Burden of Chronic Obstructive Pulmonary Disease Attributable to Air Pollution in Türkiye (1990–2021)

Abstract

Objective: Exposure to particulate matter and ozone has been linked to decreased lung capacity, hospitalizations, and mortality from Chronic Obstructive Pulmonary Disease (COPD). This study aims to evaluate the mortality rate attributed to air pollution-related Chronic Obstructive Pulmonary Disease (COPD) in Türkiye over the past 30 years. Materials and Methods: This was a epidemiological study. Age-standardized mortality statistics for COPD caused by outdoor (Particulate Matter 2.5 and Ozone) and indoor (solid fuel) air pollution were obtained from the Global Burden of Disease (GBD) database. Changes in cause-specific death rate trends in Türkiye between 1990 and 2021 were assessed using Joinpoint regression analysis to calculate annual percentage changes (APC) and average annual percentage changes. Results: Age-standardized mortality rates (ASMRs) declined from 48.41 (per 100,000) (95% CI: 39.31; 55.91) to 35.78 (95% CI: 24.03; 44.40) with an APC of -0.26 (95% CI: -0.46; -0.04) over the 1990-2021 period for both sexes. While there is a consistent downward trend in ASMRs attributed to household air pollution from solid fuels for both genders, different upward trends were observed over the years for ASMRs attributed to ambient particulate matter pollution and ambient ozone pollution. Conclusion: Over the last 30 years in Türkiye, while the mortality rate linked with solid fuel consumption has generally decreased, the mortality rates associated with PM and ozone have fluctuated. This suggests that legislation addressing indoor air quality has been effective, but health risks associated with outdoor air quality have persisted in Türkiye over the past 30 years.

Keywords

• Air pollution
• Chronic Obstructive Pulmonary Disease
• Trend analysis
• Türkiye

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