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A study by the University Hospital of Amiens shows an increase in hospitalizations and emergency care for exacerbation of COPD symptoms during episodes of heavy pollution.
The more polluted the air, the more people with COPD have trouble breathing and the more they go to the hospital, says the PolluBPCO CHU Amiens study. The authors analyzed data from 168 patients who consulted 240 times for exacerbations of COPD * during the year 2017. Most patients included in the study had advanced COPD: 35.1% stage 3 and 35.1% stage 4, compared with 6 , 5% in stage 1.
The observations:
- During air pollution episodes caused by PM10 fine particles in January and February 2017, 3 peak visits to COPD patients were observed, as well as a higher mean hospitalization rate.
- Consultation peaks generally occurred between 3 and 5 days after the onset of the pollution peak.
- The peak of ozone in the summer during the heat wave also corresponds to a peak of consultation for exacerbations.
- From June to September, no PM10 pollution peak and no peak COPD exacerbations were observed.
For the authors, "PM10 and PM2.5, levels of nitrogen dioxide and ozone alone do not explain the increase in emergency care due to exacerbations of COPD, but its role is significantly established". The influenza epidemic (peaks in January-February and December) also exacerbates the symptoms of COPD, as well as pollen "even if the impact is less clear". In any case "Highlighting a link between over-hospitalization due to exacerbation of COPD and pollution peaks could be a public decision-making element to improve air quality.".
CHU Amiens will conduct further reviews in 2019, including a follow-up of twelve patients included in the PolluBPCO project and having experienced more than two exacerbations of their COPD by 2017. A second component of the research will be conducted in 2020 with the BePoPi Study which will include composition of particles and analysis of heavy metals in the air.
* increase in respiratory symptoms, starting acutely for more than 48 hours, or justifying a therapeutic modification.
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