COPD, Pollen and Deaths
People with chronic obstructive pulmonary diseases (COPD) are often warned by doctors to stay indoors when there are high pollution or ozone levels. This is because these things in the air make it harder to breathe for anyone. Breathing polluted air can actually send patients with COPD to the emergency room! But what about other things in the air? This is a time where trees are budding, flower begin to bloom and grass is cut more often. Can this affect patients with COPD just as much as pollution?
A study published in the highly respected journal Lancet looked into this question.(1) They measured the affect of pollution and pollen on COPD patients by the number of deaths on days with high levels of pollution or pollen on those days before and on the day of the deaths. It has already been shown in other studies that days with higher pollution levels increase the number of deaths in COPD patients. (2) (3) These researchers wanted to see if the same held true for pollen.
They found a dose-response relationship between the amount of pollen in the air and COPD deaths. (1) This means that the higher the pollen level, the more COPD patients died. The researchers also mentioned that there was no confounding by pollution levels. This means that high pollution days and high pollen days did not occur at the same time. So, the deaths were not due to high pollution levels on these high pollen days.
What does this mean for patients with COPD? Breathing in pollen reduces the forced expiratory volume or amount of air that can get in and out of the lungs. (4) This is because the lungs are inflamed due to breathing in pollen. When COPD patients have this much trouble breathing, they should go to the hospital immediatly for treatment to reduce the inflammation. To prevent this, patients with COPD should stay indoors and keep their windows closed on days with high pollen levels. They can listen to the news or go on weather websites for their area to find out if each day is considered a high pollen level day.
1. Relation between airborne pollen concentrations and daily cardiovascular and respiratory disease mortality. Brunekreef, B, et al. 9214, 2000, Lancet, Vol. 355, pp. 1517-18.
2. Mortality and air pollution: associations persest with continued advances in research methodology. Pope, CA. 1999, Environ Health Perspect, Vol. 107, pp. 613-14.
3. Particulate air pollution and acute health effects. Seaton, A, et al. 1995, Lancet, Vol. 345, pp. 176-78.
4. Eosinophilia and positive skin tests predict cardiovascular mortality in a genaral population sample followed for 30 years. Hospers, JJ, et al. 1999, Am J Epidemiol, Vol. 150, pp. 482-91.
Laurie M. DeChello, MPH, CPH
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