. 2021 Dec;76(12):1236-1241.

doi: 10.1136/thoraxjnl-2020-216223. Epub 2021 May 11.

Chronic airflow obstruction and ambient particulate air pollution

Andre F S Amaral¹, Peter G J Burney², Jaymini Patel², Cosetta Minelli², Filip Mejza³, David M Mannino⁴, Terence A R Seemungal⁵, Padukudru Anand Mahesh⁶, Li Cher Lo⁷, Christer Janson⁸, Sanjay Juvekar⁹, Meriam Denguezli¹⁰, Imed Harrabi¹⁰, Emiel F M Wouters¹¹, Hamid Cherkaski¹², Kevin Mortimer^{13

14}, Rain Jogi¹⁵, Eric D Bateman¹⁶, Elaine Fuertes², Mohammed Al Ghobain¹⁷, Wan Tan¹⁸, Daniel O Obaseki¹⁹, Asma El Sony²⁰, Michael Studnicka²¹, Althea Aquart-Stewart²², Parvaiz Koul²³, Herve Lawin²⁴, Asaad Ahmed Nafees²⁵, Olayemi Awopeju¹⁹, Gregory E Erhabor¹⁹, Thorarinn Gislason^{26

27}, Tobias Welte²⁸, Amund Gulsvik²⁹, Rune Nielsen^{29

30}, Louisa Gnatiuc³¹, Ali Kocabas³², Guy B Marks^{33

34}, Talant Sooronbaev³⁵, Bertrand Hugo Mbatchou Ngahane³⁶, Cristina Barbara³⁷, A Sonia Buist³⁸; BOLD (Burden of Obstructive Lung Disease) Collaborative Research Group; BOLD (Burden of Obstructive Lung Disease) Collaborative Research Group members

