Studies evaluating the role of long-term exposure to fine particulate matter (PM) on chronic obstructive pulmonary disease (COPD) development showed inconsistent results and were limited to Western countries. We aimed to determine the association between long-term exposure to PM and COPD development in metropolitan cities in Korea, which have higher PM levels than those in Western country studies. We constructed a retrospective cohort (elderly aged over 65 years who resided in 7 metropolitan cities in 2008) using Korea health insurance data. A total of 687,940 elderlies who had not visited hospitals due to COPD for 3 years (from 2008 to 2010) were followed-up from 2011 to 2016. The first hospital visit due to COPD during the follow-up period was regarded as COPD development. Daily district-level PM concentrations were estimated by chemical transport model and 60-month moving average PM were assigned to each subject in time-varying Cox proportional hazard model. The mean concentration of modelled PM in 7 metropolitan cities during the study period (from 2006 to 2016) was 28.0 μg/m and 259,700 subjects newly visited the hospital due to COPD. COPD hospital visit hazard ratio for a 10 μg/m increase in 60-month moving average PM concentration was 1.09 (95% confidence interval: 1.07, 1.11). Risks remained unchanged following different PM exposure levels (48-month moving average, and average PM concentrations for 2008 and 2008–2010) and in subgroup analysis by subject characteristics (sex, age, and income groups). By following-up 687,940 elderly subjects who resided in metropolitan cities in Korea for 6 years, long-term PM exposure showed association with COPD development.

中文翻译：

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老年人长期接触细颗粒物与慢性阻塞性肺病的发生

评估长期接触细颗粒物 (PM) 对慢性阻塞性肺病 (COPD) 发展的影响的研究显示结果不一致，并且仅限于西方国家。我们的目的是确定韩国大城市长期接触 PM 与慢性阻塞性肺病 (COPD) 发展之间的关联，这些城市的 PM 水平高于西方国家研究中的水平。我们利用韩国健康保险数据构建了一个回顾性队列（2008 年居住在 7 个大城市的 65 岁以上老年人）。 2011年至2016年对687,940名因慢性阻塞性肺病3年（2008年至2010年）未曾就诊的老年人进行随访。随访期间首次因慢性阻塞性肺病就诊视为慢性阻塞性肺病发展。通过化学品传输模型估算每日地区级 PM 浓度，并在时变 Cox 比例风险模型中将 60 个月移动平均 PM 分配给每个受试者。研究期间（2006年至2016年）7个大城市的模拟PM平均浓度为28.0微克/立方米，有259,700名受试者新近因慢性阻塞性肺病到医院就诊。 60 个月移动平均 PM 浓度增加 10 μg/m 的 COPD 医院就诊风险比为 1.09（95% 置信区间：1.07、1.11）。根据不同的 PM 暴露水平（48 个月移动平均值以及 2008 年和 2008-2010 年的平均 PM 浓度）以及按主题特征（性别、年龄和收入组）进行的亚组分析，风险保持不变。通过对居住在韩国大都市的 687,940 名老年人进行为期 6 年的跟踪调查，发现长期接触 PM 与慢性阻塞性肺病 (COPD) 的发展存在关联。