Exposure to Indoor Particulate Matter Worsens the Symptoms and Acute Exacerbations in Chronic Obstructive Pulmonary Disease Patients of Southwestern Taiwan: A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Measurements and Instruments
2.3.1. Demographic and Clinical Characteristics
2.3.2. Respiratory Symptoms
2.3.3. COPD Assessment Test (CAT)
2.3.4. London Chest Activity of Daily Living (LCADL) Scale
2.3.5. Acute Exacerbation
2.3.6. Air Quality Assessment
2.4. Statistical Analyses
3. Results
3.1. Patient Characteristics
3.2. PM2.5 and PM10 Concentrations and Abnormal Proportions
3.3. Association between PM2.5 Concentrations, Symptoms, and Activities of Daily Living (ADL)
3.4. Association between PM10 Concentrations, Symptoms, and ADL
3.5. Association between PM (PM2.5 and PM10) and Acute Exacerbation of COPD
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variable | n (%) or Mean ± Standard Deviation (SD) |
---|---|
Gender | |
Male | 19 (100.0) |
Weight status | |
Underweight | 5 (26.3) |
Normal | 8 (42.1) |
Overweight | 3 (15.8) |
Obese | 3 (15.8) |
Employment status | |
Part-time job | 2 (10.5) |
Retired | 17 (89.5) |
Education level | |
Uneducated | 3 (15.8) |
Elementary school | 10 (52.6) |
Junior high school or above | 6 (31.6) |
Regular exercise | |
No | 14 (73.7) |
Yes | 5 (26.3) |
Cigarette smoking | |
Quit | 14 (73.7) |
Current smoker | 5 (26.3) |
Family smoking | |
No | 10 (52.6) |
Yes | 8 (42.1) |
Sometimes | 1 (5.3) |
Whether the window was open or not | |
Always open | 10 (52.6) |
Always closed | 8 (42.1) |
Sometimes | 1 (5.3) |
Disease severity * | |
Moderate | 6 (31.6) |
Severe | 8 (42.1) |
Very severe | 5 (26.3) |
Age (years) | 72.6 ± 6.8 |
Body mass index (BMI) (kg/m2) | 22.7 ± 6.7 |
Waist-hip ratio | 1.00 ± 0.11 |
Charlson comorbidity index (CCI) # | 5.7 ± 1.1 |
FEV1 at 1st visit (%) | 42.4 ± 15.0 |
Chronic obstructive pulmonary disease (COPD) duration (years) | 5.1 ± 2.9 |
Variable | Outdoor | Living Room | Bedroom | Kitchen | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Normal # (obs = 6) | Abnormal * (obs = 77) | B | Normal # (obs = 9) | Abnormal * (obs = 74) | B | Normal # (obs = 13) | Abnormal * (obs = 70) | B | Normal # (obs = 7) | Abnormal * (obs = 76) | B | |
Respiratory Symptoms | ||||||||||||