Collaborators, Affiliations

Collaborators

Hasan Hafizi, Anila Aliko, Donika Bardhi, Holta Tafa, Natasha Thanasi, Arian Mezini, Alma Teferici, Dafina Todri, Jolanda Nikolla, Rezarta Kazasi, Hamid Hacene Cherkaski, Amira Bengrait, Tabarek Haddad, Ibtissem Zgaoula, Maamar Ghit, Abdelhamid Roubhia, Soumaya Boudra, Feryal Atoui, Randa Yakoubi, Rachid Benali, Abdelghani Bencheikh, Nadia Ait-Khaled, Guy Marks, Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle, Michael Studnicka, Torkil Dawes, Bernd Lamprecht, Lea Schirhofer, Akramul Islam, Syed Masud Ahmed, Shayla Islam, Qazi Shafayetul Islam, Mesbah Ul-Haque, Tridib Roy Chowdhury, Sukantha Kumar Chatterjee, Dulal Mia, Shyamal Chandra Das, Mizanur Rahman, Nazrul Islam, Shahaz Uddin, Nurul Islam, Luiza Khatun, Monira Parvin, Abdul Awal Khan, Maidul Islam, Herve Lawin, Arsene Kpangon, Karl Kpossou, Gildas Agodokpessi, Paul Ayelo, Benjamin Fayomi, Bertrand Mbatchou, Atongno Humphrey Ashu, Wan C Tan, Christine Lo, NanShan Zhong, Shengming Liu, Jiachun Lu, Pixin Ran, Dali Wang, Jingping Zheng, Yumin Zhou, Rain Jõgi, Hendrik Laja, Katrin Ulst, Vappu Zobel, Toomas-Julius Lill, Ayola Akim Adegnika, Tobias Welte, Isabelle Bodemann, Henning Geldmacher, Alexandra Schweda-Linow, Thorarinn Gislason, Bryndis Benedikdtsdottir, Kristin Jörundsdottir, Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gundmundsson, Mahesh Rao, Parvaiz A Koul, Sajjad Malik, Nissar A Hakim, Umar Hafiz Khan, Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde, Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup, Sanjay Juvekar, Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke, Sharda Chaudhary, Suvarna Bondre, Savita Walke, Ashleshsa Gawhane, Anil Sapkal, Rupali Argade, Vijay Gaikwad, Sundeep Salvi, Bill Brashier, Jyoti Londhe, Sapna Madas, Althea Aquart-Stewart, Akosua Francia Aikman, Talant M Sooronbaev, Bermet M Estebesova, Meerim Akmatalieva, Saadat Usenbaeva, Jypara Kydyrova, Eliza Bostonova, Ulan Sheraliev, Nuridin Marajapov, Nurgul Toktogulova, Berik Emilov, Toktogul Azilova, Gulnara Beishekeeva, Nasyikat Dononbaeva, Aijamal Tabyshova, Kevin Mortimer, Wezzie Nyapigoti, Ernest Mwangoka, Mayamiko Kambwili, Martha Chipeta, Gloria Banda, Suzgo Mkandawire, Justice Banda, Li-Cher Loh, Abdul Rashid, Siti Sholehah, Mohamed C Benjelloun, Chakib Nejjari, Mohamed Elbiaze, Karima El Rhazi, E F M Wouters, Lowie Vanfleteren, Daniel Obaseki, Gregory Erhabor, Olayemi Awopeju, Olufemi Adewole, Amund Gulsvik, Tina Endresen, Lene Svendsen, Asaad A Nafees, Muhammad Irfan, Zafar Fatmi, Aysha Zahidie, Natasha Shaukat, Meesha Iqbal, Luisito F Idolor, Teresita S de Guia, Norberto A Francisco, Camilo C Roa, Fernando G Ayuyao, Cecil Z Tady, Daniel T Tan, Sylvia Banal-Yang, Vincent M Balanag, Renato B Dantes, Lourdes Amarillo, Lakan U Berratio, Lenora C Fernandez, Norberto A Francisco, Gerard S Garcia, Teresita S de Guia, Luisito F Idolor, Sullian S Naval, Thessa Reyes, Camilo C Roa, Ma Flordeliza Sanchez, Leander P Simpao, Ewa Nizankowska Mogilnicka, Jakub Frey, Rafal Harat, Filip Mejza, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Cristina Bárbara, Fátima Rodrigues, Hermínia Dias, João Cardoso, João Almeida, Maria João Matos, Paula Simão, Moutinho Santos, Reis Ferreira, M Al Ghobain, H Alorainy, E El-Hamad, M Al Hajjaj, A Hashi, R Dela, R Fanuncio, E Doloriel, I Marciano, L Safia, Eric Bateman, Anamika Jithoo, Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck, Kirthi Gunasekera, Rajitha Wickremasinghe, Asma Elsony, Hana A Elsadig, Nada Bakery Osman, Bandar Salah Noory, Monjda Awad Mohamed, Suhaiba Khalifa, Mahmoud Elhadi, Mohand Hassan, Dalia Abdelmonam, Christer Janson, Inga Sif Olafsdottir, Katarina Nisser, Ulrike Spetz Nyström, Gunilla Hägg, Gun-Marie Lund, Terence Seemungal, Fallon Lutchmansingh, Liane Conyette, Imed Harrabi, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha, Wahbi Belhaj Khalifa, Ali Kocabaş, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan, Peter Gj Burney, Anamika Jithoo, Louisa Gnatiuc, Hadia Azar, Jaymini Patel, Caron Amor, James Potts, Michael Tumilty, Fiona McLean, Risha Dudhaiya, A Sonia Buist, Mary Ann McBurnie, William M Vollmer, Suzanne Gillespie, Sean Sullivan, Todd A Lee, Kevin B Weiss, Robert L Jensen, Robert Crapo, Paul Enright, David M Mannino, John Cain, Rebecca Copeland, Dana Hazen, Jennifer Methvin

