Behavioral interventions to reduce particulate matter exposure in patients with COPD

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is commonly affected by particulate matter (PM) exposure. In this study, we aimed to evaluate whether behavioral interventions to reduce PM exposure improve clinical outcomes in patients with COPD. Methods: A multicenter randomized controlled trial will be conducted involving 120 participants recruited from 3 hospitals in the capital region of the Republic of Korea. Patients aged 40 to 80 years with a diagnosis of COPD and a forced expiratory volume at 1 s <80% of the predicted value are eligible for inclusion. The participants will be randomized to either the intervention group or the usual care group (2:1). The behavioral interventions will comprise the following activities: checking air quality forecast; operating indoor air cleaners and regular check-ups of filters; ventilating the home regularly by opening windows; adhering to inhaler treatment; and refraining from going out on high air pollution days. “Internet-of-things”-based, gravimetric, and light-scattering methods will be used to measure indoor and outdoor PM concentrations. To estimate the degree of individual PM exposure, a time-activity diary and land use regression modeling will be used. The efficacy of the behavioral interventions on the following outcomes will be analyzed: amount of PM exposure, changes in forced expiratory volume at 1 s from the baseline, changes in respiratory symptoms and quality of life, risks of exacerbation, hospitalization, and death. Discussion: Given the harmful effect of air pollutants, individual-level interventions to reduce exposure may be significant. However, there is a lack of evidence on how effective such interventions are to date. This study will be able to provide physicians and patients with evidence-based strategies to reduce PM exposure in daily life. Trial registration number: NCT04878367

Environment and Public Health: Air Pollution and Chronic Diseases

“…Systematic reviews of both short-term and long-term studies concerning air pollutants, morbidity, and mortality are needed to further support our findings [9,15].…”

“…Although public policy has a primary role in reducing air pollution, modifications in personal lifestyles can reduce the harmful effects of PM. Interventions to reduce the exposure to PM air pollutants in the daily life of patients with COPD can be important [15]. The use of an air purifier indoors has been shown to reduce the incidence of COPD and childhood asthma, as has the use of a personal mask outdoors on days with increased air pollution [16,17].…”

Air pollution and long-term risk of hospital admission due to chronic obstructive pulmonary disease exacerbations in Poland: a time-stratified, case-crossover study

“…The evidence linking COPD exacerbations with ambient air pollution calls for measures to counter this effect. An ongoing study is assessing how behavioral interventions, such as checking air quality forecasts, staying inside on days with the most pollution, and using air purifiers, might protect patients with COPD from exposure to air pollutants and its consequences, including exacerbations [45]. Lowering ambient air pollution has also been associated with reduced COPD admissions.…”

Association between exposure to specific PM 2.5 constituents and environment, lifestyle, and clinical parameters in patients with COPD

“…The details of the current study protocol are provided in our previously published article (Kang et al, 2021).…”