The role of air pollution in COPD and implications for therapy

INTRODUCTION: Exposure to many environmental conditions, apart from tobacco, as a risk factor for developing chronic obstructive pulmonary disease (COPD) has been comprehensively studied. AREAS COVERED: Global estimates of air pollution depict a scenario of a considerable burden on respiratory health. Exposure to biomass smoke and occupational inhaled agents have been described as potentially related to causing or aggravating COPD. A number of emerging natural or accidental disasters have been suggested as a new source of exposure. Management of COPD patients exposed to different substances should include avoidance, especially in the more susceptible populations and proper pharmacological treatment considering potential association with particular clinical presentations. Expert commentary: Altogether, the available information indicates that appraisal of different environmental pollution exposures is clinically relevant, and should be systematically evaluated in COPD.