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Exacerbations of COPD^*

Environmental Mechanisms

^* From the ELEGI Colt Research Laboratories (Professor MacNee), University of Edinburgh Medical School, Edinburgh, and the Department of Biological Sciences (Professor Donaldson), Napier University, Edinburgh, Scotland.

Correspondence to: Professor William MacNee, Respiratory Medicine, ELEGI, Colt Research Laboratories, Wilkie Building, Medical School, Teviot Place, Edinburgh EH8 9AG, Scotland; e-mail w.macnee@ed.ac.uk

Air pollution as a trigger for exacerbations of COPD has been recognized for > 50 years, and has led to the development of air quality standards in many countries that substantially decreased the levels of air pollutants derived from the burning of fossil fuels, such as black smoke and sulfur dioxide. However, the recent dramatic increase in motor vehicle traffic has produced a relative increase in the levels of newer pollutants, such as ozone and fine-particulate air pollution < 10 µm in diameter. Numerous epidemiologic studies have shown associations between the levels of these air pollutants and adverse health effects, such as exacerbations of airways diseases and even deaths from respiratory and cardiovascular causes. Elucidation of the mechanism of the harmful effects of these pollutants should allow improved risk assessment for patients with airways diseases who are be susceptible to the effects of these air pollutants.

Key Words: air pollution • COPD • exacerbations • fine-particulate air pollution • mechanisms

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