Cough | 3.8 ± 1.8 | 3.3 ± 1.8 | −0.20 | 3.8 ± 1.9 | 3.3 ± 1.8 | −0.56 | 3.4 ± 1.9 | 3.3 ± 1.8 | −0.10 | 3.4 ± 2.0 | 3.3 ± 1.8 | −0.57 |
Phlegm | 4.2 ± 1.3 | 3.5 ± 1.8 | −0.22 | 3.8 ± 1.9 | 3.5 ± 1.8 | −0.49 | 3.5 ± 1.8 | 3.5 ± 1.8 | −0.12 | 3.7 ± 1.7 | 3.5 ± 1.8 | −0.64 |
Dyspnea | 2.2 ± 1.6 | 2.9 ± 1.6 | 0.84 | 3.1 ± 1.9 | 2.8 ± 1.6 | −0.32 | 2.8 ± 1.8 | 2.8 ± 1.6 | −0.10 | 2.0 ± 1.5 | 2.9 ± 1.6 | 0.48 |
Wheezing | 1.2 ± 0.4 | 2.3 ± 1.5 | 1.46 ** | 1.1 ± 0.3 | 2.4 ± 1.6 | 0.80 *** | 1.5 ± 1.2 | 2.4 ± 1.5 | 0.45 | 1.1 ± 0.4 | 2.3 ± 1.5 | 1.03 ** |
Total | 11.3 ± 4.1 | 12.0 ± 4.8 | 1.88 | 11.8 ± 4.5 | 11.9 ± 4.8 | −0.62 | 11.3 ± 5.3 | 12.0 ± 4.6 | 0.09 | 10.3 ± 4.6 | 12.1 ± 4.7 | 0.00 |
COPD Assessment Test (CAT) | ||||||||||||
Physical | 7.2 ± 4.0 | 7.8 ± 4.2 | 0.93 * | 8.1 ± 4.7 | 7.8 ± 4.2 | −0.16 | 8.3 ± 5.0 | 7.7 ± 4.1 | −0.82 | 5.7 ± 4.0 | 8.0 ± 4.2 | 0.16 |
Psycho | 2.7 ± 2.0 | 3.1 ± 2.7 | 0.04 | 2.6 ± 2.0 | 3.1 ± 2.7 | 0.61 | 2.8 ± 2.0 | 3.1 ± 2.7 | 0.12 | 1.7 ± 1.7 | 3.2 ± 2.7 | 0.15 |
Total | 9.8 ± 5.9 | 10.9 ± 6.5 | 0.93 | 10.8 ± 6.7 | 10.9 ± 6.5 | 0.34 | 11.2 ± 7.0 | 10.8 ± 6.4 | −0.81 | 7.4 ± 5.7 | 11.2 ± 6.5 | 0.23 |
London ADL | ||||||||||||
Self-care | 21.0 ± 6.0 | 20.3 ± 4.8 | 0.17 | 18.1 ± 7.5 | 20.6 ± 4.4 | 2.15 | 18.5 ± 6.5 | 20.7 ± 4.5 | 1.98 | 21.9 ± 5.8 | 20.2 ± 4.8 | 0.69 |
Domestic | 22.3 ± 17.3 | 19.6 ± 13.7 | −1.28 | 17.6 ± 13.2 | 20.1 ± 14.0 | 4.26 | 18.0 ± 14.6 | 20.1 ± 13.8 | 3.77 | 21.7 ± 15.0 | 19.6 ± 13.8 | 2.19 |
Sport | 3.2 ± 2.7 | 4.0 ± 2.4 | 0.38 | 4.2 ± 3.7 | 3.9 ± 2.2 | −0.53 | 4.4 ± 3.5 | 3.9 ± 2.2 | −0.83 | 2.4 ± 2.7 | 4.1 ± 2.3 | 0.07 |
Leisure | 1.5 ± 3.2 | 1.4 ± 1.8 | −0.15 | 2.0 ± 2.8 | 1.4 ± 1.8 | −0.56 | 1.8 ± 2.4 | 1.4 ± 1.8 | −0.32 | 1.3 ± 3.0 | 1.4 ± 1.8 | −0.34 |
Total | 48.0 ± 17.5 | 45.3 ± 13.9 | −0.84 | 41.9 ± 14.1 | 46.0 ± 14.1 | 5.27 | 42.7 ± 15.0 | 46.1 ± 13.9 | 4.55 | 47.3 ± 15.4 | 45.4 ± 14.0 | 2.63 |
Variable | Outdoor | Living Room | Bedroom | Kitchen | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Normal # (obs = 43) | Abnormal * (obs = 40) | B | Normal # (obs = 46) | Abnormal * (obs = 37) | B | Normal # (obs = 50) | Abnormal * (obs = 33) | B | Normal # (obs = 46) | Abnormal * (obs = 37) | B | |
Respiratory Symptoms | ||||||||||||
