Ambient Air Pollution and the Burden of Respiratory Diseases: A Cross-Sectional Study of Urban Adults
Ambient Air Pollution and the Burden of Respiratory Diseases: A Cross-Sectional Study of Urban Adults
Author(s):M Aiswarya
Received: 2020-07-04
Accepted: 2020-08-01
Published: 2020-08-19
Abstract
Background: Ambient air pollution is a leading environmental risk factor for respiratory ill health, yet quantitative evidence from high-exposure urban populations remains limited. We examined the association between residential ambient air pollution and respiratory morbidity and lung function in urban adults.
Methods: In a population-based cross-sectional study, 2,400 community-dwelling adults were sampled using a multistage cluster design. Long-term residential exposure to PM2.5, PM10, and NO2 was estimated by land-use regression and categorised into tertiles. Respiratory symptoms and physician-diagnosed asthma and COPD were ascertained by standardised questionnaire, and lung function by spirometry. Multivariable logistic and linear regression models estimated adjusted associations per 10 µg/m³ increment in each pollutant.
Results: The prevalence of chronic respiratory symptoms and of physician-diagnosed asthma and COPD increased monotonically across PM2.5 tertiles (all P for trend < 0.001). Each 10 µg/m³ increase in PM2.5 was associated with higher odds of COPD (adjusted odds ratio [aOR] 1.33, 95% CI 1.15–1.54), wheeze (aOR 1.28, 1.15–1.43), and any respiratory outcome (aOR 1.26, 1.16–1.37). Mean FEV1 was 0.21 L lower in the highest versus lowest exposure category (95% CI −0.29 to −0.13).
Conclusion: Higher ambient air pollution exposure was associated with greater respiratory morbidity and poorer lung function in a dose-dependent manner, supporting air quality improvement as a public health priority.
Methods: In a population-based cross-sectional study, 2,400 community-dwelling adults were sampled using a multistage cluster design. Long-term residential exposure to PM2.5, PM10, and NO2 was estimated by land-use regression and categorised into tertiles. Respiratory symptoms and physician-diagnosed asthma and COPD were ascertained by standardised questionnaire, and lung function by spirometry. Multivariable logistic and linear regression models estimated adjusted associations per 10 µg/m³ increment in each pollutant.
Results: The prevalence of chronic respiratory symptoms and of physician-diagnosed asthma and COPD increased monotonically across PM2.5 tertiles (all P for trend < 0.001). Each 10 µg/m³ increase in PM2.5 was associated with higher odds of COPD (adjusted odds ratio [aOR] 1.33, 95% CI 1.15–1.54), wheeze (aOR 1.28, 1.15–1.43), and any respiratory outcome (aOR 1.26, 1.16–1.37). Mean FEV1 was 0.21 L lower in the highest versus lowest exposure category (95% CI −0.29 to −0.13).
Conclusion: Higher ambient air pollution exposure was associated with greater respiratory morbidity and poorer lung function in a dose-dependent manner, supporting air quality improvement as a public health priority.
Keywords: air pollution; particulate matter; PM2.5; respiratory disease; COPD; asthma; lung function; cross-sectional study
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