Journal article
Ambient ozone effects on respiratory outcomes among smokers modified by neighborhood poverty: An analysis of SPIROMICS AIR
The Science of the total environment, Vol.829, pp.154694-154694
07/10/2022
DOI: 10.1016/j.scitotenv.2022.154694
PMCID: PMC9117415
PMID: 35318050
Abstract
Neighborhood poverty has been associated with poor health outcomes. Previous studies have also identified adverse respiratory effects of long-term ambient ozone. Factors associated with neighborhood poverty may accentuate the adverse impact of ozone on respiratory health.
To evaluate whether neighborhood poverty modifies the association between ambient ozone exposure and respiratory morbidity including symptoms, exacerbation risk, and radiologic parameters, among participants of the SPIROMICS AIR cohort study.
Spatiotemporal models incorporating cohort-specific monitoring estimated 10-year average outdoor ozone concentrations at participants' homes. Adjusted regression models were used to determine the association of ozone exposure with respiratory outcomes, accounting for demographic factors, education, individual income, body mass index (BMI), and study site. Neighborhood poverty rate was defined by percentage of families living below federal poverty level per census tract. Interaction terms for neighborhood poverty rate with ozone were included in covariate-adjusted models to evaluate for effect modification.
1874 participants were included in the analysis, with mean (± SD) age 64 (± 8.8) years and FEV1 (forced expiratory volume in one second) 74.7% (±25.8) predicted. Participants resided in neighborhoods with mean poverty rate of 9.9% (±10.3) of families below the federal poverty level and mean 10-year ambient ozone concentration of 24.7 (±5.2) ppb. There was an interaction between neighborhood poverty rate and ozone concentration for numerous respiratory outcomes, including COPD Assessment Test score, modified Medical Research Council Dyspnea Scale, six-minute walk test, and odds of COPD exacerbation in the year prior to enrollment, such that adverse effects of ozone were greater among participants in higher poverty neighborhoods.
Individuals with COPD in high poverty neighborhoods have higher susceptibility to adverse respiratory effects of ambient ozone exposure, after adjusting for individual factors. These findings highlight the interaction between exposures associated with poverty and their effect on respiratory health.
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•Long-term exposure to low levels of ozone is associated with respiratory morbidity.•Respiratory effects of long-term ozone exposure are worse in poorer neighborhoods.•Ozone may act in synergy with other exposures common in poor neighborhoods.
Details
- Title: Subtitle
- Ambient ozone effects on respiratory outcomes among smokers modified by neighborhood poverty: An analysis of SPIROMICS AIR
- Creators
- Daniel C. Belz - Department of Medicine, Johns Hopkins University, 1830 E. Monument, 5th Floor, Baltimore, MD 21205, USAHan Woo - Department of Medicine, Johns Hopkins University, 1830 E. Monument, 5th Floor, Baltimore, MD 21205, USANirupama Putcha - Johns Hopkins UniversityLaura M. Paulin - Dartmouth–Hitchcock Medical CenterKirsten Koehler - BloombergAshraf Fawzy - Johns Hopkins UniversityNeil E. Alexis - University of North Carolina at Chapel HillR. Graham Barr - Columbia University Irving Medical CenterAlejandro P. Comellas - University of IowaChristopher B. Cooper - University of California, Los AngelesDavid Couper - University of North Carolina at Chapel HillMark Dransfield - University of Alabama at BirminghamAmanda J. Gassett - University of WashingtonMeiLan Han - University of MichiganEric A. Hoffman - University of IowaRichard E. Kanner - University of UtahJerry A. Krishnan - University of Illinois ChicagoFernando J. Martinez - Cornell UniversityRobert Paine - University of UtahRoger D. Peng - BloombergStephen Peters - Wake Forest UniversityCheryl S. Pirozzi - University of Utah, 50 North Medical Drive, Salt Lake City, UT 84132, USAPrescott G. Woodruff - University of California, San FranciscoJoel D. Kaufman - University of WashingtonNadia N. Hansel - Department of Medicine, Johns Hopkins University, 1830 E. Monument, 5th Floor, Baltimore, MD 21205, USASubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) Investigators
- Resource Type
- Journal article
- Publication Details
- The Science of the total environment, Vol.829, pp.154694-154694
- DOI
- 10.1016/j.scitotenv.2022.154694
- PMID
- 35318050
- PMCID
- PMC9117415
- NLM abbreviation
- Sci Total Environ
- ISSN
- 0048-9697
- eISSN
- 1879-1026
- Publisher
- Elsevier B.V
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000050, name: NHLBI; DOI: 10.13039/100000066, name: NIEHS; DOI: 10.13039/100000139, name: EPA
- Language
- English
- Date published
- 07/10/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984318722902771
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