Cough | 3.3 ± 1.8 | 3.4 ± 1.9 | −0.25 | 3.4 ± 1.8 | 3.2 ± 1.8 | −0.26 | 3.5 ± 1.8 | 3.2 ± 1.9 | −0.08 | 3.3 ± 1.8 | 3.4 ± 1.8 | −0.06 |
Phlegm | 3.4 ± 1.7 | 3.6 ± 1.8 | −0.07 | 3.5 ± 1.7 | 3.5 ± 1.8 | −0.24 | 3.6 ± 1.7 | 3.4 ± 1.9 | 0.04 | 3.4 ± 1.7 | 3.7 ± 1.8 | 0.02 |
Dyspnea | 2.6 ± 1.6 | 3.1 ± 1.6 | 0.40 | 2.7 ± 1.7 | 3.0 ± 1.5 | 0.39 | 2.8 ± 1.7 | 2.8 ± 1.5 | 0.13 | 2.6 ± 1.7 | 3.1 ± 1.5 | 0.25 |
Wheezing | 2.1 ± 1.5 | 2.4 ± 1.6 | 0.43 | 2.0 ± 1.5 | 2.5 ± 1.5 | 0.36 * | 2.1 ± 1.6 | 2.4 ± 1.5 | 0.18 | 2.0 ± 1.5 | 2.5 ± 1.5 | 0.38 * |
Total | 11.4 ± 5.1 | 12.5 ± 4.2 | 0.40 | 11.6 ± 5.0 | 12.3 ± 4.3 | 0.30 | 12.0 ± 4.9 | 11.8 ± 4.5 | 0.32 | 11.3 ± 5.2 | 12.7 ± 4.0 | 0.51 |
CAT | ||||||||||||
physical | 7.6 ± 4.4 | 8.0 ± 4.1 | −0.16 | 7.5 ± 4.3 | 8.2 ± 4.1 | 0.29 | 7.8 ± 4.3 | 7.8 ± 4.1 | 0.67 | 7.2 ± 4.2 | 8.5 ± 4.1 | 0.47 |
psycho | 2.7 ± 2.4 | 3.4 ± 2.8 | 0.20 | 2.7 ± 2.4 | 3.4 ± 2.9 | 0.41 | 2.9 ± 2.5 | 3.2 ± 2.8 | 0.10 | 2.5 ± 2.2 | 3.7 ± 3.0 | 0.67 |
Total | 10.3 ± 6.5 | 11.4 ± 6.5 | 0.00 | 10.2 ± 6.3 | 11.6 ± 6.6 | 0.65 | 10.7 ± 6.5 | 11.1 ± 6.5 | 0.75 | 9.8 ± 6.1 | 12.2 ± 6.7 | 1.10 |
London ADL | ||||||||||||
Self-care | 20.3 ± 5.3 | 20.4 ± 4.4 | 0.67 | 20.2 ± 5.1 | 20.6 ± 4.5 | 0.49 | 19.8 ± 5.3 | 21.2 ± 3.9 | 1.27 | 20.5 ± 5.1 | 20.2 ± 4.5 | 0.20 |
Domestic | 18.8 ± 15.2 | 20.8 ± 12.3 | 3.28 | 18.3 ± 15.0 | 21.7 ± 12.2 | 4.07 | 19.0 ± 14.2 | 21.0 ± 13.5 | 4.15 | 17.8 ± 15.3 | 20.2 ± 11.5 | 4.95 |
Sport | 3.8 ± 2.6 | 4.1 ± 2.1 | −0.09 | 3.9 ± 2.5 | 4.0 ± 2.2 | −0.32 | 4.1 ± 2.5 | 3.7 ± 2.2 | −0.69 | 3.8 ± 2.5 | 4.1 ± 2.2 | −0.22 |
Leisure | 1.3 ± 2.1 | 1.6 ± 1.8 | 0.32 | 1.3 ± 2.0 | 1.6 ± 1.8 | 0.58 | 1.4 ± 2.1 | 1.5 ± 1.6 | 0.28 | 1.2 ± 2.0 | 1.6 ± 1.8 | 0.52 |
Total | 44.3 ± 15.4 | 46.9 ± 12.5 | 4.09 | 43.6 ± 14.8 | 48.9 ± 12.9 | 5.58 * | 44.3 ± 14.1 | 47.4 ± 13.9 | 5.34 | 43.4 ± 15.1 | 48.2 ± 12.4 | 6.18 * |
Parameter | No. of obs | Emergency Room (ER) Visit | Admission Due to Acute Exacerbation (AE) | ||||
---|---|---|---|---|---|---|---|
Event (%) | OR (95% CI) | p | Event (%) | OR (95% CI) | p | ||
PM2.5 | |||||||
Outdoor | |||||||
Normal # | 6 | 0 (0.0) | Reference | - | 0 (0.0) | Reference | - |
Abnormal * | 77 | 26 (33.8) | NA | NA | 26 (33.8) | NA | NA |
Living room | |||||||
Normal # | 9 | 0 (0.0) | Reference | - | 0 (0.0) | Reference | - |
