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      International Journal of COPD (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on pathophysiological processes underlying Chronic Obstructive Pulmonary Disease (COPD) interventions, patient focused education, and self-management protocols. Sign up for email alerts here.

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      Short-term effects of ambient air pollution on chronic obstructive pulmonary disease admissions in Beijing, China (2013–2017)

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          Abstract

          Purpose

          Evidence between air pollution and COPD admissions is inconsistent and limited in China. In this study, we aimed to explore the effects of air pollutants on COPD admissions in Beijing, China.

          Patients and methods

          Daily COPD hospital admission visits derived from tertiary and secondary hospitals in Beijing were retrieved from January 2013 to February 2017. Air pollutant levels and meteorological data over the same periods were also achieved. Generalized additive model was applied to estimate the percentage changes with 95% CIs in daily admissions corresponding to 10 µg/m 3 increases in pollutants levels [1 mg/m 3 in carbon monoxide (CO)], stratified by age, gender, and season.

          Results

          Seventy-three thousand seventy-six COPD hospital admission visits were included with mean daily visits of 48 (21). Cumulative lag effect with per 10 µg/m 3 increase in air pollutant levels was largest for nitrogen dioxide (NO 2) with 3.03% (95% CI: 1.82%–4.26%) at lag 06, for sulfur dioxide (SO 2) with 2.07% (95% CI: 1.00%–3.15%) at lag 01, for particulate matter ≤10 µm in aerodynamic diameter (PM 10) with 0.92% (95% CI: 0.55%–1.30%) at lag 07, and for particulate matter ≤2.5 µm in aerodynamic diameter (PM 2.5) with 0.82% (95% CI: 0.38%–1.26%) at lag 06, respectively. Percentage increase for each 1 mg/m 3 increase in CO was 5.99% (95% CI: 2.74%–9.34%) at lag 06. Further, stronger effects on COPD admissions were found in warm seasons than in cold seasons.

          Conclusion

          Short-term exposures to PM 2.5, PM 10, NO 2, SO 2, and CO had adverse effects on COPD hospitalizations in Beijing with different magnitudes and lag days.

          Most cited references32

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          An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease.

          Although cigarette smoking is the most important cause of chronic obstructive pulmonary disease (COPD), a substantial proportion of COPD cases cannot be explained by smoking alone. To evaluate the risk factors for COPD besides personal cigarette smoking. We constituted an ad hoc subcommittee of the American Thoracic Society Environmental and Occupational Health Assembly. An international group of members was invited, based on their scientific expertise in a specific risk factor for COPD. For each risk factor area, the committee reviewed the literature, summarized the evidence, and developed conclusions about the likelihood of it causing COPD. All conclusions were based on unanimous consensus. The population-attributable fraction for smoking as a cause of COPD ranged from 9.7 to 97.9%, but was less than 80% in most studies, indicating a substantial burden of disease attributable to nonsmoking risk factors. On the basis of our review, we concluded that specific genetic syndromes and occupational exposures were causally related to the development of COPD. Traffic and other outdoor pollution, secondhand smoke, biomass smoke, and dietary factors are associated with COPD, but sufficient criteria for causation were not met. Chronic asthma and tuberculosis are associated with irreversible loss of lung function, but there remains uncertainty about whether there are important phenotypic differences compared with COPD as it is typically encountered in clinical settings. In public health terms, a substantive burden of COPD is attributable to risk factors other than smoking. To prevent COPD-related disability and mortality, efforts must focus on prevention and cessation of exposure to smoking and these other, less well-recognized risk factors.
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            Epidemiological time series studies of PM2.5 and daily mortality and hospital admissions: a systematic review and meta-analysis

            Background Short-term exposure to outdoor fine particulate matter (particles with a median aerodynamic diameter <2.5 μm (PM2.5)) air pollution has been associated with adverse health effects. Existing literature reviews have been limited in size and scope. Methods We conducted a comprehensive, systematic review and meta-analysis of 110 peer-reviewed time series studies indexed in medical databases to May 2011 to assess the evidence for associations between PM2.5 and daily mortality and hospital admissions for a range of diseases and ages. We stratified our analyses by geographical region to determine the consistency of the evidence worldwide and investigated small study bias. Results Based upon 23 estimates for all-cause mortality, a 10 µg/m3 increment in PM2.5 was associated with a 1.04% (95% CI 0.52% to 1.56%) increase in the risk of death. Worldwide, there was substantial regional variation (0.25% to 2.08%). Associations for respiratory causes of death were larger than for cardiovascular causes, 1.51% (1.01% to 2.01%) vs 0.84% (0.41% to 1.28%). Positive associations with mortality for most other causes of death and for cardiovascular and respiratory hospital admissions were also observed. We found evidence for small study bias in single-city mortality studies and in multicity studies of cardiovascular disease. Conclusions The consistency of the evidence for adverse health effects of short-term exposure to PM2.5 across a range of important health outcomes and diseases supports policy measures to control PM2.5 concentrations. However, reasons for heterogeneity in effect estimates in different regions of the world require further investigation. Small study bias should also be considered in assessing and quantifying health risks from PM2.5.
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              Fine Particulate Air Pollution and Daily Mortality. A Nationwide Analysis in 272 Chinese Cities.

              Evidence concerning the acute health effects of air pollution caused by fine particulate matter (PM2.5) in developing countries is quite limited.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2019
                23 January 2019
                : 14
                : 297-309
                Affiliations
                [1 ]Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China, xukf@ 123456pumch.cn
                [2 ]Office of Medical Insurance, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
                [3 ]School of Statistics, Shandong University of Finance and Economics, Jinan, China
                Author notes
                Correspondence: Kai-Feng Xu, Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No 1 Wangfujing Hutong, Beijing 100730, China, Tel +86 10 6915 5040, Fax +86 10 6915 5039, Email xukf@ 123456pumch.cn
                Article
                copd-14-297
                10.2147/COPD.S188900
                6350834
                30774327
                605aafb8-da21-4702-801a-d42142d614f4
                © 2019 Gao et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Respiratory medicine
                adverse effects,air pollution,copd,time series analysis,hospital visits
                Respiratory medicine
                adverse effects, air pollution, copd, time series analysis, hospital visits

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