Does ambient CO have protective effect for COPD patient?

Abstract

Background: Existing studies found paradoxical effects of carbon monoxide (CO) on human health. Carbon monoxide (CO), at high concentrations, is a well-known toxicant, but recent studies suggest that CO at low concentrations may have protective health effects under certain conditions.

Objectives: To investigate the acute effect of ambient CO on hospital admission for chronic obstructive pulmonary disease (COPD) in Shanghai, China.

Methods: Daily data on COPD admissions and CO concentrations between 2006 and 2008 were collected. We applied over-dispersed generalized additive Poisson models, adjusted for weather conditions, day of the week and public holidays, long-term and seasonal trends.

Results: During the study period, the average CO concentration was 1.3mg/m(3), well below the international health-based standard. Negative associations were found between ambient CO concentration and daily COPD hospitalization. An interquartile range increase (0.6 mg/m(3)) in CO concentration at lag 3 day corresponded to -2.97% (95% confidence interval: -4.63%, -1.31%) change in COPD hospitalization. The negative associations were robust after adjustment for co-pollutants (PM10, NO2 and SO2). The protective effect of CO appeared to be more evident in the cool season.

Conclusion: Short-term exposure to CO at low ambient concentration may be associated with reduced risk of COPD hospitalization. Our results may contribute to a comprehensive understanding on the health effects of ambient CO.

Keywords: Carbon monoxide; Chronic obstructive pulmonary disease; Time-series models.