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Outdoor air pollution: impact on chronic obstructive pulmonary disease patients

Ko, Fanny WS; Hui, David SC

Current Opinion in Pulmonary Medicine: March 2009 - Volume 15 - Issue 2 - p 150–157
doi: 10.1097/MCP.0b013e32832185ee
Obstructive, occupational and environmental diseases: Edited by Basil Varkey

Purpose of review Chronic obstructive pulmonary disease (COPD) is an important disease worldwide, imposing huge economic burden on society. Outdoor air pollutants have a wide variety of harmful effects on humans, including local effects on the airway and systemic inflammation. Recent publications (2007–2008) on the effects of outdoor air pollutants specifically on COPD patients are reviewed in this article.

Recent findings Recent studies that assessed the effect of outdoor pollution on COPD mortality have mainly focused on particulate pollutants. Whether outdoor air pollution may lead to the development of COPD remains controversial, as there are conflicting data on whether outdoor pollution would lead to both short and long-term decline in lung function. An association is generally observed between increased levels of outdoor air pollutants and increased hospital admissions, emergency department visits and higher mortality for patients with COPD. There is some evidence that temperature may modify the effect of air pollutants on these patients.

Summary Although there is good evidence linking increased outdoor air pollution to increased morbidity, healthcare resources utilization and higher mortality among patients with COPD, it is controversial whether outdoor air pollution is a key factor in the development of this disease.

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong

Correspondence to Dr Fanny W.S. Ko, MD, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong Tel: +852 2632 2785; fax: +852 2637 5393; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.