollution, using air cleaners and filters is recommended when particulate levels exceed safe thresholds.