Association between Air Pollution Exposure and the Prevalence of Chronic Obstructive Pulmonary Disease in Urban versus Rural Populations.

Original Article

Abstract

Background

Chronic Obstructive Pulmonary Disease (COPD) continues to be a significant public health concern. There is evidence that air pollution aggravates the development and progression of disorders of the lungs. Specifically, during the developing stage of a country, there is greater exposure to fine particulate matter (PM2.5) and coarse particulate matter (PM10) and nitrogen dioxide (NO₂); this has been linked to a greater rate of prevalence of COPD among urban populations.

Objectives

To evaluate the association between air pollution exposure and prevalence of COPD and to compare disease severity between urban and rural populations by integrating regional air quality indices with patient characteristics.

Methodology

A cross-sectional study was conducted over six months in  Department of Pulmonology PIMS Islamabad Pakistan from 05 jan to june 2024. A total of 600 adults aged ≥40 years (300 from each area) underwent spirometry based on GOLD criteria (FEV₁/FVC < 0.70). Ambient air pollution data (PM2.5, PM10, NO2) were obtained from environmental stations. Data were analyzed using SPSS v24.0 with chi-square and multivariate regression models applied.

Results

The study enrolled 50 patients, evenly distributed between urban and rural settings. Participants were aged 40–82 years. Urban residents reported higher smoking rates and exposure to pollution. The spirometry-confirmed COPD prevalence was significantly higher among urban participants compared to rural (22% vs. 13%).The mean age of participants was 58.2 ± 9.6 years. COPD prevalence was significantly higher in the urban group (22%) than the rural group (13%), with a p-value of 0.004. Urban air pollution levels were markedly elevated, with PM2.5 averaging 85 µg/m³ compared to 42 µg/m³ in rural areas. Pearson correlation revealed a significant association between higher PM2.5 levels and COPD prevalence (r = 0.61, p < 0.001). Logistic regression confirmed urban residence (OR 2.1, 95% CI: 1.4–3.2) and smoking (OR 3.5, 95% CI: 2.2–5.4) as independent risk factors.

Conclusion

Our study determined the relevance of someone with the case the risk of onset of COPD was much higher near centers where the PM2.5 and NO2.15 were diagnosed. Higher PM2.5 and NO2.15 concentrations were very likely responsible for the COPD cases diagnosed in the study if the smoking and professional cases for COPD risk were excluded. This suggested the need for someone to consider revising the policies where the risk of carrying COPD will be increased to define if the COPD will likely improve in the first world or if the policies need to be integrated in to square a tougher COPD risk to individuals living in a developing urban life in a first world country.