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COPD exacerbations are related to poor air quality in Innsbruck

Background: Triggers of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are diverse and not only of infectious nature. Increasing urbanization and rising transit traffic across the Alps contribute to an increase in airborne pollutants, which are potentially involved in the pathogenesis of AECOPD. Aims and Objectives: To analyze in a simplified model, whether air pollution has an impact on the frequency of AECOPD compared to pulmonary embolism (PE) in the city area of Innsbruck (Austria). Methods: In this retrospective study, the frequency of AECOPD and PE was recorded at the emergency department of the University Hospital of Innsbruck between 2010 and 2017 and compared to daily air quality parameters (NO, NO2, PM10, PM2.5, O3, CO, SO2) provided by the Tyrolean State Government. Results: In total, 669 AECOPD and 857 PE events were registered. Days with AECOPD revealed significantly higher concentrations of CO and SO2 compared to days without AECOPD, whereas days with PE displayed an elevation of NO. Higher frequencies of AECOPD during winter months correlated with higher CO and SO2 levels, disclosing a seasonal trend, while no such pattern was observed for PE. A binary logistic regression model revealed NO2, CO, SO2, PM2.5, and the month to significantly predict AECOPD; although, the predictive potential was low. However, applying the same model, PE showed an even lower predictive potential. Conclusion: Our data suggest a rather weak yet significant correlation between AECOPD and airborne pollutants, especially during winter months, contrasting the results for PE. More complex models are needed to confirm the generated hypotheses to raise awareness for this underrecognized trigger of AECOPD.