A comparative study of the disease burden of COPD attributable to PM2.5 in China, Japan, and South Korea from 1990 to 2019

Background: Particulate matter pollution (PM2.5) is a major cause of air pollution and an important risk factor for chronic obstructive pulmonary disease (COPD). The COPD disease burden situation in East Asia is severe, and China, Japan, and South Korea are the three largest economies in East Asia. We hope to reveal the changing trends of COPD disease burden attributable to PM2.5 and its age, period, and cohort effects in three typical East Asian countries to provide a reference for public health planning. Methods: : We analyzed trends in change based on GBD2019 using JoinPoint regression models and the effect of age, period and cohort on the disease burden of COPD attributable to PM2.5 using age-period-cohort models. Results: : From 1990 to 2019, except for the global age-standardized mortality rate (ASMR) of COPD attributable to ambient particulate matter pollution (APM) for all genders, all other ASMRs showed a downward trend. All were decreasing except for the age-standardized DALY attributed to APM for females in global. Mortality of COPD attributable to PM2.5 increases with age in Korea and Japan. Mortality of COPD attributable to PM2.5 peaks in the 85-90 year age group and then declines in global. Mortality of COPD attributable to PM2.5 in China declines after peaking in the 90-95 year age group. Mortality of COPD attributable to PM2.5 decreased over time in China, Korea, and global, while it increased in Japan from 2015 to 2019. In China, Japan, and global, mortality of COPD attributable to PM2.5 was lower the later the birth, while in Korea it decreased after a small increase in the 1900-1910 cohort. Conclusion: Most COPD disease burden attributable to PM2.5 is on the decline; Large regional differences in COPD disease burden attributable to PM2.5; The risk of COPD due to HAP and APM differed in different areas; COPD mortality attributable to PM2.5 both increased with age and decreased with time and cohort. Countries in Asia with a high COPD disease burden attributable to PM2.5 should develop targeted measures to control local PM2.5 according to pollutant type and age group to reduce the COPD disease burden caused by PM2.5 according to local conditions.