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. 2023 Dec 15;79(1):35-42.
doi: 10.1136/thorax-2022-219691.

Combined effect of ozone and household air pollution on COPD in people aged less than 50 years old

Zhenzhen Xing  1   2 , Ting Yang  3 , Su Shi  4 , Xia Meng  4 , Di Chai  1 , WeiMing Liu  5 , Yaqi Tong  1 , Yuxia Wang  1 , Yali Ma  1 , MingMing Pan  1 , Jia Cui  1 , Huanyu Long  1 , Tieying Sun  1 , Renjie Chen  4 , YanFei Guo  6
Affiliations

Combined effect of ozone and household air pollution on COPD in people aged less than 50 years old

Zhenzhen Xing et al. Thorax. .

Abstract

Objectives: Air pollution has been suggested as an important risk factor for chronic obstructive pulmonary disease (COPD); however, evidence of interactive effects on COPD between different factors was sparse, especially for young adults. We aimed to assess the combined effects of ambient ozone (O3) and household air pollution on COPD in young individuals.

Methods: We conducted a population-based study of residents aged 15-50 years in the low-income and middle-income regions of western China. We used multivariable logistic regression models to examine the associations between long-term ozone exposure and COPD in young individuals.

Results: A total of 6537 young cases were identified among the participants, with a COPD prevalence rate of 7.8 (95% CI 7.2% to 8.5%), and most young COPD individuals were asymptomatic. Exposure to household air pollution was associated with COPD in young patients after adjustment for other confounding factors (OR 1.82, 95% CI 1.41 to 2.37). We also found positive associations of COPD with O3 per IQR increase of 20 ppb (OR 1.92, 95% CI 1.59 to 2.32). The individual effects of household air pollution and O3 were 1.68 (95% CI 1.18 to 2.46) and 1.55 (95% CI 0.99 to 2.43), respectively, while their joint effect was 3.28 (95% CI 2.35 to 4.69) with the relative excess risk due to interaction of 1.05 (95% CI 0.33 to 1.78).

Conclusions: This study concludes that exposure to ambient O3 and household air pollution might be important risk factors for COPD among young adults, and simultaneous exposure to high levels of the two pollutants may intensify their individual effects.

Keywords: COPD epidemiology; Health Economist.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Forest plot showing OR for young COPD participants. Each square represents an OR. The horizontal lines indicate 95% CIs. Adjusted for age, sex, BMI and education plus history of asthma, history of TB and environmental exposures (ozone (O3), HAP, smoking status and occupational exposure). BMI, body mass index; COPD, chronic obstructive pulmonary disease; HAP, household air pollution; TB, tuberculosis.
Figure 2
Figure 2
Concentration response curves between ozone (O3) exposures and COPD. COPD, chronic obstructive pulmonary disease; ppb, parts per billion.
See this image and copyright information in PMC

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