Affiliations

¹ National Heart and Lung Institute, Imperial College London, London, UK a.amaral@imperial.ac.uk.
² National Heart and Lung Institute, Imperial College London, London, UK.
³ Centre for Evidence Based Medicine, 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.
⁴ Preventive Medicine and Environmental Health, University of Kentucky, Lexington, Kentucky, USA.
⁵ Clinical Medical Sciences, The University of the West Indies at St Augustine, Saint Augustine, Tunapuna-Piarco, Trinidad and Tobago.
⁶ Respiratory Medicine, JSS Medical College and Hospital, Mysore, Karnataka, India.
⁷ Department of Medicine, RCSI & UCD Malaysia Campus, Georgetown, Pulau Pinang, Malaysia.
⁸ Respiratory, Allergy and Sleep Research, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
⁹ Vadu Rural Health Program, King Edward Memorial Hospital Pune, Pune, Maharashtra, India.
¹⁰ Laboratoire de Physiologie et des Explorations Fonctionnelles, Universite de Sousse Faculte de Medecine de Sousse, Sousse, Tunisia.
¹¹ Department of Respiratory Medicine, Maastricht University, Maastricht, The Netherlands.
¹² Service de Epidemiologie et Medecine Preventive, Universite Badji Mokhtar Annaba Faculte de Medecine, Annaba, Algeria.
¹³ Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
¹⁴ Respiratory Medicine, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK.
¹⁵ Lung Clinic, Tartu University Hospital, Tartu, Estonia.
¹⁶ Division of Respiratory Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa.
¹⁷ Department of Medicine, King Saud bin Abdulaziz University for Health Sciences & King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.
¹⁸ iCAPTURE Centre, The University of British Columbia, Vancouver, Ontario, Canada.
¹⁹ Medicine, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria.
²⁰ Director, Epi-Lab, Khartoum, Sudan.
²¹ Department of Pulmonary Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria.
²² Department of Internal Medicine, The University of the West Indies at Mona, Mona, Saint Andrew, Jamaica.
²³ Pulmonary Medicine, SKIMS, Srinagar, Jammu and Kashmir, India.
²⁴ Occupational and Environmental Health, University of Abomey-Calavi, Cotonou, Littoral, Benin.
²⁵ Community Health Sciences, Aga Khan University, Karachi, Pakistan.
²⁶ Department of Sleep, Landspitali University Hospital, Reykjavik, UK.
²⁷ Medicine, University of Iceland, Reykjavik, Iceland.
²⁸ Respiratory Medicine, Medizinische Hochschule Hannover, Hannover, Germany.
²⁹ Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
³⁰ Department of Clinical Science, University of Bergen, Bergen, Norway.
³¹ Nuffield Department of Population Health, Oxford University, Oxford, UK.
³² Department of Chest Disease, Cukurova University, School of Medicine, Adana, Turkey.
³³ Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, Glebe, New South Wales, Australia.
³⁴ South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
³⁵ Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan.
³⁶ Internal Medicine, Douala General Hospital, Douala, Cameroon.
³⁷ Institute of Environmental Health, Lisbon Medical School, Lisbon University, Lisboa, Portugal.
³⁸ Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, Oregon, USA.

PMID: 33975927
PMCID: PMC8606424
DOI: 10.1136/thoraxjnl-2020-216223

Chronic airflow obstruction and ambient particulate air pollution

Andre F S Amaral et al. Thorax. 2021 Dec.

. 2021 Dec;76(12):1236-1241.

doi: 10.1136/thoraxjnl-2020-216223. Epub 2021 May 11.

