Document Type: Original Article


1 Emergency Department, Iran University of Medical Sciences, Tehran, Iran

2 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

3 Department of Hematology Oncology, Alborz University of Medical Sciences, Karaj, Iran

4 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran


Objective: There are many communities at risk by a series of air pollution episodes. Tehran is one of the most polluted cities in the world. The presence of one or more air pollutants with a certain concentration in a particular period of time can cause several adverse effects on human and animals’ well-being that can cause much morbidity. There are several pollutants in the air but some of them can cause severe adverse effects on the lungs and air ways.
Methods: In this retrospective cross-sectional study 1958 patients with exacerbation of chronic obstructive pulmonary disease (COPD) who were admitted in the emergency department (ED) of Rasol Akram hospital between March 2004 and March 2006 entered the study. Data such as number of admissions, air pollution particles (CO, SO2, O3, NO2, PM10) according to available documents were analyzed.
Results: From 1958 patients who enrolled in this study, 887 (53.5%) were male and 771 (46.5%) were female. According to statistical analysis, we could observe a significant correlation between the concentration of Co, PM10, So2 with ED admission rate of COPD exacerbation (P: 0.031, 0.008, and 0.001 respectively). The effect of PM10, So2 and Co was more significant respectively in logistic regression on ED admission.
Conclusion: There was significant correction between concentrations of air pollutants with number of ED admission for COPD exacerbation.


Main Subjects

1. Sunyer J. Urban air pollution and chronic obstructive pulmonary disease: a review. Eur Respir J 2001; 17(5): 1024-33. doi: 10.1183/09031936.01.17510240.

2. Brook RD, Rajagopalan S, Pope CA 3rd, Brook JR, Bhatnagar A, Diez-Roux AV, et al. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 2010; 121: 2331-78. doi:


3. Chen L, Verrall K, Tong S. Air particulate pollution due to bushfires and respiratory hospital admissions in Brisbane, Australia. Int J Environ Heal Res 2006; 16(3): 181-91. doi: 10.1080/09603120600641334.

4. UK Ministry of Health. Reports on Public Health and Medical Subjects. London: Ministry of Health; 1954.

5. Zanobetti A, Schwartz J, Samoli E, Gryparis A, Touloumi G, Peacock J, et al. The temporal pattern of respiratory and heart disease mortality in response to air pollution. Environ Health Perspect 2003; 111(9): 1188-93. doi: 10.1289/ehp.5712.

6. Le TG, Ngo L, Mehta S, Do VD, Thach TQ, Vu DX, et al. Effects of short-term exposure to air pollution on hospital admissions of young children for acute lower respiratory infections in Ho Chi Minh City, Vietnam. Res Rep Health Eff Inst 2012; (169): 5-72.

7. Kim SY, Peel JL, Hannigan MP, Dutton SJ, Sheppard L, Clark ML, et al. The temporal lag structure of short-term associations of fine particulate matter chemical constituents and cardiovascular and respiratory hospitalizations. Environ Health Perspect 2012; 120(8): 1094-9. doi: 10.1289/ehp.1104721.

8. Peters A, Frohlich M, Doring A, Immervoll T, Wichmann HE, Hutchinson WL, et al. Particulate air pollution is associated with an acute phase response in men; results from the MONICA-Augsburg Study. Eur Heart J 2001; 22: 1198-204. doi: 10.1053/ euhj.2000.2483.

9. Romieu I, Gouveia N, Cifuentes LA, de Leon AP, Junger W, Vera J, et al. Multicity study of air pollution and mortality in Latin America. Res Rep Health Eff Inst 2012; (171): 5-86.

10. Kan H, Chen B, Zhao N, London SJ, Song G, Chen G, et al. Part 1. A time-series study of ambient air pollution and daily mortality in Shanghai, China. Res Rep Health Eff Inst 2010; (154): 17-78.

11. Qian Z, He Q, Lin HM, Kong L, Zhou D, Liang S, et al. Part 2. Association of daily mortality with ambient air pollution, and effect modification by extremely high temperature in Wuhan, China. Res Rep Health Eff Inst 2010; (154): 91-217.

12. Merrifield A, Schindeler S, Jalaludin B, Smith W. Health effects of the September 2009 dust storm in Sydney, Australia: did emergency department visits and hospital admissions increase? Environ Health 2013; 12: 32. doi: 10.1186/1476-069X-12-32.

13. Bind MA, Baccarelli A, Zanobetti A, Tarantini L, Suh H, Vokonas P, et al. Air pollution and markers of coagulation, inflammation, and endothelial function: associations and epigene-environment interactions in an elderly cohort. Epidemiology 2012; 23(2): 332-40.

doi: 10.1097/ede.0b013e31824523f0.

14. Mills NL, Törnqvist H, Gonzalez MC, Vink E, Robinson SD, Söderberg S, et al. Ischemic and thrombotic effects of dilute diesel-exhaust inhalation in men with coronary heart disease. N Engl J Med 2007; 357(11): 1075-82.