Association Between Chronic PM2.5 Exposure and CT-Detected Lung Abnormalities in the SPIROMICS Cohort
Year: 2026
Type: article
Abstract: RATIONALE: Air pollution contributes additively to COPD morbidity beyond tobacco exposure. Limited current data focuses on the impact of fine particulate matter ≤ 2.5 µm in aerodynamic diameter (PM2.5) on COPD pathogenesis and CT-detected lung abnormalities. OBJECTIVE: To test the association between long term PM2.5 and CT measures of lung disease. METHODS: We studied participants enrolled in the SPIROMICS cohort (age 40-80 years; > = 20 pack-years). As part of the SPIROMICS Air study, 10-year mean outdoor concentrations of PM2.5 prior to enrollment at each participant's home were estimated using a hierarchical high-resolution spatiotemporal model. Using baseline chest CT scans completed at study enrollment, functional small airway disease and emphysema were quantified as percentages of total lung volume. We tested the association between PM2.5 and measures of emphysema (PRMEMPH), functional small airway disease (PRMfsad), and large airway disease (Pi10) using mixed effect regression models. Additional mixed effect regression models tested the association of PM2.5 with FEV1 and symptom scores. We stratified all analyses by baseline severity of airflow obstruction on spirometry: none (GOLD 0), mild-moderate (GOLD 1-2) and severe (GOLD 3-4), and non-tobacco exposed, healthy control participants. RESULTS: Among the 2,355 participants aged 40-80 years old included in this analysis, 176 were non-tobacco exposed control participants, 754 were GOLD 0, 982 GOLD 1-2 and 443 GOLD 3-4. Median 10-year average outdoor PM2.5 concentration for the entire cohort was 10.73 μg/m3 with an interquartile range of 3.52 μg/m3. In GOLD 0 participants, prior 10-year PM2.5 exposure was associated with greater baseline emphysema (1.33, 95% CI [1.12,1.59] per one IQR increase) and functional small airway disease (1.22, [95% CI 1.06, 1.40]); and lower FEV1 -68.8 ml [-126.3, -11.3]. Interaction analysis revealed an association between 10-year PM2.5 exposures and greater baseline symptom scores limited to women younger than 65 in the GOLD 0 and control group. No significant associations were found in participants with COPD. CONCLUSION: PM2.5 exposure was associated with CT-detected emphysema and small airway disease as well as lower FEV1 among those with smoking history and no airflow obstruction. Additionally, PM2.5 exposure was associated with greater symptom scores in women younger than 65 years.
Authors: Christopher B Bosma, Lantian Xu, Susan Murray, Laura M Paulin, Joel D Kaufman, Nadia N Hansel, Neil E Alexis, R Graham Barr, Jessica Bon, Swaraj Bose, Alejandro P Comellas, Christopher B Cooper, David Couper, Jeffrey L Curtis, Craig J Galban, Charles R Hatt, Emilia A Hermann, Eric A Hoffman, Ella A Kazerooni, Abhilash S Kizhakke Puliyakote, Fernando J Martinez, Jill A Ohar, Robert Paine, Nirupama Putcha, Sarath Raju, Joseph M Reinhardt, Coralynn Sack, Wassim W Labaki, MeiLan K Han
Institutions: University of Michigan, Michigan Medicine, Dartmouth–Hitchcock Medical Center, University of Washington, Johns Hopkins University, University of North Carolina at Chapel Hill, Columbia University Irving Medical Center, Columbia University, Wake Forest University Health Sciences, Wake Forest University, University of Iowa, University of Iowa Health Care, University of California, Los Angeles, University of Massachusetts Chan Medical School, University of Utah
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7163149210
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