Association between ambient air pollution and mortality from chronic obstructive pulmonary disease in Wuhan, China: a population-based time-series study.

Evidence on the short-term effects of ambient air pollution on chronic obstructive pulmonary disease (COPD) mortality is still not conclusive. The aim of this study was to investigate the relationships between them in Wuhan China. Daily death numbers, concentrations of air pollutants (PM2.5, PM10, SO2, NO2, and O3), and meteorological characteristics in Wuhan from January 1, 2014, to December 31, 2019, were collected. Time-series analysis using generalized additive model was applied. The results showed that a total of 16,150 deaths (7.37 deaths per day) from COPD were observed. The daily average concentrations of PM2.5, PM10, SO2, NO2, and O3 were 59.03, 90.48, 12.91, 48.84, and 91.77 µg/m3, respectively. In single pollutant model, for every increase of 10 µg/m3 in PM10, SO2, and NO2 levels, COPD mortality increased by 0.583% (95% CI: 0.055-1.113%), 4.299% (95% CI: 0.978-7.729%), and 1.816% (95% CI: 0.515-3.313%) at lag03, respectively. No significant associations were found for PM2.5 and O3. Subgroup analysis demonstrated that females were more susceptible to PM2.5, PM10, SO2, and NO2. The concentrations of PM10, SO2, and NO2 were significantly associated with COPD mortality for older adults. The effects of PM2.5 and O3 on COPD mortality were higher in warm period. In two-pollutant models, the significantly positive associations between SO2 and NO2 and COPD mortality remained after adjusting for PM2.5 or O3. In conclusions, short-term exposure to PM10, SO2, and NO2 are significantly associated with a higher risk of COPD mortality. Female or elderly are more susceptible to air pollution. It is urgent to implement the environmental protection policy.