Spatial Association of Environmental and Dietary Factors with COPD Deaths

Abstract

Introduction

Chronic obstructive pulmonary disease (COPD) remains a significant health concern globally and spatiotemporal investigations on the etiology and progression of COPD are needed to develop more effective and timely preventive measures. To address this continuing need, we explored the association of air-quality and meteorological markers, fruit and vegetable consumption and drinking water source trajectories with COPD death rate.

Methods

For 81 provinces of Turkey, we extracted and merged data in four dimensions: provincial COPD deaths, provincial annual meteorological and air-quality markers, drinking water source data covering rivers, dams, wells, and springs, and annual provincial fruits and vegetables consumption. To investigate the association of these markers with COPD deaths, we used a spatial modelling approach accounting for the spatial autocorrelation.

Results

Controlling for household expenditure on cigarette and alcohol and elderly population size, our models suggest that provinces with higher consumption of lemon and higher temperature reported lower level of COPD deaths and provinces high in Nitrogen Dioxide concentration reported higher COPD deaths on average.

Conclusion

Therefore, provinces with such profiles need to develop closer screening and follow-up of patients with COPD and encourage healthier diets and lifestyles.

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Keywords:

• chronic obstructive pulmonary disease
• air quality markers
• meteorology markers
• drinking water sources
• fruit and vegetable consumption

Data Sharing Statement

As the death records and fruit and vegetable consumption data used in this report were granted access only to the corresponding author, we do not have permission to share these data components; however, we can share the air quality data upon request.

Ethics

This is not applicable as no human subject data has been used in this study; only province-level aggregate data has been used.

Acknowledgment

This study was partially funded by TUBITAK Directorate of Science Fellowships and Grant Programmes (BİDEB)-2232 International Fellowship for Outstanding Researchers. We also thank the Turkish Republic Ministry of Commerce and Turkish Statistical Institute for data sharing. The opinion raised in this article solely belongs to its authors and does not represent the position of TUBITAK, Turkish Republic Ministry of Commerce and Turkish Statistical Institute in any shape or form.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

Partial financial support was received from TUBITAK Directorate of Science Fellowships and Grant Programmes (BIDEB)-2232 International Fellowship for Outstanding Researchers (Award No: 118C306).