Environmental Triggers of COPD Symptoms: A Case Cross-Over Study

Details

• Personal Author:
  DeVries R ; Gore RJ ; Kriebel D ; Rosiello R ; Sama SR
• Description:
  Introduction: This study investigated the hypothesis that common environmental chemical exposures with known irritant or sensitising properties trigger exacerbations for patients with chronic obstructive pulmonary disease (COPD). Methods: We conducted a case cross-over study in 168 patients with COPD who were members of a disease management group in central Massachusetts. Participants completed a baseline health survey and several short exposure surveys. Exposure surveys were administered by a nurse when a participant telephoned to report an exacerbation (case periods) and at a maximum of three randomly identified control periods when they were not experiencing an exacerbation. We compared exposures in the week preceding an exacerbation with exposures in normal (non-exacerbation) weeks. The questionnaire assessed short-term (1 week) home, community and workplace activities and exposures that may be associated with COPD exacerbation. Results: Self-reported exercise was negatively associated with exacerbation (OR=0.59, 95% CI: 0.35 to 1.00). Among the environmental chemical exposures, car and truck exhaust (OR=4.36, 95% CI: 1.76 to 10.80) and use of scented laundry products (OR=2.69, 95% CI: 1.31 to 5.52) showed strong positive effects. Self-reported respiratory infections were strongly associated with exacerbation (OR=7.90, 95% CI 4.29 to 14.50). Variations in outdoor temperature were associated with COPD exacerbation risk (moderate versus cold temperature OR=1.95, 95% CI 1.09 to 3.49 and warm versus cold OR=0.43, 95% CI: 0.26 to 0.70). Conclusions: These results suggest that some environmental chemical exposures may play a role in triggering COPD exacerbations. If confirmed, they may provide useful guidance for patients with COPD to better manage their disease. [Description provided by NIOSH]
• Subjects:
  Occupational Health Respiratory System Respiratory Tract Diseases Safety Surveys And Questionnaires
• Keywords:
  Chemicals Chronic Obstructive Pulmonary Disease COPD Exposure Methods Questionnaires Respiratory Diseases Respiratory Irritants
• ISSN:
  2052-4439
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  4
• Issue:
  1
• NIOSHTIC Number:
  nn:20057334
• Citation:
  BMJ Open Respir Res 2017 Jul; 4(1):e000179
• Email:
  Susan_Sama@uml.edu
• Federal Fiscal Year:
  2017
• Performing Organization:
  University of Massachusetts - Lowell
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  BMJ Open Respiratory Research
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9a5f440daf296faa013fc1f21d3a30d2f9f65f5f26c0867f122d4e80ff16e672164d1513bbe796c0b00e033209caad6a5eafb37be2d0e6cdbc142ab4359ba15e
• Download URL:
  https://stacks.cdc.gov/view/cdc/214721/cdc_214721_DS1.pdf
• File Type:
  [PDF - 828.16 KB ]