Poor Air Quality Linked to Higher Risk for Mortality in COPD

Medscape

4 days ago

Individuals with chronic obstructive pulmonary disease (COPD) were vulnerable to even small increases in fine particulate matter < 2.5 μm in diameter (PM2.5), with significantly higher risk among those with comorbidities such as lung cancer, coronary arterial disease, or chronic kidney disease.
METHODOLOGY:
Researchers conducted a retrospective cohort analysis to assess the association between long-term exposure to PM2.5 and all-cause mortality in veterans with COPD.
They included 1,124,973 veterans (mean age, 68 years; 95.60% men) diagnosed with COPD between 2016 and 2019 who were enrolled in the Veterans Health Administration.
They obtained ambient PM2.5 concentrations from annual air pollution models from 2000 to 2016, available at NASA's Socioeconomic Data and Applications Center; the average 5-year PM2.5 exposure for the cohort was 8.18 µg/m 3 .
. The odds of all-cause mortality associated with 5-year average PM2.5 exposure were estimated, and comorbidities associated with mortality were identified.
TAKEAWAY:
Each 1 μg/m 3 increase in long-term PM2.5 exposure was associated with a 3.8% increase in the odds of mortality (adjusted odds ratio [aOR], 1.038; 95% CI, 1.035-1.040) among patients with COPD.
increase in long-term PM2.5 exposure was associated with a 3.8% increase in the odds of mortality (adjusted odds ratio [aOR], 1.038; 95% CI, 1.035-1.040) among patients with COPD. Individuals with comorbidities such as lung cancer (aOR, 1.051; 95% CI, 1.035-1.068), coronary arterial disease (aOR, 1.039; 95% CI, 1.033-1.044), and chronic kidney disease (aOR, 1.042; 95% CI, 1.034-1.049) showed higher susceptibility to PM2.5 exposure than those without comorbidities.
Men, individuals living in the most disadvantaged neighborhoods, and those identifying as Asian had higher odds of mortality with increasing PM2.5 exposure.
Decreases in PM2.5 concentrations were associated with lower odds of all-cause mortality at all exposure levels for patients with COPD and those with additional comorbidities.
IN PRACTICE:
'Our findings suggest that even small decreases in PM2.5 NAAQS [National Ambient Air Quality Standards] will benefit the millions of Americans living with COPD,' the authors wrote.
SOURCE:
This study was led by Camille Robichaux, MD, University of Minnesota, Minneapolis. It was published online on May 2, 2025, in Annals of the American Thoracic Society .
LIMITATIONS:
The veteran population studied was older, consisted solely of men, and had a higher prevalence of smoking and comorbidities, potentially limiting generalizability. Additionally, the use of modeled data for air pollution exposure, rather than direct measurements, may not have provided an accurate representation of individual exposure levels.
DISCLOSURES:
This study was supported by grants from the National Institutes of Health's National Heart, Lung, and Blood Institute; the National Center for Advancing Translational Sciences; and others. Resources and facilities were provided by the Minneapolis VA Health Care System. The authors declared having no conflicts of interest.