Authors

Collaborators

Hasan Hafizi, Anila Aliko, Donika Bardhi, Holta Tafa, Natasha Thanasi, Arian Mezini, Alma Teferici, Dafina Todri, Jolanda Nikolla, Rezarta Kazasi, Hamid Hacene Cherkaski, Amira Bengrait, Tabarek Haddad, Ibtissem Zgaoula, Maamar Ghit, Abdelhamid Roubhia, Soumaya Boudra, Feryal Atoui, Randa Yakoubi, Rachid Benali, Abdelghani Bencheikh, Nadia Ait-Khaled, Guy Marks, Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle, Michael Studnicka, Torkil Dawes, Bernd Lamprecht, Lea Schirhofer, Akramul Islam, Syed Masud Ahmed, Shayla Islam, Qazi Shafayetul Islam, Mesbah Ul-Haque, Tridib Roy Chowdhury, Sukantha Kumar Chatterjee, Dulal Mia, Shyamal Chandra Das, Mizanur Rahman, Nazrul Islam, Shahaz Uddin, Nurul Islam, Luiza Khatun, Monira Parvin, Abdul Awal Khan, Maidul Islam, Herve Lawin, Arsene Kpangon, Karl Kpossou, Gildas Agodokpessi, Paul Ayelo, Benjamin Fayomi, Bertrand Mbatchou, Atongno Humphrey Ashu, Wan C Tan, Christine Lo, NanShan Zhong, Shengming Liu, Jiachun Lu, Pixin Ran, Dali Wang, Jingping Zheng, Yumin Zhou, Rain Jõgi, Hendrik Laja, Katrin Ulst, Vappu Zobel, Toomas-Julius Lill, Ayola Akim Adegnika, Tobias Welte, Isabelle Bodemann, Henning Geldmacher, Alexandra Schweda-Linow, Thorarinn Gislason, Bryndis Benedikdtsdottir, Kristin Jörundsdottir, Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gundmundsson, Mahesh Rao, Parvaiz A Koul, Sajjad Malik, Nissar A Hakim, Umar Hafiz Khan, Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde, Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup, Sanjay Juvekar, Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke, Sharda Chaudhary, Suvarna Bondre, Savita Walke, Ashleshsa Gawhane, Anil Sapkal, Rupali Argade, Vijay Gaikwad, Sundeep Salvi, Bill Brashier, Jyoti Londhe, Sapna Madas, Althea Aquart-Stewart, Akosua Francia Aikman, Talant M Sooronbaev, Bermet M Estebesova, Meerim Akmatalieva, Saadat Usenbaeva, Jypara Kydyrova, Eliza Bostonova, Ulan Sheraliev, Nuridin Marajapov, Nurgul Toktogulova, Berik Emilov, Toktogul Azilova, Gulnara Beishekeeva, Nasyikat Dononbaeva, Aijamal Tabyshova, Kevin Mortimer, Wezzie Nyapigoti, Ernest Mwangoka, Mayamiko Kambwili, Martha Chipeta, Gloria Banda, Suzgo Mkandawire, Justice Banda, Li-Cher Loh, Abdul Rashid, Siti Sholehah, Mohamed C Benjelloun, Chakib Nejjari, Mohamed Elbiaze, Karima El Rhazi, E F M Wouters, Lowie Vanfleteren, Daniel Obaseki, Gregory Erhabor, Olayemi Awopeju, Olufemi Adewole, Amund Gulsvik, Tina Endresen, Lene Svendsen, Asaad A Nafees, Muhammad Irfan, Zafar Fatmi, Aysha Zahidie, Natasha Shaukat, Meesha Iqbal, Luisito F Idolor, Teresita S de Guia, Norberto A Francisco, Camilo C Roa, Fernando G Ayuyao, Cecil Z Tady, Daniel T Tan, Sylvia Banal-Yang, Vincent M Balanag, Renato B Dantes, Lourdes Amarillo, Lakan U Berratio, Lenora C Fernandez, Norberto A Francisco, Gerard S Garcia, Teresita S de Guia, Luisito F Idolor, Sullian S Naval, Thessa Reyes, Camilo C Roa, Ma Flordeliza Sanchez, Leander P Simpao, Ewa Nizankowska Mogilnicka, Jakub Frey, Rafal Harat, Filip Mejza, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Cristina Bárbara, Fátima Rodrigues, Hermínia Dias, João Cardoso, João Almeida, Maria João Matos, Paula Simão, Moutinho Santos, Reis Ferreira, M Al Ghobain, H Alorainy, E El-Hamad, M Al Hajjaj, A Hashi, R Dela, R Fanuncio, E Doloriel, I Marciano, L Safia, Eric Bateman, Anamika Jithoo, Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck, Kirthi Gunasekera, Rajitha Wickremasinghe, Asma Elsony, Hana A Elsadig, Nada Bakery Osman, Bandar Salah Noory, Monjda Awad Mohamed, Suhaiba Khalifa, Mahmoud Elhadi, Mohand Hassan, Dalia Abdelmonam, Christer Janson, Inga Sif Olafsdottir, Katarina Nisser, Ulrike Spetz Nyström, Gunilla Hägg, Gun-Marie Lund, Terence Seemungal, Fallon Lutchmansingh, Liane Conyette, Imed Harrabi, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha, Wahbi Belhaj Khalifa, Ali Kocabaş, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan, Peter Gj Burney, Anamika Jithoo, Louisa Gnatiuc, Hadia Azar, Jaymini Patel, Caron Amor, James Potts, Michael Tumilty, Fiona McLean, Risha Dudhaiya, A Sonia Buist, Mary Ann McBurnie, William M Vollmer, Suzanne Gillespie, Sean Sullivan, Todd A Lee, Kevin B Weiss, Robert L Jensen, Robert Crapo, Paul Enright, David M Mannino, John Cain, Rebecca Copeland, Dana Hazen, Jennifer Methvin

