Association between outdoor air pollution and acute exacerbation of chronic obstructive pulmonary disease in Xinjiang, China

This study investigated the association between short-term exposure to air pollutants and hospital admissions for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in Northwest China. We analyzed data from a tertiary hospital in Xinjiang (2014-2023), along with air pollutant and meteorological data. Using a time-series approach with generalized additive models and distributed lag nonlinear models, we found that interquartile range increases in PM₂.₅, PM₁₀, NO₂, CO, and O₃ were associated with increased AECOPD admissions of 4.70% (95% CI: 1.48%, 8.01%), 1.61% (0.38%, 2.86%), 15.97% (7.36%, 25.28%), 35.64% (15.84%, 58.82%), and 5.89% (1.10%, 10.90%), respectively, with peak effects at lag 0. Stratified analyses identified sex-, age-, and season-specific relationships, including protective effects of O₃ and CO in males at longer lags, heightened susceptibility to particulate matter and NO₂ in adults aged ≥65 years, and distinct seasonal patterns for NO₂, O₃, and CO. These findings demonstrate that short-term air pollution exposure is significantly associated with AECOPD hospitalizations in this understudied region.