Relative environmental and social disadvantage in patients with idiopathic pulmonary fibrosis.

Details

• Personal Author:
  Avitzur N ; Collard HR ; DeDent AM ; Johannson KA ; Lamidi M ; Nathan SD ; Noth EM ; Thakur N
• Description:
  Background: Air pollution exposure is associated with disease severity, progression and mortality in patients with idiopathic pulmonary fibrosis (IPF). Combined impacts of environmental and socioeconomic factors on outcomes in patients with IPF are unknown. The objectives of this study were to characterise the relationships between relative environmental and social disadvantage with clinical outcomes in patients with IPF. Methods: Patients with IPF were identified from a longitudinal database at University of California, San Francisco. Residential addresses were geocoded and linked to the CalEnviroScreen 3.0 (CES), a tool that quantifies environmental burden in California communities, combining population, environmental and pollution vulnerability into individual and composite scores (higher scores indicating greater disadvantage). Unadjusted and adjusted linear and logistic regression and Fine and Gray proportional hazards models were used. Results: 603 patients were included. Higher CES was associated with lower baseline forced vital capacity (beta=-0.073, 95% CI -0.13 to -0.02; p=0.006) and diffusion capacity of the lung for carbon monoxide (beta=-0.11, 95% CI -0.16 to -0.06; p<0.001). Patients in the highest population vulnerability quartile were less likely to be on antifibrotic therapy (OR=0.33; 95% CI 0.18 to 0.60; p=0.001) at time of enrolment, compared with those in the lowest quartile. An association between CES and mortality was suggested, but sensitivity analyses demonstrated inconsistent results. Relative disadvantage of the study cohort appeared lower compared with the general population. Conclusions: Higher environmental exposures and vulnerability were associated with lower baseline lung function and lower antifibrotic use, suggesting that relative socioenvironmental disadvantage has meaningful impacts on patients with IPF. [Description provided by NIOSH]
• Subjects:
  Air Pollution Cohort Studies Environmental Exposure Healthcare Disparities Lung Lung Diseases Mortality Occupational Health Respiratory System Respiratory Tract Diseases Safety

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• Keywords:
  Environmental exposure; Lung fibrosis; Pulmonary disorders; Air pollution; Socioeconomics; Mortality rates; Cohort studies; Health disparities
• ISSN:
  0040-6376
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 3 ; OSHA Region 9 ; Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  77
• Issue:
  12
• NIOSHTIC Number:
  nn:20065514
• Citation:
  Thorax 2022 Dec; 77(12):1237-1242
• Contact Point Address:
  Dr Kerri A Johannson, Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
• Email:
  kerri.johannson@ahs.ca
• Federal Fiscal Year:
  2023
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Thorax
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0e6a6bc49e359f5ecc7099576f4a972eee6a8f0c0f9c07b9f1036f48c80dcfc8ab3cd5da2ab02330113013c33c5657a8f8fb7508d070d6f4a5bfa03e3e1db97c
• Download URL:
  https://stacks.cdc.gov/view/cdc/249461/cdc_249461_DS1.pdf
• File Type:
  [PDF - 680.45 KB ]