{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T10:49:27Z","timestamp":1791542967311,"version":"4.3.4"},"reference-count":40,"publisher":"European Respiratory Society (ERS)","issue":"1","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR Health Protection Research Unit in Environmental Exposures and Health"},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/L019744\/1"],"award-info":[{"award-number":["MR\/L019744\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2020,12,12]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Previous studies have investigated the effects of air pollution on chronic obstructive pulmonary disease (COPD) patients using either fixed-site measurements or a limited number of personal measurements, usually for one pollutant and a short time period. These limitations may introduce bias and distort the epidemiological associations as they do not account for all the potential sources or the temporal variability of pollution.<\/jats:p><jats:p>We used detailed information on individuals\u2019 exposure to various pollutants measured at fine spatiotemporal scale to obtain more reliable effect estimates. A panel of 115 patients was followed up for an average continuous period of 128\u2005days carrying a personal monitor specifically designed for this project that measured temperature, nitrogen dioxide (NO<jats:sub>2<\/jats:sub>), ozone (O<jats:sub>3<\/jats:sub>), nitric oxide (NO), carbon monoxide (CO), and particulate matter with aerodynamic diameter &lt;2.5 and &lt;10\u2005\u03bcm at 1-min time resolution. Each patient recorded daily information on respiratory symptoms and measured peak expiratory flow (PEF). A pulmonologist combined related data to define a binary variable denoting an \u201cexacerbation\u201d. The exposure\u2013response associations were assessed with mixed effects models.<\/jats:p><jats:p>We found that gaseous pollutants were associated with a deterioration in patients\u2019 health. We observed an increase of 16.4% (95% CI 8.6\u201324.6%), 9.4% (95% CI 5.4\u201313.6%) and 7.6% (95% CI 3.0\u201312.4%) in the odds of exacerbation for an interquartile range increase in NO<jats:sub>2<\/jats:sub>, NO and CO, respectively. Similar results were obtained for cough and sputum. O<jats:sub>3<\/jats:sub>was found to have adverse associations with PEF and breathlessness. No association was observed between particulate matter and any outcome.<\/jats:p><jats:p>Our findings suggest that, when considering total personal exposure to air pollutants, mainly the gaseous pollutants affect COPD patients\u2019 health.<\/jats:p>","DOI":"10.1183\/13993003.03432-2020","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T16:57:38Z","timestamp":1612457858000},"page":"2003432","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":50,"title":["Personal exposure to air pollution and respiratory health of COPD patients in London"],"prefix":"10.1183","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1071-6892","authenticated-orcid":false,"given":"Dimitris","family":"Evangelopoulos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia","family":"Chatzidiakou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Walton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klea","family":"Katsouyanni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-4869","authenticated-orcid":false,"given":"Jennifer K.","family":"Quint","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roderic L.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Barratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"2024102102141813000_58.1.2003432.1","unstructured":"World Health Organization . Disease Burden and Mortality Estimates, Cause-specific Mortality, 2000\u20132016. Geneva, WHO, 2016."},{"key":"2024102102141813000_58.1.2003432.2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12660"},{"key":"2024102102141813000_58.1.2003432.3","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00002610"},{"key":"2024102102141813000_58.1.2003432.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.97.10051064"},{"key":"2024102102141813000_58.1.2003432.5","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1093\/oxfordjournals.aje.a116730","article-title":"Air pollution and emergency room admissions for chronic obstructive pulmonary disease: a 5-year study","volume":"137","author":"Sunyer","year":"1993","journal-title":"Am J Epidemiol"},{"key":"2024102102141813000_58.1.2003432.6","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.091371"},{"key":"2024102102141813000_58.1.2003432.7","first-page":"1814","article-title":"Global associations between air pollutants and chronic obstructive pulmonary disease hospitalizations. A systematic review","volume":"13","author":"Moore","year":"2016","journal-title":"Ann Am Thorac Soc"},{"key":"2024102102141813000_58.1.2003432.8","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.078360"},{"key":"2024102102141813000_58.1.2003432.9","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12940-018-0432-8","article-title":"Measurement error in a multi-level analysis of air pollution and health: a simulation study","volume":"18","author":"Butland","year":"2019","journal-title":"Environ Health"},{"key":"2024102102141813000_58.1.2003432.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1352-2310(03)00466-7"},{"key":"2024102102141813000_58.1.2003432.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa071535"},{"key":"2024102102141813000_58.1.2003432.12","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.atmosenv.2012.11.060","article-title":"The use of electrochemical sensors for monitoring urban air quality in low-cost, high-density networks","volume":"70","author":"Mead","year":"2013","journal-title":"Atmos Environ"},{"key":"2024102102141813000_58.1.2003432.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011330"},{"key":"2024102102141813000_58.1.2003432.14","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1038\/s41533-018-0089-3","article-title":"Recruitment of patients with Chronic Obstructive Pulmonary Disease (COPD) from the Clinical Practice Research Datalink (CPRD) for research","volume":"28","author":"Quint","year":"2018","journal-title":"NPJ Prim Care Respir Med"},{"key":"2024102102141813000_58.1.2003432.15","doi-asserted-by":"crossref","first-page":"4643","DOI":"10.5194\/amt-12-4643-2019","article-title":"Characterising low-cost sensors in highly portable platforms to quantify personal exposure in diverse environments","volume":"12","author":"Chatzidiakou","year":"2019","journal-title":"Atmos Meas Tech"},{"key":"2024102102141813000_58.1.2003432.16","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00003213"},{"key":"2024102102141813000_58.1.2003432.