Affiliations

¹ National Heart and Lung Institute, Imperial College London, London, UK a.amaral@imperial.ac.uk.
² National Heart and Lung Institute, Imperial College London, London, UK.
³ Centre for Evidence Based Medicine, 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.
⁴ Preventive Medicine and Environmental Health, University of Kentucky, Lexington, Kentucky, USA.
⁵ Clinical Medical Sciences, The University of the West Indies at St Augustine, Saint Augustine, Tunapuna-Piarco, Trinidad and Tobago.
⁶ Respiratory Medicine, JSS Medical College and Hospital, Mysore, Karnataka, India.
⁷ Department of Medicine, RCSI & UCD Malaysia Campus, Georgetown, Pulau Pinang, Malaysia.
⁸ Respiratory, Allergy and Sleep Research, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
⁹ Vadu Rural Health Program, King Edward Memorial Hospital Pune, Pune, Maharashtra, India.
¹⁰ Laboratoire de Physiologie et des Explorations Fonctionnelles, Universite de Sousse Faculte de Medecine de Sousse, Sousse, Tunisia.
¹¹ Department of Respiratory Medicine, Maastricht University, Maastricht, The Netherlands.
¹² Service de Epidemiologie et Medecine Preventive, Universite Badji Mokhtar Annaba Faculte de Medecine, Annaba, Algeria.
¹³ Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
¹⁴ Respiratory Medicine, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK.
¹⁵ Lung Clinic, Tartu University Hospital, Tartu, Estonia.
¹⁶ Division of Respiratory Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa.
¹⁷ Department of Medicine, King Saud bin Abdulaziz University for Health Sciences & King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.
¹⁸ iCAPTURE Centre, The University of British Columbia, Vancouver, Ontario, Canada.
¹⁹ Medicine, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria.
²⁰ Director, Epi-Lab, Khartoum, Sudan.
²¹ Department of Pulmonary Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria.
²² Department of Internal Medicine, The University of the West Indies at Mona, Mona, Saint Andrew, Jamaica.
²³ Pulmonary Medicine, SKIMS, Srinagar, Jammu and Kashmir, India.
²⁴ Occupational and Environmental Health, University of Abomey-Calavi, Cotonou, Littoral, Benin.
²⁵ Community Health Sciences, Aga Khan University, Karachi, Pakistan.
²⁶ Department of Sleep, Landspitali University Hospital, Reykjavik, UK.
²⁷ Medicine, University of Iceland, Reykjavik, Iceland.
²⁸ Respiratory Medicine, Medizinische Hochschule Hannover, Hannover, Germany.
²⁹ Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
³⁰ Department of Clinical Science, University of Bergen, Bergen, Norway.
³¹ Nuffield Department of Population Health, Oxford University, Oxford, UK.
³² Department of Chest Disease, Cukurova University, School of Medicine, Adana, Turkey.
³³ Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, Glebe, New South Wales, Australia.
³⁴ South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
³⁵ Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan.
³⁶ Internal Medicine, Douala General Hospital, Douala, Cameroon.
³⁷ Institute of Environmental Health, Lisbon Medical School, Lisbon University, Lisboa, Portugal.
³⁸ Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, Oregon, USA.

PMID: 33975927
PMCID: PMC8606424
DOI: 10.1136/thoraxjnl-2020-216223

Abstract

Smoking is the most well-established cause of chronic airflow obstruction (CAO) but particulate air pollution and poverty have also been implicated. We regressed sex-specific prevalence of CAO from 41 Burden of Obstructive Lung Disease study sites against smoking prevalence from the same study, the gross national income per capita and the local annual mean level of ambient particulate matter (PM_2.5) using negative binomial regression. The prevalence of CAO was not independently associated with PM_2.5 but was strongly associated with smoking and was also associated with poverty. Strengthening tobacco control and improved understanding of the link between CAO and poverty should be prioritised.

Keywords: COPD epidemiology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: RN reports grants and personal fees from Boehringer Ingelheim, AstraZeneca and Novartis outside the submitted work. EDB reports personal fees from Novartis, AstraZeneca, Orion, Menarirni, Boehringer Ingelheim and ALK outside the submitted work. KM reports grants from GlaxoSmithKline during the conduct of the study. TW reports grants from Boehringer Ingelheim and Pfizer during the conduct of the study. FM reports fees from Medycyba Praktyczna, Sandoz and Chiesi outside the submitted work. DM reports salary and shares from GlaxoSmithKline outside the submitted work. IH reports grants from Boehringer Ingelheim during the conduct of the study.

Figures

**Figure 1**
Relation between prevalence of chronic airflow obstruction and annual mean levels of (a) PM_2.5 (all composition, μg/m³) for the whole sample, (B) PM_2.5 (all composition, μg/m³) for never smokers and (C) PM_2.5 (dust and sea-salt removed, μg/m³) for the whole sample.

See this image and copyright information in PMC

References

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Chronic airflow obstruction and ambient particulate air pollution

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Chronic airflow obstruction and ambient particulate air pollution

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Conflict of interest statement

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