Increasing temperatures linked to worsening COPD symptoms
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Warmer weather was associated with worsening COPD symptoms, as early as 2 days after a rise in ambient temperature, in adults with COPD, according to new data presented at the virtual European Respiratory Society International Congress.
“With increasing temperatures worldwide due to the ongoing climate crisis, the risks of increased morbidity are not equally distributed among all patient groups,” Supaksh Gupta, MD, pulmonary and critical care fellow at the University of Washington, Seattle, told Healio. “Individuals living with COPD may be one such subset of patients at increased risk due to the warming climate.”
Gupta and colleagues conducted a time-stratified case-crossover analysis that evaluated 1,177 current and former smokers (mean age, 63.7 years; mean time to first exacerbation, 603 days) from the SPIROMICS cohort from 2010 to 2015. All participants had at least one COPD exacerbation. Researchers assessed COPD exacerbation risk based on local ambient temperatures that were measured on the day of exacerbation and in the preceding 7 days.
Risk for COPD exacerbations increased with rising temperatures in the preceding 6 days. According to the researchers, the observed risk for exacerbation peaked at 2 days after temperatures rose.
When researchers controlled for relative humidity during the study period, every 1°C increase in ambient temperature was associated with a 2% increase in odds of COPD exacerbation 2 days following increased temperatures (P = .002).
“Existing data suggested that extremes of temperature, both hot and cold, as well as heat waves, were associated with an increased risk of exacerbations in individuals with COPD. It was surprising to us to see smaller increases in temperature, that were not necessarily outside of normally expected values, also appear to be associated with an increased risk of morbidity in COPD patients,” Gupta told Healio.
The mechanisms underlying the link between temperature and COPD exacerbations are not fully understood, but may include hyperventilation, which can lead to increased pressure in the chest cavity and a subsequent decrease in blood flow back to the heart, according to an ERS press release.
“Further research is warranted to better characterize the degree of risk in individuals with COPD based on various climate change-related exposures, along with an evaluation of potential protective factors that may mitigate those risks,” Gupta told Healio. “With the increasing frequency of wildfires due to the ongoing climate crisis, it will also be important to better understand the impact these fires and their smoke have upon respiratory health in individuals with preexisting lung diseases.”