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61382-8"},{"key":"2024102102141813000_58.1.2003432.18","unstructured":"Ministry of Housing, Communities and Local Government . English indices of deprivation 2015. 2015. http:\/\/imd-by-postcode.opendatacommunities.org\/imd\/2015. Date accessed: December 31, 2019."},{"key":"2024102102141813000_58.1.2003432.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2016.08.018"},{"key":"2024102102141813000_58.1.2003432.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2008.06.004"},{"key":"2024102102141813000_58.1.2003432.21","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.envint.2018.07.012","article-title":"Human exposure to ozone in school and office indoor environments","volume":"119","author":"Salonen","year":"2018","journal-title":"Environ Int"},{"key":"2024102102141813000_58.1.2003432.22","unstructured":"World Health Organization . Review of Evidence on Health Aspects of Air Pollution \u2013 REVIHAAP Project: Final Technical Report. Geneva, WHO, 2013."},{"key":"2024102102141813000_58.1.2003432.23","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.155358"},{"key":"2024102102141813000_58.1.2003432.24","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.6.1614"},{"key":"2024102102141813000_58.1.2003432.25","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2008.040857"},{"key":"2024102102141813000_58.1.2003432.26","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.scitotenv.2015.10.114","article-title":"The exposure metric choices have significant impact on the association between short-term exposure to outdoor particulate matter and changes in lung function: findings from a panel study in chronic obstructive pulmonary disease patients","volume":"542","author":"Ni","year":"2016","journal-title":"Sci Total Environ"},{"key":"2024102102141813000_58.1.2003432.27","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S0140-6736(17)32643-0","article-title":"Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60\u2005years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study","volume":"391","author":"Sinharay","year":"2018","journal-title":"Lancet"},{"key":"2024102102141813000_58.1.2003432.28","unstructured":"US Environmental Protection Agency . Integrated Science Assessment (ISA) for Particulate Matter (Final Report). EPA\/600\/R-19\/188. Washington, US EPA, 2019."},{"key":"2024102102141813000_58.1.2003432.29","unstructured":"US Environmental Protection Agency . Integrated Science Assessment (ISA) for Ozone and Related Photochemical Oxidants (Final Report). EPA\/600\/R-20\/012. Washington, US EPA, 2020."},{"key":"2024102102141813000_58.1.2003432.30","unstructured":"US Environmental Protection Agency . Integrated Science Assessment (ISA) For Oxides of Nitrogen \u2013 Health Criteria (Final Report). EPA\/600\/R-15\/068. Washington, US EPA, 2016."},{"key":"2024102102141813000_58.1.2003432.31","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12931-015-0229-z","article-title":"Influence of weather and atmospheric pollution on physical activity in patients with COPD","volume":"16","author":"Alahmari","year":"2015","journal-title":"Respir Res"},{"key":"2024102102141813000_58.1.2003432.32","doi-asserted-by":"crossref","first-page":"10635","DOI":"10.3390\/ijerph120910635","article-title":"Effect of personal exposure to PM2.5 on respiratory health in a Mexican panel of patients with COPD","volume":"12","author":"Cortez-Lugo","year":"2015","journal-title":"Int J Environ Res Public Health"},{"key":"2024102102141813000_58.1.2003432.33","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.2000.16a11.x"},{"key":"2024102102141813000_58.1.2003432.34","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/1476-069X-11-75","article-title":"Particulate matter air pollution and respiratory symptoms in individuals having either asthma or chronic obstructive pulmonary disease: a European multicentre panel study","volume":"11","author":"Karakatsani","year":"2012","journal-title":"Environ Health"},{"key":"2024102102141813000_58.1.2003432.35","doi-asserted-by":"crossref","first-page":"105500","DOI":"10.1016\/j.envint.2020.105500","article-title":"PM2.5 and NO2 exposure errors using proxy measures, including derived personal exposure from outdoor sources: a systematic review and meta-analysis","volume":"137","author":"Evangelopoulos","year":"2020","journal-title":"Environ Int"},{"key":"2024102102141813000_58.1.2003432.36","doi-asserted-by":"publisher","DOI":"10.1136\/oem.55.10.651"},{"key":"2024102102141813000_58.1.2003432.37","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.00108419"},{"key":"2024102102141813000_58.1.2003432.38","doi-asserted-by":"crossref","first-page":"e093","DOI":"10.1097\/EE9.0000000000000093","article-title":"Comparing the performance of air pollution models for nitrogen dioxide and ozone in the context of a multilevel epidemiological analysis","volume":"4","author":"Butland","year":"2020","journal-title":"Environ Epidemiol"},{"key":"2024102102141813000_58.1.2003432.39","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/j.scitotenv.2017.12.042","article-title":"The cumulative effect of air pollutants on the acute exacerbation of COPD in Shanghai, China","volume":"622","author":"Sun","year":"2018","journal-title":"Sci Total Environ"},{"key":"2024102102141813000_58.1.2003432.40","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000158918.57071.3e"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.03432-2020","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T07:48:16Z","timestamp":1740383296000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.03432-2020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,4]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,7,20]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1183\/13993003.03432-2020"],"URL":"https:\/\/doi.org\/10.1183\/13993003.03432-2020","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,4]]}}}