Chemical constituents and sources of indoor PM2.5 and cardiopulmonary function in patients with chronic obstructive pulmonary disease: Estimation of individual and joint effects.

BACKGROUND: The cardiopulmonary effects of chemical constituents and sources of indoor fine particulate matter (PM2.5) remain unclear. OBJECTIVES: To examine the individual and joint effects of constituents of indoor PM2.5 on cardiopulmonary function of patients with chronic obstructive pulmonary disease (COPD) and the role of identified sources. METHODS: This panel study recruited 43 stable COPD patients from November 2015 to May 2016 in Beijing, China. Daily indoor and outdoor PM2.5 were collected for five consecutive days simultaneously. Twenty-four elements were measured and principal component analysis was used for source appointment. Pulmonary function and blood pressure (BP) were also measured at daily visit. The linear mixed-effect models were used to estimate the effect of each constituent and source. Bayesian kernel machine regression (BKMR) models were used to estimate the overall effect of all measured constituents. RESULTS: The combustion, indoor soil/dust and road dust sources were identified as the main sources of indoor PM2.5 and combustion sources contributed over 40% during the heating season. Most constituents were significantly associated with elevated BP of COPD patients and the joint effects of mixed exposures were also significant especially during the heating season. Most associations of chemical constituents with pulmonary function were negative but not statistically significant during the heating season, as was the joint effect. Few associations were observed during the non-heating season. Further, we observed combustion sources throughout the study period and road dust sources during the heating season were significantly associated with increased BP but not decreased pulmonary function. CONCLUSION: The combustion and road dust sources and their related constituents of indoor PM2.5 could cause adverse effects on cardiovascular function of COPD patients especially during the heating season, but the effect on pulmonary function still needs to be further studied.