Influence of Gaseous Pollutants on COPD Exacerbations in Patients with Cardiovascular Comorbidities

  • Michal ZielinskiEmail author
  • Mariusz Gasior
  • Dariusz Jastrzebski
  • Aneta Desperak
  • Dariusz Ziora
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1114)


Exacerbations of chronic obstructive pulmonary disease (COPD) are a serious public health issue. Ambient pollution and meteorological factors are considered among precipitating factors. There are few data concerning the impact of ambient pollutants other than particulates on COPD exacerbations. Among gaseous pollutants four main groups of substances are primarily monitored: nitrogen oxides (NOx), sulphur dioxide (SO2), carbon monoxide (CO), and ozone (O3). In this study, 12,889 hospitalizations in the years 2006–2014 due to exacerbations of COPD in patients having a co-existing cardiovascular pathology were retrospectively analyzed. Cardiovascular disease was ruled out as the underlying reason of hospitalization. Data concerning the then accompanying gaseous pollutants and weather conditions were collected. The findings were that the impact of SO2 content was significantly associated with the relative risk (RR) of COPD exacerbation when the exposure took place at least 30 days or longer before hospital admission (RR 1.04–1.05; p < 0.05). In contrast, risk of COPD exacerbation rose when a shortening of the time lag between exposure to NOx and hospital admission was considered (RR 1.02–1.04; p < 0.05). O3 exposure was associated with a lower risk irrespective of the length of exposure/exacerbation lag (RR 0.77–0.90; p < 0.05). There were insignificant associations observed for CO. In conclusion, the study demonstrates a salient influence of a co-existing cardiovascular malady on the appearance of COPD-related respiratory exacerbations when the pollutant SO2 and NOx contents rose. In contrast, higher O3 content was associated with a lower risk of COPD exacerbation.


Cardiovascular comorbidities COPD Emergency admissions Exacerbations Gaseous air pollutants Environmental health. 


Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Michal Zielinski
    • 1
    Email author
  • Mariusz Gasior
    • 2
  • Dariusz Jastrzebski
    • 1
  • Aneta Desperak
    • 2
  • Dariusz Ziora
    • 1
  1. 1.Department of Lung Diseases and Tuberculosis, School of Medicine with the Division of Dentistry in ZabrzeMedical University of SilesiaKatowicePoland
  2. 2.Third Department of Cardiology, School of Medicine with the Division of Dentistry in ZabrzeMedical University of SilesiaKatowicePoland

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