Associations between Ambient Particulate Matter and Nitrogen Dioxide and Chronic Obstructive Pulmonary Diseases in Adults and Effect Modification by Demographic and Lifestyle Factors

This study was undertaken to investigate the associations between chronic exposure to particulate matter of medium aerodynamic diameter <= 10 or <= 2.5 mu m (PM10 or PM2.5) and nitrogen dioxide (NO2) levels and lung function and to examine a possible change in these relationships by demographic and lifestyle factors. Chronic obstructive pulmonary disease (COPD) was defined using the Global Initiative for COPD criteria (forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70%). Associations of lung function and COPD with PM10 or PM2.5 or NO2 were examined using linear and logistic regression analyses among 1264 Korean adults. The highest tertiles of PM2.5 (>= 37.1 mu g/m(3)) and NO2 (>= 53.8 mu g/m(3)) exposure were significantly associated with COPD (highest versus lowest tertile of PM2.5: adjusted odds ratio (OR) = 1.79, 95% CI: 1.02-3.13; highest versus lowest tertile of NO2: adjusted OR = 1.83, 95% CI: 1.04-3.21). A 10 mu g/m(3) increase in PM10 concentration was associated with a 1.85 L (95% CI -3.65 to -0.05) decrease in FEV1 and a 1.73 L (95% CI -3.35 to -0.12) decrease in FVC, with the strongest negative association among older people and those with less education. Reduced lung function was associated with PM2.5 exposure in subjects with no physical activity. This study provides evidence that exposure to ambient air pollution has adverse effects on lung function in adults.