Back to Browse Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 9 » Issue 1

Long-term dynamics of death rates of emphysema, asthma, and pneumonia and improving air quality

Authors Kravchenko J, Akushevich I, Abernethy AP, Holman S, Ross Jr WG, Lyerly HK

Received 2 January 2014

Accepted for publication 9 April 2014

Published 16 June 2014 Volume 2014:9(1) Pages 613—627

DOI http://dx.doi.org/10.2147/COPD.S59995

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Julia Kravchenko,1 Igor Akushevich,2 Amy P Abernethy,3 Sheila Holman,4 William G Ross Jr,5 H Kim Lyerly1,6

1Department of Surgery, 2Center for Population Health and Aging, 3Duke Clinical Research Institute, Duke University Medical Center, Duke University, Durham, 4Division of Air Quality, North Carolina Department of Environment and Natural Resources, Raleigh, 5Nicholas School of the Environment, 6Department of Pathology, Duke University Medical Center, Duke University, Durham, NC, USA

Background: The respiratory tract is a major target of exposure to air pollutants, and respiratory diseases are associated with both short- and long-term exposures. We hypothesized that improved air quality in North Carolina was associated with reduced rates of death from respiratory diseases in local populations.
Materials and methods: We analyzed the trends of emphysema, asthma, and pneumonia mortality and changes of the levels of ozone, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matters (PM2.5 and PM10) using monthly data measurements from air-monitoring stations in North Carolina in 1993–2010. The log-linear model was used to evaluate associations between air-pollutant levels and age-adjusted death rates (per 100,000 of population) calculated for 5-year age-groups and for standard 2000 North Carolina population. The studied associations were adjusted by age group-specific smoking prevalence and seasonal fluctuations of disease-specific respiratory deaths.
Results: Decline in emphysema deaths was associated with decreasing levels of SO2 and CO in the air, decline in asthma deaths–with lower SO2, CO, and PM10 levels, and decline in pneumonia deaths–with lower levels of SO2. Sensitivity analyses were performed to study potential effects of the change from International Classification of Diseases (ICD)-9 to ICD-10 codes, the effects of air pollutants on mortality during summer and winter, the impact of approach when only the underlying causes of deaths were used, and when mortality and air-quality data were analyzed on the county level. In each case, the results of sensitivity analyses demonstrated stability. The importance of analysis of pneumonia as an underlying cause of death was also highlighted.
Conclusion: Significant associations were observed between decreasing death rates of emphysema, asthma, and pneumonia and decreases in levels of ambient air pollutants in North Carolina.

Keywords: chronic obstructive pulmonary disease, sulfur dioxide, carbon monoxide, nitrogen dioxide, particulate matter

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] View Full Text [HTML] 

 

Readers of this article also read:

Liposomal n-butylidenephthalide protects the drug from oxidation and enhances its antitumor effects in glioblastoma multiforme

Lin YL, Chang KF, Huang XF, Hung CL, Chen SC, Chao WR, Liao KW, Tsai NM

International Journal of Nanomedicine 2015, 10:6009-6020

Published Date: 28 September 2015

Companion diagnostics and molecular imaging-enhanced approaches for oncology clinical trials

Van Heertum RL, Scarimbolo R, Ford R, Berdougo E, O’Neal M

Drug Design, Development and Therapy 2015, 9:5215-5223

Published Date: 11 September 2015

An innovative approach to the topical treatment of acne

Sparavigna A, Tenconi B, De Ponti I, La Penna L

Clinical, Cosmetic and Investigational Dermatology 2015, 8:179-185

Published Date: 9 April 2015

SERS-based quantitative detection of ovarian cancer prognostic factor haptoglobin

Perumal J, Balasundaram G, Mahyuddin AP, Choolani M, Olivo M

International Journal of Nanomedicine 2015, 10:1831-1840

Published Date: 6 March 2015

Effects of a hybrid micro/nanorod topography-modified titanium implant on adhesion and osteogenic differentiation in rat bone marrow mesenchymal stem cells

Zhang WJ, Li ZH, Huang QF, Xu L, Li JH, Jin YQ, Wang GF, Liu XY, Jiang XQ

International Journal of Nanomedicine 2013, 8:257-265

Published Date: 11 January 2013

Interaction between submicron COD crystals and renal epithelial cells

Peng H, Ouyang JM, Yao XQ, Yang RE

International Journal of Nanomedicine 2012, 7:4727-4737

Published Date: 29 August 2012

Fe3O4/Au magnetic nanoparticle amplification strategies for ultrasensitive electrochemical immunoassay of alfa-fetoprotein

Gan N, Jin H, Li T, Zheng L

International Journal of Nanomedicine 2011, 6:3259-3269

Published Date: 9 December 2011