Abstract

Chronic obstructive pulmonary disease (COPD) is a significant global health issue. Although smoking is a primary risk factor, air pollution is becoming more and more associated with its development. The relationship between the incidence of COPD and air pollution exposure was the subject of this meta-analysis. In order to identify studies published up to February 1, 2025, a systematic search of pertinent databases was conducted to investigate the correlation between air pollution and the incidence of COPD. The aggregate risk ratio (RR) and heterogeneity were calculated by pooling data from eligible studies using a random-effects model. The impact of these factors on the observed associations was investigated through meta-regression analyses. A total of 3,610,889 participants were included in eighteen studies. The overall RR for COPD incidence among those exposed to air pollution was 0.07 (95% CI: 0.05, 0.12), which is counterintuitive and likely reflects high heterogeneity. Subgroup analyses performed for various pollutant categories and exposure durations also demonstrated substantial associations; however, the heterogeneity was substantial (I² = 100% for all). The test for subgroup differences was not significant, despite the fact that significant associations were observed across income levels. The incidence of COPD was not significantly correlated with pollutant type, exposure duration, or income level, as indicated by meta-regression analyses. Despite the substantial heterogeneity and unusually low risk ratio, this meta-analysis indicates a statistically significant association between air pollution exposure and COPD incidence. This suggests that there is significant variability in study methodologies and exposure assessments.

Key words: Air Pollution, COPD, Meta-Analysis, incidence.