Association between extreme temperature exposure and COPD health outcomes in China: study protocol for a systematic review.

INTRODUCTION

The Chinese continent is grappling with a rising prevalence of chronic obstructive pulmonary disease (COPD) in conjunction with the growing threat of climate change and its associated extreme temperature. This systematic review aims to assess the relationship between extreme temperature exposures (heat and cold exposure) and COPD health outcomes in Chinese populations.

METHODS AND ANALYSIS: This study will assess the relationship between extreme temperature exposures and COPD health outcomes through a systematic review and meta-analysis. Observational studies meeting the inclusion criteria will be included, and the Population-Exposure-Comparator-Outcome-Study (PECOS) research design standard will be adopted to examine how extreme temperatures impact COPD-related mortality and morbidity including hospitalizations and acute exacerbations. A literature search will be conducted across multiple databases, including PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure (CNKI), WANGFANG Data, VIP and Sinomed. We will evaluate the reporting quality, methodological quality and evidence quality of these observational, cohort, and cross-sectional studies using Risk of Bias in Non-randomized Studies-of Environmental Exposure (ROBINS-E) assessment tool, and integrate the evidence within the GRADE framework. Additionally, the analysis of outcomes will be performed using the narrative synthesis and R software.

ETHICS AND DISSEMINATION: Ethical approval is not required for this review. The results of this study will be disseminated through publication in a peer-reviewed journal.

STUDY PROTOCOL REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261281322, identifier (CRD420261281322).