Published ahead of print on May 16, 2007, doi:10.1164/rccm.200605-589OC Am. J. Respir. Crit. Care Med., Volume 176, Number 5, September 2007, 465-472 A more recent version of this article appeared on September 1, 2007
Submitted on May 2, 2006 Indoor Air Quality in Homes of Patients with Chronic Obstructive Pulmonary DiseaseLiesl M Osman1*,1 Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen, Scotland, United Kingdom, 2 Aberdeen Royal Infirmary, Chest Clinic, NHS Grampian, Aberdeen, Scotland, United Kingdom, 3 Aberdeen City Council, Aberdeen, Scotland, United Kingdom, 4 Institute of Occupational Medicine, Edinburgh, Scotland, United Kingdom, 5 Department of Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, Scotland, United Kingdom * To whom correspondence should be addressed. E-mail: med078{at}abdn.ac.uk.
Rationale Outdoor air quality is associated with respiratory morbidity and mortality. Less is known of the relationship of indoor air quality to respiratory health of groups vulnerable to outdoor air such as those with Chronic Obstructive Pulmonary Disease (COPD). Objectives To investigate among patients with COPD the association of health status with indoor air quality in their homes. Methods Observational study of indoor environmental characteristics of homes of 148 patients with severe COPD in the North East of Scotland. Measurements Airborne living room levels of PM2.5 (µg/m3) were measured over 8 to 14 hours using DustTrak monitors. Nitrogen dioxide exposure (ppb) in living rooms was measured over one week. Endotoxin (EU/mg) in living room dust was measured. Health status of participants was assessed by the St George's Respiratory Health Questionnaire (Symptoms, Activity Limitation and Disease Impact). Main Results Mean age of participants was 69 years. 45% were male, 39% smokers. 49% lived in smoking households. Average indoor PM2.5 levels were 18 µg/m3, nitrogen dioxide 7.8ppb, endotoxin 95.8 EU/mg of dust. PM2.5 was significantly higher in smoking households (p<0.001) and was associated with higher levels of endotoxin and NO2. PM2.5 was significantly associated with increased symptom burden (p<0.01), with greater effect for current smokers. Endotoxin and nitrogen dioxide exposure were not related to health status. Conclusion Higher levels of PM2.5 are associated with worse health status of these patients with severe COPD. Indoor levels of PM2.5 are significantly higher in homes with smokers. Key words: Respiratory disease, particulates, morbidity
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