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ObjectiveDespite of the tentative role of asbestos in chronic obstructive pulmonary disease (COPD), their lung function variation in relation to air pollution remains unexplored. This cross-sectional study aimed to explore the effects of air pollution on severe airway obstruction (SAO) in asbestos-related COPD.MethodsCOPD subjects were retrospectively recruited, and their asbestos exposure and SAO were verified using the existence of pleural plaque in chest X-ray and the predicted value of forced expiratory volume in 1 second in percentage less than 50%, respectively, followed by examining the association between PM_2.5, PM₁₀, SO₂, NO₂, O₃, and CO and SAO stratified by asbestos exposure using regression model.ResultsSAO percentage was 67.2% (41/61) and 65.2% (15/23) in COPD subjects without and with asbestos exposure, respectively. An increased 3-day average concentration of CO and O₃ correlated with SAO (odds ratio, 95% confidence interval: 0.06, 0.01-0.41 and 0.09, 0.01-0.64, respectively). Moreover, an increased 5-day average CO concentration also correlated with SAO (0.13, 0.02-0.71) prior to hospital admission of COPD subjects irrespective of asbestos exposure, and SAO failed to be associated with asbestos exposure.ConclusionsCertain gaseous pollution at low concentration might generally exhibit a negative association with SAO in COPD subjects, indicating the negligibly negative impact of air pollution on lung function deterioration in asbestos-related COPD.