Ultrafine Particle Exposures in a Population of Former Smokers with COPD

Chronic Obstructive Pulmonary disease (COPD) is the third leading cause of death in the United States, affecting over 10 million adults, and the fifth leading cause of death worldwide. Mortality attributable to COPD is projected to increase and those with COPD suffer high morbidity, including poor quality of life, activity limitation and exacerbations leading to ED visits and hospitalizations. Individuals with COPD are susceptible to the health effects of air pollution. Exposure to indoor PM2.5 has been associated with respiratory symptoms and increased risk of exacerbation. However, little is known about whether there is an independent effect of ultrafine particles on COPD morbidity. To study indoor UFP and COPD outcomes, in-home monitoring of UFP has been conducted in the homes of 35 non-smoking adults with COPD for 1-week periods. This monitoring has been done concurrently with PM2.5 and NO2 monitoring, providing a holistic look at air pollution exposures in this potentially susceptible population. This cohort is well characterized, comprised of former smokers with impaired lung function indicating moderate to severe COPD. Respiratory questionnaires and lung function have been obtained with simultaneous monitoring of in-home air pollution at 3 and 6 months after enrollment. Peak UFP exposures are highly correlated with cooking events and exposures typically vary over 2 orders of magnitude within a day. We will evaluate the independent effects of UFP on respiratory morbidity in this cohort of former smokers with COPD.