title: Exposure to Indoor Particulate Matter Worsens the Symptoms and Acute Exacerbations in Chronic Obstructive Pulmonary Disease Patients of Southwestern Taiwan: A Pilot Study.
abstract: Ambient particulate matter (PM) can trigger adverse reactions in the respiratory system, but less is known about the effect of indoor PM. In this longitudinal study, we investigated the relationships between indoor PM and clinical parameters in patients with moderate to very severe chronic obstructive pulmonary disease (COPD). Indoor air quality (PM2.5and PM10levels) was monitored in the patients' bedroom, kitchen, living room, and front door at baseline and every two months for one year. At each home visit, the patients were asked to complete spirometry and questionnaire testing. Exacerbations were assessed by chart review and questionnaires during home visits. Generalized estimating equation (GEE) analysis (n= 83) showed that the level of wheezing was significantly higher in patients whose living room and kitchen had abnormal (higher than ambient air quality standards in Taiwan) PM2.5and PM10levels. Patients who lived in houses with abnormal outdoor PM2.5levels had higher COPD Assessment Test scores (physical domain), and those who lived in houses with abnormal PM10levels in the living room and kitchen had higher London Chest Activity of Daily Living scores. Increased PM levels were associated with worse respiratory symptoms and increased risk of exacerbation in patients with moderate to very severe COPD.
authors.affiliation: Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), Puzi City 613, Taiwan. mcchi@mail.cgust.edu.tw.|Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi City 613, Taiwan. mcchi@mail.cgust.edu.tw.
authors.forename: Miao-Ching
authors.initials: MC
authors.lastname: Chi
authors.affiliation: Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), Puzi City 613, Taiwan. seguo@mail.cgust.edu.tw.|Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Puzi City 613, Taiwan. seguo@mail.cgust.edu.tw.|Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Puzi City 613, Taiwan. seguo@mail.cgust.edu.tw.
authors.forename: Su-Er
authors.initials: SE
authors.lastname: Guo
authors.affiliation: Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), Puzi City 613, Taiwan. slhuang@mail.cgust.edu.tw.|Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Puzi City 613, Taiwan. slhuang@mail.cgust.edu.tw.
authors.forename: Su-Lun
authors.initials: SL
authors.lastname: Hwang
authors.affiliation: Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), Puzi City 613, Taiwan. ctchou@gw.cgust.edu.tw.|Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Puzi City 613, Taiwan. ctchou@gw.cgust.edu.tw.
authors.forename: Chiang-Ting
authors.initials: CT
authors.lastname: Chou
authors.affiliation: Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi City 613, Taiwan. f124510714@adm.cgmh.org.|Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Puzi City 613, Taiwan. f124510714@adm.cgmh.org.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan. f124510714@adm.cgmh.org.
authors.forename: Chieh-Mo
authors.initials: CM
authors.lastname: Lin
authors.affiliation: Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi City 613, Taiwan. lin0927@adm.cgmh.org.tw.|Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Puzi City 613, Taiwan. lin0927@adm.cgmh.org.tw.|Department of Respiratory Care, Chang Gung University, Taoyuan 333, Taiwan. lin0927@adm.cgmh.org.tw.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Lin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000393:Air Pollutants / Q000032:analysis*; D016902:Air Pollution, Indoor / Q000032:analysis*; D004784:Environmental Monitoring; D006798:Housing; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis; D008137:Longitudinal Studies; D008297:Male; D052638:Particulate Matter / Q000032:analysis*; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D012135:Respiratory Sounds; D013147:Spirometry; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: COPD assessment test; acute exacerbation of COPD (AECOPD); chronic obstructive pulmonary disease; hospitalization; indoor air quality; respiratory symptoms