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Abstract
Impaired lung function is associated with morbidity and mortality in the elderly. However, there is a paucity of data regarding the long-term effects of particulate matter (PM) on lung function among the elderly. This study evaluated the exposure-response relationship between ambient PM and different lung function indices among the elderly in Taiwan. A cross-sectional survey of individuals aged ≥65 years was conducted in Taiwan from October 2015 to September 2016. Those who attended the annual health examination for the elderly in five hospitals of varying background PM concentrations were enrolled. The long-term (2015 annual mean concentration) exposure to air pollution was estimated by the Kriging method at the residence of each subject. The association between ambient PM exposure and lung function was evaluated by linear regression modeling, with adjustments for age, sex, height, weight, educational attainment, presence of asthma or chronic obstructive pulmonary disease, smoking status, season, and co-pollutants. There were 1241 subjects (mean age, 70.5 years). The mean residential PM2.5 and PM2.5–10 in 2015 was 26.02 and 18.01 μg/m3, respectively. After adjustments for confounders and co-pollutants, the FVC decrease was best associated with fine particles (PM2.5), whereas the FEV1, FEF25–75%, FEF25% and FEF50% decreases were best associated with coarse particles (PM2.5–10). An IQR (10 μg/m3) increase in PM2.5 decreased FVC by 106.38 ml (4.47%), while an IQR (7.29 μg/m3) increase in PM2.5–10 decreased FEV1 and FEF25–75% by 91.23 ml (4.85%) and 104.44 ml/s (5.58%), respectively. Among the Taiwanese elderly, long-term PM2.5 exposure mainly decreases the vital capacity of lung function. Moreover, PM2.5–10 has a stronger negative effect on the function of conductive airways than PM2.5.
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1 Department of Environmental and Occupational Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of medicine and NTU Hospital, Taipei City, Taiwan
2 Department of Geomatics, National Cheng Kung University, Tainan City, Taiwan
3 National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
4 School of Medicine, National Yang-Ming University, Taipei City, Taiwan; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei City, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan; Department of Neurosurgery, Taipei City Hospital, Taipei City, Taiwan
5 Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
6 Department of Occupational Medicine, Health Management Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
7 Department of Family Medicine, Hualien Tzu-Chi General Hospital, Hualien, Taiwan
8 Division of Geriatrics, Dalin Tzu-Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
9 Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of medicine and NTU Hospital, Taipei City, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei City, Taiwan