Joint effect of long-term exposure to ambient air pollution on the prevalence of chronic obstructive pulmonary disease using the Korea National Health and Nutrition Examination Survey 2010-2019

Eunjin Kwon; Taiyue Jin; Young-Ah You; Byungmi Kim

doi:10.1016/j.chemosphere.2024.142137

Joint effect of long-term exposure to ambient air pollution on the prevalence of chronic obstructive pulmonary disease using the Korea National Health and Nutrition Examination Survey 2010-2019

Chemosphere. 2024 Apr 24:358:142137. doi: 10.1016/j.chemosphere.2024.142137. Online ahead of print.

Authors

Eunjin Kwon¹, Taiyue Jin², Young-Ah You³, Byungmi Kim⁴

Affiliations

¹ Division of Allergy and Respiratory Disease Research, Department of Chronic Disease Convergence Research, National Institute of Health, Cheongju, South Korea.
² Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, South Korea.
³ Department of Obstetrics and Gynecology, Ewha Medical Research Institute, Ewha Womans University Medical School, 07985 Seoul, South Korea.
⁴ Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, South Korea; Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea. Electronic address: kbm5369@ncc.re.kr.

PMID: 38670507
DOI: 10.1016/j.chemosphere.2024.142137

Abstract

Background: Little is known about the relationship between long-term joint exposure to mixtures of air pollutants and the prevalence of chronic obstructive pulmonary disease (COPD). We aimed to assess the joint impact of long-term exposure to ambient air pollution on the prevalence of COPD in Korea, especially in areas with high levels of air pollution.

Methods: We included 22,387 participants who underwent spirometry tests in 2010-2019. The community multiscale air quality model was used to estimate the levels of ambient air pollution at residential addresses. The average exposure over the 5 years before the examination date was used to calculate the concentrations of air pollution. Forced expiratory volume in 1 s and forced vital capacity were used to define restrictive lung disease, COPD, and moderate-to-severe COPD. Quantile-based g-computation models were used to assess the joint impact of air pollution on COPD prevalence.

Results: A total of 2535 cases of restrictive lung disease, 2787 cases of COPD, and 1399 cases of moderate-to-severe COPD were identified. In the individual pollutant model, long-term exposure was significantly associated with both restrictive lung disease and COPD. In the mixture pollutant model, the odds ratios (ORs, 95% confidence intervals) for restrictive lung disease increased with each quartile increment in the 1- to 5-year average mixtures: 1.14 (1.02-1.28, 1 year), 1.25 (1.11-1.41, 2 years), 1.26 (1.11-1.42, 3 years), 1.32 (1.16-1.51, 4 years), and 1.37 (1.19-1.58, 5 years), respectively. The increase in ORs of restrictive lung disease accelerated over time. By contrast, the ORs of COPD showed a decreasing trend over time.

Conclusions: Long-term exposure to air pollutants, both individually and jointly, was associated with an increased risk of developing COPD, particularly restrictive lung disease. Our findings highlight the importance of comprehensively assessing exposure to various air pollutants in relation to COPD.

Keywords: Air pollution; Chronic obstructive pulmonary disease; Joint effect; Long-term exposure; Quantile-based g-computation; Restrictive lung disease.