Acute Exacerbations of COPD in Miami

Journal of Clinical Medicine

Michael Campos¹  Naresh Kumar²  Mehdi Mirsaeidi³  MiguelPardinas Gutierrez³  Paquita Zuidema⁴ 

[1] Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, FL and Miami Veterans Affairs Medical Center, Miami, FL 33136, USA;Environmental Health Division, Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL 33136, USA;Pulmonary and Critical Care, Jackson Memorial Hospital, Miami, FL 33136, USA;Rosenstiel School of Marine and Atmospheric Science, University of Miami School of Medicine, Miami, FL 33136, USA;

关键词: Saharan dust outbreak;    COPD;    climate change;    particulate matter;    extreme weather;   

DOI  :  10.3390/jcm9082496

来源: DOAJ

【 摘 要 】

Background: Air pollution is increasingly recognized as a risk factor for acute exacerbation of chronic obstructive pulmonary disease (COPD). Changing climate and weather patterns can modify the levels and types of air pollutants. For example, dust outbreaks increase particulate air pollution. Objective: This paper examines the effect of Saharan dust storms on the concentration of coarse particulate matter in Miami, and its association with the risk of acute exacerbation of COPD (AECOPD). Methods: In this prospective cohort study, 296 COPD patients (with 313 events) were followed between 2013 and 2016. We used Light Detection and Ranging (LIDAR) and satellite-based Aerosol Optical Depth (AOD) to identify dust events and quantify particulate matter (PM) exposure, respectively. Exacerbation events were modeled with respect to location- and time-lagged dust and PM exposures, using multivariate logistic regressions. Measurements and main results: Dust duration and intensity increased yearly during the study period. During dust events, AOD increased by 51% and particulate matter ≤2.5 µm in aerodynamic diameter (PM_2.5) increased by 25%. Adjusting for confounders, ambient temperature and local PM_2.5 exposure, one-day lagged dust exposure was associated with 4.9 times higher odds of two or more (2+ hereto after) AECOPD events (odds ratio = 4.9; 95% CI = 1.8–13.4; p < 0.001). Ambient temperature exposure also showed a significant association with 2+ and 3+ AECOPD events. The risk of AECOPD lasted up to 15 days after dust exposure, declining from 10× higher on day 0 to 20% higher on day 15. Conclusions: Saharan dust outbreaks observed in Miami elevate the concentration of PM and increase the risk of AECOPD in COPD patients with recurring exacerbations.

【 授权许可】

Unknown