Abstract

ORDUZ GARCIA, CARLOS EDUARDO; TORO, MARÍA VICTORIA  and  GOMEZ, JUAN CARLOS. COPD, CHRONIC BRONCHITIS AND RESPIRATORY SYMPTOMS ASSOCIATED WITH PM10 POLLUTION IN THE CITY OF MEDELLIN (COLOMBIA). rev.fac.med [online]. 2013, vol.21, n.1, pp.21-28. ISSN 0121-5256.

There is increasing evidence that air pollution in cities has long-term effects on chronic respiratory disease in children, yet there are scarce studies with non conclusive results in adults. We examined the associations between pollution resulting from PM10 and respiratory symptoms, chronic bronchitis and COPD in the city of Medellín (Colombia) in order to determine if these levels were associated with a higher prevalence of adult chronic respiratory diseases. The objectives of this study were: to assess the prevalence of respiratory symptoms, chronic bronchitis and COPD in these two areas, to compare the prevalence of these pathologies between the two areas, and make a comparison of the relative risks in order to determine if such difference is statistically significant. A cross-sectional study with an analytical component was designed. The research was performed in two stages. In the first stage (Phase I) the environmental issues were assessed and the areas of high and low pollution caused by PM10 were selected. In the second stage (Phase II) a cross-sectional epidemiological investigation with an analytical component was designed. A questionnaire was used and a spirometry was performed before and after administering inhaled salbutamol 200 mg, accordingly to ATS/ERS protocol. The used operative definitions were as follows: Chronic bronchitis: cough and phlegm for three months during two consecutive years. COPD: FEV/FVC < 70% post-bronchodilator. Respiratory symptoms: Cough phlegm, wheezing, dyspnea. The analysis was performed using a SPSS software. A total of 578 subjects (381 in the area of Guayabal and 197 subjects in the area of Robledo) were included. Following the statistical analysis, it was found that living for over five (5) years in an area with average pollution by PM10 levels of 75 mg/m3, in comparison with living for more than five (5) years in an area with levels of 45 mg/m3 is associated with a higher prevalence of respiratory symptoms namely cough and phlegm, chronic bronchitis, bronchial obstruction and COPD. It was concluded that living in an area polluted with PM10 during 5 years or more is associated with higher prevalence of respiratory symptoms, chronic bronchitis and COPD. The relative risk of developing COPD is significantly higher in the area with higher levels of pollution by PM10. This shows that air pollution resulting from PM10 has long-term effects on adult chronic respiratory disease. Additional studies are required to confirm these findings.

Keywords : Chronic bronchitis; COPD; Respiratory symptoms; Epidemiology; Environmental Air Pollution.

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