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. 2019 Jun;11(6):2490-2497.
doi: 10.21037/jtd.2019.05.50.

Chronic obstructive pulmonary disease exacerbations and progression in relation to ambient air pollutants exposure

Miglena Doneva  1 , Guenka Petrova  1 , Daniela Petrova  2 , Maria Kamusheva  1 , Valentina Petkova  1 , Konstantin Tachkov  1 , Ventsislava Pencheva  2 , Ognyan Georgiev  2
Affiliations

Chronic obstructive pulmonary disease exacerbations and progression in relation to ambient air pollutants exposure

Miglena Doneva et al. J Thorac Dis. 2019 Jun.

Abstract

Background: The information for the impact of air pollutants on the severity of chronic obstructive pulmonary disease (COPD) and hospital admissions in Bulgaria is scarce. The aim of the study is to assess the relationship between some ambient air pollution and exacerbations levels as well as hospital admissions of patients with COPD in Bulgaria.

Methods: A multi-center, prospective, one-year observational study was conducted among 426 COPD patients. Data from pollution monitoring are collected from the Executive Environment Agency (EEA).

Results: The results showed that the pollution with sulfur dioxide (SO2) is less than limit concentrations recommended by the European Union and World Health Organization (WHO), while the pollution with PM exceeds limits values of WHO two times. The mean rate of exacerbations in selected towns are between 0.5-3, the number of exacerbations with hospitalization are between 0.2-1.8 and length of hospital stay is between 1-14 days.

Conclusions: The study confirms that air pollution leads to increased number of exacerbations and hospital stay. The patients with mild level of COPD have 0.86 exacerbations and 2.61 days in hospital per year, while in case of very severe COPD these values increase 4 times. Outside pollutions lead to worsening of the disease severity and hospitalizations due to a higher rate of COPD exacerbations.

Keywords: Air pollution; chronic obstructive pulmonary disease (COPD); exacerbations; hospital stay; particulate matter.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The durability and number of exacerbations per patient per year.
Figure 2
Figure 2
The correlation between number of exacerbations and hospital admissions.
Figure 3
Figure 3
The numbers of exacerbations with hospital admission per patient per year.
Figure 4
Figure 4
Exacerbations per patient according to level of pollution. (A) PM10; (B) SO2.
See this image and copyright information in PMC

References

    1. WHO air quality guidelines: past, present and future. Copenhagen: WHO Regional Office for Europe; 2017.
    1. Krzyzanowski M, Apte J, Bonjour S, et al. Air pollution in the mega-cities. Curr Envir Health Report 2014;1:185-91. 10.1007/s40572-014-0019-7 - DOI
    1. WHO factsheets. Available online: http://www.who.int/mediacentre/factsheets/fs313/en/
    1. Abe KC, Miraglia SG. Health impact assessment of air pollution in São Paulo, Brazil. Int J Environ Res Public Health 2016;13. doi: . 10.3390/ijerph13070694 - DOI - PMC - PubMed
    1. WHO report 2012. Available online: https://www.who.int/gho/phe/outdoor_air_pollution/en/