5-year particulate matter exposure behind elevated mortality in Black patients with COPD

Key takeaways:

• As exposure to PM_2.5 went up, odds for mortality also went up among patients with COPD.
• Black patients with COPD must be thought about when air pollution standards are made.

WASHINGTON — Fine particulate matter pollution exposure over 5 years is behind heightened mortality risk in Black patients with COPD, according to an abstract presented at the American Thoracic Society International Conference.

“Higher all-cause mortality in Black patients with COPD is explained by long-term exposure to PM_2.5,” Camille Robichaux, MD, pulmonary and critical care fellow at University of Minnesota, and colleagues wrote. “People with COPD are vulnerable to environmental exposures, which are often inequitably distributed.”

Using data from Veterans Health Administration records of patients with COPD from 2016 to 2019, Robichaux and colleagues assessed 1.1 million patients to find out if long-term PM_2.5 exposure is behind the increased risk for all-cause mortality observed in Black patients with COPD.

Researchers found patients’ neighborhood level socioeconomic status through their home address, which they also used to find patients’ census tract level urbanicity.

To determine how PM_2.5 exposure is related to mortality risk, researchers created two logistic regression models. The first model adjusted for age, race and Charlson Comorbidity Index, whereas the second model adjusted for these factors plus 5-year average PM_2.5 exposure found through NASA data.

When checking how many patients in the study population died as of Jan. 29, 2021, one-third of the total was found, according to the abstract,

Compared with white patients, Black patients demonstrated increased odds for mortality (adjusted OR = 1.02; 95% CI, 1.01-1.03) in the first model, whereas Asian patients had decreased odds (aOR = 0.66; 95% CI, 0.62-0.71).

In terms of the impact PM_2.5 has on mortality in patients with COPD, researchers observed that every additional unit in this pollution meant that odds for mortality went up by 4% (aOR = 1.04; 95% CI, 1.03-1.04).

Black patients with COPD did not have increased odds for mortality (aOR = 0.99; 95% CI, 0.97-1.07) compared with white patients in the second model, according to the abstract.

“Although the majority of this cohort experience PM_2.5 exposure levels within the current EPA standard, even lower levels of PM_2.5 exposure affects all-cause mortality in patients with COPD,” Robichaux and colleagues wrote. “Regulatory standards for PM_2.5 should consider the impact on people with COPD, particularly those from marginalized communities.”