Global associations between air pollutants and Chronic Obstructive Pulmonary Disease (COPD) exacerbations: a systematic review

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Title: Global associations between air pollutants and Chronic Obstructive Pulmonary Disease (COPD) exacerbations: a systematic review
Authors: Moore, EA
Chatzidiakou, L
Kuku, M-O
Jones, RL
Smeeth, L
Beevers, S
Kelly, FJ
Barratt, B
Quint, JK
Item Type: Conference Paper
Abstract: Background: COPD exacerbations (AECOPD) affect lung function decline and quality of life. The effect of exposure to different air pollutants on AECOPD is unclear. Aim: We systematically reviewed the literature examining associations between air pollutants and hospital admissions for AECOPD. Methods: MEDLINE, EMBASE, BIOSIS & Science Citation Index were searched until September 2015. Inclusion criteria focused on studies presenting solely a COPD outcome defined by hospital admissions, and a measure of gaseous air pollutants and particle fractions. The association between each pollutant with COPD admissions was investigated in meta-analyses using random-effects models. Analyses were stratified by geographical clusters to investigate the evidence worldwide. Results: 46 studies were included and results showed marginal positive associations. The number of included studies was small with high heterogeneity between them and there was evidence of small-study bias. Geographical clustering of the effects of pollution on COPD hospital admissions was evident and reduced heterogeneity significantly. The most consistent association was between a 1mg/m3 increase in carbon monoxide levels with COPD related admissions; Odds Ratio: 1.2 (95%CI: 1.01-1.03). Conclusions: There is mixed evidence on the effects of pollution on AECOPD. Limitations of previous studies include the low spatio-temporal resolution of pollutants, inadequate control for confounding factors, and the use of aggregated health data that ignore personal characteristics. The need for personal exposure monitoring in a large number of geographical locations is evident.
Issue Date: 8-Nov-2016
Date of Acceptance: 23-May-2016
URI: http://hdl.handle.net/10044/1/52226
DOI: https://dx.doi.org/10.1183/13993003.congress-2016.PA1126
ISSN: 0903-1936
Publisher: European Respiratory Society
Start Page: PA1126
End Page: PA1126
Journal / Book Title: European Respiratory Journal
Volume: 48
Issue: Suppl 60
Copyright Statement: Copyright ┬ęthe authors 2016
Sponsor/Funder: Medical Research Council (MRC)
Medical Research Council (MRC)
Medical Research Council (MRC)
Medical Research Council (MRC)
Funder's Grant Number: G0801056B
G0801056
MR/L01341X/1
RTJ9594911-1
Conference Name: European Respiratory Society Congress 2016
Keywords: 11 Medical And Health Sciences
Respiratory System
Publication Status: Published
Start Date: 2016-09-03
Finish Date: 2016-09-07
Conference Place: London
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine



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