Spatial Association of Environmental and Dietary Factors with COPD Deaths

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Aktas S., Tuzuner B., Mergen M., Sultan-Ali I., KOÇAK M.

International Journal of COPD, vol.17, pp.1643-1650, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 17
  • Publication Date: 2022
  • Doi Number: 10.2147/copd.s364076
  • Journal Name: International Journal of COPD
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
  • Page Numbers: pp.1643-1650
  • Keywords: chronic obstructive pulmonary disease, air quality markers, meteorology markers, drinking water sources, fruit and vegetable consumption
  • Istanbul Medipol University Affiliated: Yes


Introduction: Chronic obstructive pulmonary disease (COPD) remains a significant health concern globally and spatiotemporal investigations on the etiology and progression of COPD are needed to develop more effective and timely preventive measures. To address this continuing need, we explored the association of air-quality and meteorological markers, fruit and vegetable consumption and drinking water source trajectories with COPD death rate. Methods: For 81 provinces of Turkey, we extracted and merged data in four dimensions: provincial COPD deaths, provincial annual meteorological and air-quality markers, drinking water source data covering rivers, dams, wells, and springs, and annual provincial fruits and vegetables consumption. To investigate the association of these markers with COPD deaths, we used a spatial modelling approach accounting for the spatial autocorrelation. Results: Controlling for household expenditure on cigarette and alcohol and elderly population size, our models suggest that provinces with higher consumption of lemon and higher temperature reported lower level of COPD deaths and provinces high in Nitrogen Dioxide concentration reported higher COPD deaths on average. Conclusion: Therefore, provinces with such profiles need to develop closer screening and follow-up of patients with COPD and encourage healthier diets and lifestyles.