Big picture thinking of global PM2.5-related COPD: Spatiotemporal trend, driving force, minimal burden and economic loss

Abstract

Chronic obstructive pulmonary disease (COPD) is a leading global cause of morbidity and mortality, with increasing evidence linking long-term exposure to ambient fine particulate matter (PM_2.5) to accelerated lung function decline and exacerbation of COPD symptoms. This study aimed to assess the global burden of PM_2.5-related COPD from 1990 to 2021 and project future health and economic impacts. Using Mendelian randomization, the causal relationship between PM_2.5 exposure and COPD was confirmed. Data from the Global Burden of Disease 2021 dataset was analyzed across 204 countries, considering age, gender, region, and socio-demographic index (SDI). A significant positive correlation between PM_2.5 exposure and COPD was observed. In 2021, COPD deaths due to ambient PM_2.5 exposure reached 841,466 globally, with an age-standardized mortality rate (ASR) of 10.23 per 100,000 people. DALYs were 17,683,776, with an ASR of 208.27 per 100,000. Both the number of deaths and DALYs significant increased since 1990, primarily driven by population aging and growth. Regional analysis revealed that Asia, especially China and India, bore the highest burden, high SDI regions managed to maintain relatively stable and lower rates, and there are large health inequities. Projections indicate a continued rise in COPD burden, with substantial economic implications, estimating global economic losses of approximately $1.246 trillion by 2050. These findings highlighted the urgent need for public health interventions to mitigate future health and economic impacts of PM_2.5 exposure.