Environmental Determinants of Chronic Obstructive Pulmonary Disease: The Role of Air Pollutants in Hospitalization Trends

Azam Rahimzadeh   Kalaleh; Fatemeh  Bahrambeygi; Saeid  Besharati; Masoumeh  Nomani; Zobeydeh  Saeed

doi:10.18502/ijph.v55i1.20981

Azam Rahimzadeh Kalaleh Nursing Research Center of Respiratory Diseases (NRCRD), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Fatemeh Bahrambeygi Nursing Research Center of Respiratory Diseases (NRCRD), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Saeid Besharati Nursing Research Center of Respiratory Diseases (NRCRD), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Masoumeh Nomani Research Center of Thoracic Oncology (RCTO), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
Zobeydeh Saeed Nursing Research Center of Respiratory Diseases (NRCRD), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v55i1.20981

Keywords: Air pollution; Air quality index (AQI); Relative risk

Abstract

Background: Air pollution is an important global public health concern with multiple consequences for the individuals with respiratory diseases. We aimed to assess the influence of air pollution variables on the hospitalization rates of individuals with chronic obstructive pulmonary disease (COPD).

Methods: Atmospheric pollutant parameters, such as NO₂, SO₂, CO, O₃, PM₂.₅, PM₁₀, and AQI, from Mar 2022 to Mar 2024 were measured. The information of COPD patients was extracted from Masih Daneshvari Hospital (referral center for respiratory diseases in Tehran). The relationship among data, Relative Risk (RR), and Attributable Proportion (AP) for prolonged exposure to air pollutants during a biennial period was assessed using the Air Quality Plus (2.2.4) software.

Results: March 2023 saw the highest number of hospitalizations, with an average of 4.16 cases. This was concurrent with an elevation in PM₂.₅ concentrations. Furthermore, the month of Aug 2023 exhibited a high hospitalization rate, with an average of 3.8 cases, linked to the rise in the concentration of PM₂.₅, NO₂, and O₃ air pollutants. The highest mean relative risks (RRs) associated with acute exacerbation of COPD were as follows: (PM₁₀: 1.83, PM₂.₅: 1.76).

Conclusion: High levels of air pollution, specially PM₂.₅, significantly worsen COPD conditions and are a main trigger for COPD exacerbation. Consequently, enforcing more stringent air quality regulations is an essential public health approach to alleviate the incidence of COPD.