Short- and long-term effects of ambient ozone and fine particulate matter on the respiratory health of chronic obstructive pulmonary disease subjects.

To date, no study has evaluated the short- and long-term effects air pollution exposure on emphysematous subjects who have undergone lung volume reduction surgery (LVRS). Data from the National Emphysema Treatment Trial study (1998-2003) included 1,218 subjects, aged 39 to 84. Daily values of ambient fine particulate matter (aerodynamic diameter < 2.5 μm; PM2.5) and ozone were obtained. Mixed-effects models tested the association between short- and long-term pollutant concentrations and changes in pulmonary function. Cumulative air pollution exposure was strongly associated with worsened respiratory function and symptoms. Mean PM2.5 was associated with poorer lung function. Lagged exposures were poorly associated with respiratory health outcomes. There were detrimental respiratory and pulmonary effects observed in response to even low levels of ambient air pollutants among study participants. These results are indicative that exposures even below those of air quality standards may still pose significant risks to severe chronic obstructive pulmonary disease (COPD) subjects.