title: The global contribution of outdoor air pollution to the incidence, prevalence, mortality and hospital admission for chronic obstructive pulmonary disease: a systematic review and meta-analysis.
abstract: OBJECTIVE
  This study aimed to investigate the quantitative effects of outdoor air pollution, represented by 10 µg/m(3) increment of PM10, on chronic obstructive pulmonary disease in China, United States and European Union through systematic review and meta-analysis.
  
  
  METHODS
  Publications in English and Chinese from PubMed and EMBASE were selected. The Cochrane Review Handbook of Generic Inverse Variance was used to synthesize the pooled effects on incidence, prevalence, mortality and hospital admission.
  
  
  RESULTS
  Outdoor air pollution contributed to higher incidence and prevalence of COPD. Short-term exposure was associated with COPD mortality increased by 6%, 1% and 1% in the European Union, the United States and China, respectively (p < 0.05). Chronic PM exposure produced a 10% increase in mortality. In a short-term exposure to 10 µg/m(3) PM10 increment COPD mortality was elevated by 1% in China (p < 0.05) and hospital admission enrollment was increased by 1% in China, 2% in United States and 1% in European Union (p < 0.05).
  
  
  CONCLUSIONS
  Outdoor air pollution contributes to the increasing burdens of COPD.10 µg/m(3) increase of PM10 produced significant condition of COPD death and exacerbation in China, United States and European Union. Controlling air pollution will have substantial benefit to COPD morbidity and mortality.
authors.affiliation: Beijing Key Laboratory of Cancer Therapeutic Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Tie Yi Road 10, Haidian District, Beijing 100038, China. songqingkun@gmail.com.
authors.forename: Qingkun
authors.initials: Q
authors.lastname: Song
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA. dchris@hsph.harvard.edu.
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
authors.affiliation: The Chinese University of Hong Kong, Hong Kong 999077, China. xrwang@cuhk.edu.hk.
authors.lastname: XiaorongWang
authors.affiliation: Beijing Key Laboratory of Cancer Therapeutic Vaccine, Capital Medical University Cancer Center, Beijing Shijitan Hospital, Tie Yi Road 10, Haidian District, Beijing 100038, China. renjun9688@yahoo.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Ren
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D000397:Air Pollution / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D004781:Environmental Exposure; D005060:Europe / Q000453:epidemiology; D005062:European Union; D006760:Hospitalization / Q000706:statistics & numerical data; D015994:Incidence; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced / Q000453:epidemiology* / Q000401:mortality; D014481:United States / Q000453:epidemiology
chemical_list: D000393:Air Pollutants