Objective To investigate the risks of chronic obstructive pulmonary disease (COPD) mortality associated with short-term exposure to air pollution, and to identify vulnerable populations.
Methods COPD mortality cases and daily meteorological data including air pollution between 2003 and 2012 in Shanghai were collected. Time-stratified case-crossover approach was used to assess the association between daily concentrations of air pollutants and COPD mortality. The effects of age, gender, and educational attainment were also examined as effect modifiers.
Results Altogether 106 525 mortality cases were collected. COPD was found to be significantly associated with PM10, sulfur dioxide (SO2), and nitrogen dioxide (NO2). The OR (95% CI) of COPD mortality for a 10-μg/m3 increase of PM10, SO2 , and NO2 was 1.005 (1.003-1.007), 1.014 (1.010-1.018), and 1.014 (1.009-1.019) respectively for lag 0-3 days (Lag03). For an increase of 10 μg/m3 for SO2 , the OR (95% CI) of COPD mortality for people with low educational attainment was 1.011 (1.008-1.015) for lag 3 days (Lag3), which was substantially higher than those with high educational attainment 0.995 (0.980-1.010).
Conclusion This study provides new evidence for the association between exposure to ambient air pollution and COPD mortality risk. Our results also suggest that low educational attainment may increase the risk for COPD mortality in relation to air pollution exposure.
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