Air pollution, lung function and COPD: results from the population-based UK Biobank study

TLDR

Ambient air pollution is known to raise respiratory mortality, yet its effects on lung function and COPD remain uncertain. The study aimed to assess whether ambient air pollution is linked to reduced lung function and higher COPD risk, and to identify vulnerability factors, using data from 303,887 UK Biobank participants. Cross‑sectional analyses of UK Biobank participants linked land‑use‑regression estimates of PM₂.₅, PM₁₀, PMcoarse, and NO₂ to FEV₁, FVC, FEV₁/FVC, and COPD status, while testing effect modification by sex, age, obesity, smoking, income, asthma, and occupation. Each 5 µg/m³ rise in PM₂.₅ lowered FEV₁ by 83 mL and FVC by 63 mL, and increased COPD odds by 52 % (PM₂.₅), 8 % (PM₁₀), and.

Abstract

Ambient air pollution increases the risk of respiratory mortality, but evidence for impacts on lung function and chronic obstructive pulmonary disease (COPD) is less well established. The aim was to evaluate whether ambient air pollution is associated with lung function and COPD, and explore potential vulnerability factors.We used UK Biobank data on 303 887 individuals aged 40-69 years, with complete covariate data and valid lung function measures. Cross-sectional analyses examined associations of land use regression-based estimates of particulate matter (particles with a 50% cut-off aerodynamic diameter of 2.5 and 10 µm: PM2.5 and PM10, respectively; and coarse particles with diameter between 2.5 μm and 10 μm: PMcoarse) and nitrogen dioxide (NO2) concentrations with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio and COPD (FEV1/FVC <lower limit of normal). Effect modification was investigated for sex, age, obesity, smoking status, household income, asthma status and occupations previously linked to COPD.Higher exposures to each pollutant were significantly associated with lower lung function. A 5 µg·m-3 increase in PM2.5 concentration was associated with lower FEV1 (-83.13 mL, 95% CI -92.50- -73.75 mL) and FVC (-62.62 mL, 95% CI -73.91- -51.32 mL). COPD prevalence was associated with higher concentrations of PM2.5 (OR 1.52, 95% CI 1.42-1.62, per 5 µg·m-3), PM10 (OR 1.08, 95% CI 1.00-1.16, per 5 µg·m-3) and NO2 (OR 1.12, 95% CI 1.10-1.14, per 10 µg·m-3), but not with PMcoarse Stronger lung function associations were seen for males, individuals from lower income households, and "at-risk" occupations, and higher COPD associations were seen for obese, lower income, and non-asthmatic participants.Ambient air pollution was associated with lower lung function and increased COPD prevalence in this large study.