연구성과 홍보

Environ Sci Process Impacts. 2025 May 21;27(5):1244-1252.

Title : Seasonal effect of PM2.5 exposure in patients with COPD: a multicentre panel study

Authors : Jin-Young Huh1,2, Hajeong Kim1,3, Shinhee Park4,5, Seung Won Ra6, Sung-Yoon Kang7, Bock Hyun Jung4, Mihye Kim4, Sang Min Lee8, Sang Pyo Lee7, Dirga Kumar Lamichhane9, Young-Jun Park10, Seon-Jin Lee10, Jae Seung Lee1, Yeon-Mok Oh1, Hwan-Cheol Kim9, Sei Won Lee1*

Affiliations :

1Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-Gil, Songpa-gu, Seoul 05505, South Korea.

2Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea.

3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea.

4Department of Pulmonary, Allergy and Critical Care Medicine, Gangneung Asan Hospital, Gangneung, South Korea.

5Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.

6Division of Pulmonology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.

7Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, South Korea.

8Division of Respiratory Disease and Allergy, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, South Korea.

9Department of Occupational and Environmental Medicine, College of Medicine, Inha University, Incheon, South Korea.

10Environmental Disease Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, South Korea.

DOI: 10.1039/d4em00376d.

Abstract :

Background: Exposure to particulate matter <2.5 μm (PM2.5) is linked to chronic obstructive pulmonary disease (COPD), but most studies lack individual PM2.5 measurements. Seasonal variation and their impact on clinical outcomes remain understudied. Objective: This study investigated the impact of PM2.5 concentrations on COPD-related clinical outcomes and their seasonal changes. Methods: A multicentre panel study enrolled 105 COPD patients (age range: 46-82) from July 2019 to August 2020. Their mean forced expiratory volume in 1 second after bronchodilation was 53.9%. Individual PM2.5 levels were monitored continuously with indoor measurements at residences and outdoor data from the National Ambient Air Quality Monitoring Information System. Clinical parameters, including pulmonary function tests, symptom questionnaires (CAT and SGRQ-C), and impulse oscillometry (IOS), were assessed every three months over the course of one year. Statistical analysis was conducted using a linear mixed-effect model to account for repeated measurements and control for confounding variables, including age, sex, smoking status and socioeconomic status. Results: The mean indoor and outdoor PM2.5 concentrations were 16.2 ± 8.4 μg m-3 and 17.2 ± 5.0 μg m-3, respectively. Winter had the highest PM2.5 concentrations (indoor, 18.8 ± 11.7 μg m3; outdoor, 22.5 ± 5.0 μg m-3). Higher PM2.5 concentrations significantly correlated with poorer St. George's Respiratory Questionnaire for COPD (SGRQ-C) scores and increased acute exacerbations, particularly in winter. Patients of lower socioeconomic status were more vulnerable. Increased PM2.5 concentrations were also associated with amplified small airway resistance (R5-R20). Conclusions: PM2.5 concentration changes are positively correlated with poorer SGRQ-C scores and increased acute exacerbations in COPD patients with significant seasonal variations, especially in winter.