Abnormal * | 74 | 26 (35.1) | NA | NA | 26 (35.1) | NA | NA |
Bedroom | |||||||
Normal # | 13 | 0 (0.0) | Reference | - | 0 (0.0) | Reference | - |
Abnormal * | 70 | 26 (37.1) | NA | NA | 26 (37.1) | NA | NA |
Kitchen | |||||||
Normal # | 7 | 0 (0.0) | Reference | - | 0 (0.0) | Reference | - |
Abnormal * | 76 | 26 (34.2) | NA | NA | 26 (34.2) | NA | NA |
PM10 | |||||||
Outdoor | |||||||
Normal # | 43 | 3 (7.0) | Reference | - | 3 (7.0) | Reference | - |
Abnormal * | 40 | 23 (57.5) | 30.1 (4.9–184.2) | <0.001 | 23 (57.5) | 19.5 (4.7–80.6) | <0.001 |
Living room | |||||||
Normal # | 46 | 4 (8.7) | Reference | - | 5 (10.9) | Reference | - |
Abnormal * | 37 | 22 (59.5) | 23.8 (3.0–191.3) | 0.003 | 21 (56.8) | 16.2 (3.1–84.9) | 0.001 |
Bedroom | |||||||
Normal # | 50 | 7 (14.0) | Reference | - | 7 (14.0) | Reference | - |
Abnormal * | 33 | 19 (57.6) | 12.1 (2.5–60.0) | 0.002 | 19 (57.6) | 10.5 (2.5–44.6) | 0.001 |
Kitchen | |||||||
Normal # | 46 | 3 (6.5) | Reference | - | 4 (8.7) | Reference | - |
Abnormal * | 37 | 23 (62.2) | 38.5 (4.8–311.8) | 0.001 | 22 (59.5) | 18.5 (3.7–91.9) | <0.001 |
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Chi, M.-C.; Guo, S.-E.; Hwang, S.-L.; Chou, C.-T.; Lin, C.-M.; Lin, Y.-C. Exposure to Indoor Particulate Matter Worsens the Symptoms and Acute Exacerbations in Chronic Obstructive Pulmonary Disease Patients of Southwestern Taiwan: A Pilot Study. Int. J. Environ. Res. Public Health 2017, 14, 4. https://doi.org/10.3390/ijerph14010004
Chi M-C, Guo S-E, Hwang S-L, Chou C-T, Lin C-M, Lin Y-C. Exposure to Indoor Particulate Matter Worsens the Symptoms and Acute Exacerbations in Chronic Obstructive Pulmonary Disease Patients of Southwestern Taiwan: A Pilot Study. International Journal of Environmental Research and Public Health. 2017; 14(1):4. https://doi.org/10.3390/ijerph14010004
Chicago/Turabian StyleChi, Miao-Ching, Su-Er Guo, Su-Lun Hwang, Chiang-Ting Chou, Chieh-Mo Lin, and Yu-Ching Lin. 2017. "Exposure to Indoor Particulate Matter Worsens the Symptoms and Acute Exacerbations in Chronic Obstructive Pulmonary Disease Patients of Southwestern Taiwan: A Pilot Study" International Journal of Environmental Research and Public Health 14, no. 1: 4. https://doi.org/10.3390/ijerph14010004