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Association between outdoor PM2.5 and prevalence of COPD: a systematic review and meta-analysis
  1. Feng Han1,2,
  2. Xiaoyan Yang1,
  3. Donggang Xu3,
  4. Qin Wang1,
  5. Dongqun Xu1
  1. 1 Department of Air Quality Monitoring, National Institute of Environmental Health, China CDC, Beijing, China
  2. 2 Occupational Epidemiology and Risk Assessment, The National Institute of Occupational Health and Poison Control, China CDC, Beijing, China
  3. 3 Molecular Genetics Laboratory, Institute of Military Cognitive and Brain Sciences, Academy of Military Medical Sciences, Bejing, China
  1. Correspondence to Dongqun Xu, National Institute of Environmental Health, China CDC, Beijing 100021, China; dongqunxu{at}; Qin Wang, National Institute of Environmental Health, China CDC, Beijing 100021, China; wangqin{at}


There were conflictions and differences among the results of cross-sectional studies association between PM2.5 and COPD prevalence. We aimed to explore the real association between outdoor PM2.5 and COPD prevalence, analyze the possible cause to the differences and conflictions in previous cross-sectional studies. Cross-sectional literatures about the association between outdoor PM2.5 and COPD prevalence were selected up to 12 September 2018. Subgroup analysis was performed to explore the source of the heterogeneity. Publication bias was tested via funnel plot. Leave-one-out method was used to conduct influential analysis. Variance analysis was used to analyze the influence of concentration, literature quality and age (over 60 or not) on the ln (aOR) values. The initial search revealed 230 studies, of which 8 were selected. The heterogeneity in this study was significant (I2=62, P<0.01), and random effects model was used. The pooled OR for the association between PM2.5 and COPD prevalence is 2.32(95%CI, 1.91-2.82). There was no evidence of publication bias. Subgroup analysis showed the subgroup of age seemed to be the source of heterogeneity (P=0.0143, residual I2=0%). Variance analysis showed that the differences of ln (aOR) among each concentration group(p=0.0075) were statistically significant, the same as age groups(P=0.0234). This meta-analysis study demonstrated a conclusive association between PM2.5 and prevalence of COPD (OR: 2.32, 95%CI 1.91–2.82). The significant heterogeneity among selected studies was mainly caused by age (over 60 or not). High PM2.5 concentration should be needed in further research of the relationship between PM2.5 and chronic diseases.

  • public health
  • epidemiology

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  • FH and XY are joint first authors.

  • Contributors FH, XY, DX and QW discussed and determined the planning of this manuscript together. FH and XY conducted the meta-analysis and wrote the manuscript, of which FH did a little more work. DX, QW and DX gave the suggestion to the meta-analysis, and helped to wrote the manuscript. DX and QW gave the final confirmation of the manuscript.

  • Funding This study was supported by the Public Welfare Program of National Health and Family Planning Commission of China (201402022 and 201502003). This manuscript was edited by Wallace Academic Editing.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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