Association of ambient air pollution with the prevalence and incidence of COPD

Tamara Schikowski*, Martin Adam, Alessandro Marcon, Yutong Cai, Andrea Vierkötter, Anne Elie Carsin, Benedicte Jacquemin, Zaina Al Kanani, Rob Beelen, Matthias Birk, Pierre Olivier Bridevaux, Bert Brunekeef, Peter Burney, Marta Cirach, Josef Cyrys, Kees De Hoogh, Roberto De Marco, Audrey De Nazelle, Christophe Declercq, Bertil ForsbergRebecca Hardy, Joachim Heinrich, Gerard Hoek, Debbie Jarvis, Dirk Keidel, Diane Kuh, Thomas Kuhlbusch, Enrica Migliore, Gioia Mosler, Mark J. Nieuwenhuijsen, Harish Phuleria, Thierry Rochat, Christian Schindler, Simona Villani, Ming Yi Tsai, Elisabeth Zemp, Anna Hansell, Francine Kauffmann, Jordi Sunyer, Nicole Probst-Hensch, Ursula Krämer, Nino Künzli

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

116 Citations (Scopus)


The role of air pollution in chronic obstructive pulmonary disease (COPD) remains uncertain. The aim was to assess the impact of chronic exposure to air pollution on COPD in four cohorts using the standardised ESCAPE exposure estimates. Annual average particulate matter (PM), nitrogen oxides (NO x) and road traffic exposure were assigned to home addresses using land-use regression models. COPD was defined by NHANES reference equation (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) less than the lower limit of normal) and the Global Initiative for Chronic Obstructive Lung Disease criterion (FEV1/FVC <0.70) and categorised by severity in non-asthmatics. We included 6550 subjects with assigned NOx and 3692 with PM measures. COPD was not associated with NO2 or PM10 in any individual cohort. In meta-analyses only NO2, NOx, PM10 and the traffic indicators were positively, although not significantly, associated with COPD. The only statistically significant associations were seen in females (COPD prevalence using GOLD: OR 1.57, 95% CI 1.11-2.23; and incidence: OR 1.79, 95% CI 1.21-2.68). None of the principal results were statistically significant, the weak positive associations of exposure with COPD and the significant subgroup findings need to be evaluated in further well standardised cohorts followed up for longer time, and with time-matched exposure assignments.

Original languageEnglish
Pages (from-to)614-626
Number of pages13
JournalEuropean Respiratory Journal
Issue number3
Publication statusPublished - 1 Sep 2014
Externally publishedYes


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