J Med Assoc Thai 2021; 104 (10):63-70

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Dust and Organic Carbon in Ambient Air Pollution Associated with Increased Mortality in Chronic Obstructive Pulmonary Diseases in Thailand
So-Ngern A Mail, Reechaipichitkul W , Peansukwech U , Arunsurat I , Ratanawatkul P , Chumpangern W

Objective: Particulate matter(PM) is associated with mortality in chronic obstructive pulmonary disease (COPD). The present study aimed to assess the association between the chemical components in PM and COPD mortality in Thailand.
Materials and Methods: The Poisson log-linear model and Bayesian hierarchical spatio-temporal with R package Integrated Nested Laplace Approximation (R-INLA) were used to determine the factor associated with COPD mortality, the database from the National Strategy and Planning Division, Office of the Permanent Secretary, Ministry of Public Health of Thailand and the concentration of five PM chemical components including dust-PM2.5, organic carbon, black carbon, sea salt, and sulfate, the database from Modern-Era Retrospective Analysis for Research and Application, version 2 (MERRA-2) to analyze the spatial-temporal association of COPD mortality related to chemical components between 2014 to 2016.
Results: A cumulative incident rate of COPD death was 19,285 cases or 29.49 per 100,000 populations. Health region 1 located in North of Thailand had the highest mortality, 95.86 per 100,000 population while the lowest mortality was in health region 8 located in Northeast of Thailand, 12.50 per 100,000 population. Average dust-PM2.5 and organic carbon concentrations in PM were high in North of Thailand. The spatial-temporal analysis found the association between COPD mortality and dust-PM2.5 exposure with incidence rate ratio (IRR) 2.191 (95% confidence interval (CI) 2.102 to 2.283), and organic carbon exposure with IRR 1.074 (95% CI 1.065 to 1.084). The posterior marginal for linear predictor IRR and fitted value computed of COPD mortality showed that an increase of 1 μg/m3 in dust-PM2.5 and organic carbon exposure were associated with increase of COPD mortality by 64.0% and 35.3%.
Conclusion: Dust-PM2.5 and organic carbon were associated with increase COPD mortality in Thailand. Health region 1 (North of Thailand) had the greatest magnitude of COPD mortality associated with dust-PM2.5 and organic carbon exposure.

Keywords: COPD; Mortality; Dust; Organic carbon; Thailand

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