THE ROLE OF AIR POLLUTION IN THE PROGRESSION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD): A MULTICENTER COHORT STUDYx

Background: The development of COPD is greatly affected by environmental aspects, among them being air pollution. Some research has found a correlation between exposure to air pollutants and difficulties with COPD, but information from South Asia is still lacking. Aim: The study was set up to analyze how air pollution in the environment affects the worsening of COPD in individuals treated in a tertiary center. Methods: From May 2024 to April 2025, this multicenter cohort study was carried out at Shifa International Hospital, Islamabad. Ninety people with diagnosed COPD were involved in the study and were followed for 12 months. The exposure of participants to different common air pollutants (PM2.5, PM10, NO₂, and SO₂) was measured by using monitoring data from the area where they live. How often someone had exacerbations and was hospitalized, as well as improvements or worsening in symptoms, were noted and examined in relation to the air quality index. Results: The research showed that being exposed to more of PM2.5 and PM10 leads to a decline in lung function (p<0.01). Those in areas with high levels of pollution visited the hospital and experienced more COPD exacerbations than those living in areas where pollutant levels were lower. It was also observed that people who were exposed to high levels of NO₂ and SO₂ for long periods had worse health symptoms and a lower quality of life. Conclusion: The participants involved in the study were greatly affected by air pollution, which sped up and increased their symptoms of COPD. The results point to the need for more rules to keep air safe and personalized care options, mainly in areas of high pollution. Keywords: Chronic Obstructive Pulmonary Disease, Air Pollution, PM2.5, COPD Exacerbation, Pulmonary Function, Environmental Health, Pakistan.