PT  - JOURNAL ARTICLE
AU  - Mona Elbarbary
AU  - Artem Oganesyan
AU  - Trenton Honda
AU  - Patrick Kelly
AU  - Ying Zhang
AU  - Yuming Guo
AU  - Geoffrey Morgan
AU  - Yanfei Guo
AU  - Joel Negin
TI  - Ambient air pollution, lung function and COPD: cross-sectional analysis from the WHO Study of AGEing and adult health wave 1
AID  - 10.1136/bmjresp-2020-000684
DP  - 2020 Dec 01
TA  - BMJ Open Respiratory Research
PG  - e000684
VI  - 7
IP  - 1
4099  - http://bmjopenrespres.bmj.com/content/7/1/e000684.short
4100  - http://bmjopenrespres.bmj.com/content/7/1/e000684.full
SO  - BMJ Open Resp Res2020 Dec 01; 7
AB  - Background Long-term exposure to ambient air pollution leads to respiratory morbidity and mortality; however, the evidence of the effect on lung function and chronic obstructive pulmonary disease (COPD) in older adult populations is inconsistent.Objective To address this knowledge gap, we investigated the associations between particulate matter (PM), nitrogen dioxide (NO2) exposure and lung function, as well as COPD prevalence, in older Chinese adults.Methods We used data from the WHO Study on global AGEing and adult health (SAGE) China Wave 1, which includes 11, 693 participants from 64 townships in China. A cross-sectional analysis explored the association between satellite-based air pollution exposure estimates (PM with an aerodynamic diameter of ≤10 µm [PM10], ≤2.5 µm [PM2.5] and NO2) and forced expiratory volume in one second (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio and COPD (defined as post-bronchodilator FEV1/FVC <70%). Data on lung function changes were further stratified by COPD status.Results Higher exposure to each pollutant was associated with lower lung function. An IQR (26.1 µg/m3) increase in PM2.5 was associated with lower FEV1 (−71.88 mL, 95% CI –92.13 to –51.64) and FEV1/FVC (−2.81, 95% CI −3.37 to –2.25). For NO2, an IQR increment of 26.8 µg/m3 was associated with decreases in FEV1 (−60.12 mL, 95% CI –84.00 to –36.23) and FVC (−32.33 mL, 95% CI –56.35 to –8.32). A 31.2 µg/m3 IQR increase in PM10 was linked to reduced FEV1 (−8.86 mL, 95% CI −5.40 to 23.11) and FEV1/FVC (−1.85, 95% CI −2.24 to –1.46). These associations were stronger for participants with COPD. Also, COPD prevalence was linked to higher levels of PM2.5 (POR 1.35, 95% CI 1.26 to 1.43), PM10 (POR 1.24, 95% CI 1.18 to 1.29) and NO2 (POR 1.04, 95% CI 0.98 to 1.11).Conclusion Ambient air pollution was associated with lower lung function, especially in individuals with COPD, and increased COPD prevalence in older Chinese adults.