Hongxia Duan,1 Peijun Li,1 Yingqi Wang,1 Linhong Jiang,1 Yide Wang,2 Weibing Wu,3 Xiaodan Liu1 

1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Department of Rehabilitation, Fourth Clinical Medical College of Xinjiang Medical University, Xinjiang, People’s Republic of China; 3Department of Sports Medicine, Shanghai University of Sport, Shanghai, People’s Republic of China

Correspondence: Xiaodan Liu, Email hzhp403@126.com

Background: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide, of which 41.27% of the burden may be related to particulate matter (PM) pollution. Understanding the PM-related burden of COPD at global, national and regional levels can provide evidence for public health policies.
Methods: First, the numbers of death and disability-adjusted life year (DALY), and the corresponding age-standardized rates were assessed globally and by subtype, including age, sex, sociodemographic index (SDI), country, and region from 1990 to 2021. Second, the temporal trend in disease burden was estimated by joinpoint regression analysis. Furthermore, an international health inequality analysis was used to assess the inequality slope indices and concentration indices, and frontier analysis was performed to explore the current situation and potential improvement of disease burden control. Finally, we constructed an auto regressive integrated moving average model to predict PM-related burden of COPD in the next 15 years.
Results: In 2021, the number of COPD deaths and DALYs attributed to PM were approximately 1.54 million and 33.24 million, respectively. The age-standardized death rate (ASMR) and age-standardized DALY rate (ASDR) were 1.66 and 1.50 times higher in males than in females. Interestingly, the ASMR and ASDR exhibited an increase from 2020 to 2021. The highest COPD burden attributed to PM was in low and low-middle SDI regions. Countries with an SDI between 0.3 and 0.6 had the greatest potential to reduce the COPD burden attributed to PM, especially in Asia, Oceania, and Africa. In the next 15 years, the ASMR and ASDR of COPD attributable to PM for both sexes will decrease, and the difference between male and female patients will be almost nonexistent.
Conclusion: The COPD burden attributable to PM remains a long-term problem globally, especially in males, the older adults, and low and low-middle SDI regions.

Keywords: particulate matter pollution, chronic obstructive pulmonary disease, death, disability-adjusted life year, disease burden, GBD