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Examining association between air pollution and emergency department visits and hospitalizations with acute exacerbations of people with COPD

Background: Air pollution is an important environmental risk factor affecting COPD and other respiratory system diseases. 
Objectives: The aim of this study is to determine the relationship of air pollution in the northernmost part of Turkey with acute exacerbation, admission to the emergency department and hospitalization of individuals with COPD. 
Methods: Between January 01-December 31, 2016, outpatients and hospitalized patients admitted to the state hospital due to COPD exacerbation were retrospectively analyzed. The measured values of air pollutants from the measurement stations located in the city center were obtained from the web page of the Ministry of Environment and Urbanization. 
Results: The mean age of the patients (n=2737) participating in the study was 67.5±13.3%, and 69.8% of them were male. It has been determined that the patients with COPD apply to the hospital the most during the winter and autumn periods. Air pollutants measurement values were found to be significantly higher in the spring and winter seasons (p