Risk of Developing Chronic Obstructive Pulmonary Disease in Non-Smoking Adults Exposed to Particulate Matter 2.5 Compared to Those Without Exposure

Abstract

Background: Chronic obstructive pulmonary disease (COPD) development involves a complex pathway of host and environmental factors. Other than cigarette smoking, previous studies showed air pollution (such as PM_2.5) exposure might also have an important role in COPD development because it might lead to airway remodeling and chronic lung inflammation. However, the cause and effect association between PM_2.5 and COPD in non-smoking patients is still unclear.

Methods: Literature search was performed in 5 online medical databases (PubMed, EMBASE, ScienceDirect, EBSCOhost, and Cochrane Library) along with hand-searching in Google Scholar. Filtering literature with the inclusion and exclusion criteria resulted in three relevant articles (1 case-control and 2 cohort studies). Critical appraisal was conducted using the Center of Evidence-Based Medicine (CEBM) worksheet from University of Oxford for etiologic studies.

Results: All three articles were considered valid. The prospective cohort was decided unimportant because of the non-significant adjusted hazard ratio (HR 1.23; 95% confidence interval [CI] 0.50-3.06). The case-control and retrospective study had important results with adjusted odds ratio 1.29 (95%CI 1.01-1.65) and 1.69 (95%CI 1.11-2.58), respectively. The relatively low number needed to harm (NNH) of 10-23 indicated that PM_2.5 exposure was a meaningful factor for the risk of developing COPD in non-smoker adults. Both articles were considered applicable for our case.

Conclusion: Non-smoking adults with exposure to PM_2.5, compared to those without exposure, are at higher risk of developing COPD.