Objectives

Research is lacking on the impacts of exposure to particulate matter (PM) and air pollution on patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, we investigate the effects of various air pollution factors on hospitalization for asthma and COPD.

Methods

We obtained data on pollutants—PM₁₀, PM_2.5, carbon monoxide (CO), ozone (O₃), nitrogen dioxide (NO₂), and sulfur dioxide (SO₂)—in Gyeonggi-do, South Korea. We also extracted data from Korean National Health Insurance records and investigated asthma and COPD attacks that required hospitalization from January 2007 through February 2018. We used generalized additive models with Poisson distribution and log transformation to calculate adjusted risk. A time-stratified case-crossover design was used, and conditional logistic regression was performed to analyze these data.

Results

Per-unit increases in concentrations of PM₁₀, PM_2.5, SO₂, NO₂, CO, and O₃ on different best lag days were associated with increased risks for hospital admission for COPD and asthma. SO₂ had the strongest effect on hospital admission for asthma (odds ratio [OR], 1.535; 95 % confidence interval [CI], 1.450–1.619). SO₂ also had the strongest effect on hospital admission for COPD (OR, 1.659; 95 % CI, 1.541–1.786). Subgroup analyses showed that these relationships were stronger in seniors (≥ 65 years old) and women with asthma than in men and nonseniors with COPD.

Conclusions

Short-term exposure to PM₁₀, PM_2.5, CO, O₃, NO₂, and SO₂ may result in hospitalization for asthma and COPD. Of these pollutants, SO₂ has the strongest effects. Therefore, patients with COPD and asthma should be cautioned against performing outdoor activities when SO₂ levels are high.

中文翻译：

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2007-2018 年韩国京畿道暴露于颗粒物和空气污染对哮喘和慢性阻塞性肺病住院的短期影响

目标

缺乏关于暴露于颗粒物 (PM) 和空气污染对慢性阻塞性肺病 (COPD) 或哮喘患者的影响的研究。因此，我们调查了各种空气污染因素对哮喘和慢性阻塞性肺病住院的影响。

方法

我们在韩国京畿道获得了有关污染物——PM ₁₀、PM _2.5、一氧化碳 (CO)、臭氧 (O ₃ )、二氧化氮 (NO ₂ ) 和二氧化硫 (SO _{2 ) 的数据。}我们还从韩国国民健康保险记录中提取数据，并调查了 2007 年 1 月至 2018 年 2 月期间需要住院的哮喘和慢性阻塞性肺病发作。我们使用具有泊松分布和对数变换的广义加性模型来计算调整后的风险。使用时间分层病例交叉设计，并进行条件逻辑回归分析这些数据。

结果

_{在不同的最佳滞后日，PM 10}、PM _2.5、SO ₂、NO ₂、CO 和O ₃浓度的单位增加与COPD和哮喘住院风险增加相关。SO ₂对哮喘住院的影响最大（优势比 [OR]，1.535；95 % 置信区间 [CI]，1.450–1.619）。SO ₂对 COPD 入院的影响也最大（OR，1.659；95 % CI，1.541–1.786）。亚组分析表明，老年人（≥ 65 岁）和女性哮喘患者的这些关系比男性和非老年 COPD 患者更强。

结论

短期暴露于 PM ₁₀、PM _2.5、CO、O ₃、NO ₂和SO ₂可能导致哮喘和COPD住院。在这些污染物中，SO ₂的影响最强。_{因此，当 SO 2}水平较高时，应提醒 COPD 和哮喘患者不要进行户外活动。