Environmental Substances Associated with Chronic Obstructive Pulmonary Disease: A Scoping Review

Hanna Maria Elonheimo*, Tiina Mattila, Helle Raun Andersen, Beatrice Bocca, Flavia Ruggieri, Elsi Haverinen, Hanna Tolonen

*Corresponding author for this work

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Chronic obstructive pulmonary disease (COPD) is a slowly developing non‐communica-ble disease (NCD), causing non‐reversible obstruction and leading to marked morbidity and mortality. Besides traditional risk factors such as smoking, some environmental substances can augment the risk of COPD. The European Human Biomonitoring Initiative (HBM4EU) is a program evaluating citizens’ exposure to various environmental substances and their possible health impacts. Within the HBM4EU, eighteen priority substances or substance groups were chosen. In this scoping review, seven of these substances or substance groups are reported to have an association or a possible association with COPD. Main exposure routes, vulnerable and high‐exposure risk groups, and matrices where these substances are measured are described. Pesticides in general and especially organophosphate and carbamate insecticides, and some herbicides, lead (Pb), and polycyclic aromatic hydrocarbons (PAHs) showed an association, and cadmium (Cd), chromium (Cr and CrVI), arsenic (As), and diisocyanates, a possible association with COPD and/or decreased lung function. Due to long latency in COPD’s disease process, the role of chemical exposure as a risk factor for COPD is probably underestimated. More research is needed to support evidence‐based conclusions. Generally, chemical exposure is a growing issue of concern, and prompt action is needed to safeguard public health.

Original languageEnglish
Article number3945
JournalInternational Journal of Environmental Research and Public Health
Issue number7
Publication statusPublished - 25. Mar 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • Arsenic (As)
  • Cadmium (Cd)
  • Chemical exposure
  • Chromium (Cr)
  • Chronic obstructive pulmonary disease (COPD)
  • Diisocyanates
  • HBM4EU
  • Human biomonitoring (HBM)
  • Lead (Pb)
  • Pesticides
  • Polycyclic aromatic hydrocarbons (PAHs)


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