chronic obstructive pulmonary disease (COPD).
While several days of exposure to high level air pollution was known to be a risk factor for exacerbating an existing case of COPD, this is the first study to actually link long-term air pollution exposure to the development or progression of the condition.
Many COPD sufferers, and the public in general, are unaware that chronic exposure to low levels of air pollution is most likely to occur in their own homes. The EPA reports that indoor air pollution levels, especially from airborne chemicals, can be 2 to 5 times higher than levels recorded outdoors.
The lead researcher for the new study, Zorana Andersen, Ph.D., says the results are significant on a number of levels.
“Patients, primary care physicians, pulmonologists and public health officials should all take note of our findings,” commented Dr. Anderson.
“We found significant positive associations between levels of all air pollution proxies and COPD incidence. When we adjusted for smoking status and other confounding factors, the association remained significant; indicating that long-term pollution exposure likely is a true risk factor for developing COPD.”
These associations between air pollution exposure and COPD were slightly stronger for men, obese patients and those eating less than 240 grams of fruit each day (approximately eight ounces, or just more than a single serving). But notably, the effect of air pollution on COPD was strongest in people with pre-existing diabetes and asthma.
“These results are in agreement with those of other cross-sectional studies on COPD and air pollution, and longitudinal studies of air pollution and lung function, and strengthen the conclusion that air pollution is a causal agent in development of COPD,” said Dr. Andersen.
The enhanced association between increased risk of COPD and air pollution in asthmatics and diabetics suggests the possibility of an underlying link.
“It is plausible that airflow obstruction and hyper-responsiveness in people with asthma, or systemic inflammation in people with diabetes, can lead to increased susceptibility of the lung to air pollution, resulting in airway inflammation and progression of COPD, but more research is needed in this area.” said Dr. Andersen.
“In any case, sufficient data, including the results of this study, provide evidence that traffic-related urban air pollution contributes to the burden of COPD and that reductions in traffic emissions would be beneficial to public health.”
The Danish research study was published online and ahead of the print edition of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.
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