Air Pollution and Socio-Economic Determinants of Chronic Obstructive Pulmonary Disease in Albania

Introduction. Chronic obstructive pulmonary disease (COPD) has become a global issue. The Global Burden of Disease Study reports a prevalence of 251 million cases of COPD in 2016, while it is estimated that 3.17 million deaths were caused by the disease during that period. In this paper we conduct an ecological study, to analyze the effects of socio-economic factors and air pollution on the COPD prevalence at the population level in Albania. Methods. Group-level data from 61 municipalities in Albania was used to assess the relationship between environmental exposures, living conditions, and socioeconomic factors with the prevalence of chronic obstructive pulmonary disease. Results. The regression analysis shows that for every percent increase in the concentration of PM2.5 in Albanian cities, a 32% increase in the prevalence of COPD was observed. Similarly, there was an increase in COPD prevalence associated with the increase of the urban population and the number of vehicles registered per city. It is worth mentioning that no statistically significant relationship was observed between the prevalence of COPD, smoking levels, and the Poverty Index. Conclusions. Within the limitations of an ecological analysis, these findings support an association between the prevalence of chronic obstructive pulmonary disease and environmental exposures, socioeconomic factors, and living conditions. However, there is a call to more individual-level analysis and more in-depth research to further investigate the extent of this association in Albania.