Behavioral interventions to reduce particulate matter exposure in patients with COPD

Jieun Kang, Ji Ye Jung, Jin-Young Huh, Hyun Woo Ji, Hwan-Cheol Kim, Sei Won Lee, Jieun Kang, Ji Ye Jung, Jin-Young Huh, Hyun Woo Ji, Hwan-Cheol Kim, Sei Won Lee

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.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1
Figure 1
Study sites. Participants will be enrolled from 3 academic institutions located in the capital region of the Republic of Korea: Asan Medical Center (Seoul), Severance hospital (Seoul), and Ilsan Paik Hospital (Goyang). PM measuring devices will be installed and analyzed by the measuring team from Inha University Hospital. PM = particulate matter.
Figure 2
Figure 2
Study flow. PM = particulate matter.
Figure 3
Figure 3
Study concept. This study aims to evaluate the efficacy of behavioral interventions to reduce PM exposure and its effect on the clinical outcomes of patients with COPD. We will examine if the behavioral interventions are associated with a reduction in individual PM exposure and ultimately with improved clinical outcomes. COPD = chronic obstructive pulmonary disease, IoT = internet-of-things, mMRC = modified Medical Research Council, PM = particulate matter.
Figure 4
Figure 4
Individual PM exposure estimation. The individual PM exposure estimation will be performed based on the concept of the Stochastic Human Exposure and Dose Simulation model. GPS = global positioning system, LUR = land use regression, PM = particulate matter.

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Source: PubMed

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