Reviewed by Alex SmithSep 6 2021
A new study to be presented on Sunday at the “virtual” European Respiratory Society International Congress states that warmer weather is connected to the deterioration of chronic obstructive pulmonary disease (COPD) symptoms.
Dr. Supaksh Gupta. Image Credit: Dr. Supaksh Gupta.
The examination of data obtained from 1,177 present and former smokers with COPD in the United States of America (USA) were analyzed, indicating that roughly two days after a rise in ambient temperatures, an increase in COPD exacerbations was identified.
We found that each one-degree Celsius increase in ambient temperature was associated with a 2% increase in the likelihood of COPD exacerbations in the following two days among this group of patients. This study is one of the few to explore the impact of ambient temperature on the risk of COPD exacerbations in a group of people with established COPD for whom we have detailed medical information.
Dr. Supaksh Gupta, Pulmonary and Critical Care Fellow, University of Washington
Gupta continued, “This study is one of the few to explore the impact of ambient temperature on the risk of COPD exacerbations in a group of people with established COPD for whom we have detailed medical information. Overall, it contributes to the emerging body of knowledge regarding ambient temperature and risk of COPD-related health problems. A major strength of the study is the number of people included, who live in various major US towns and cities."
“Other studies have shown a connection between extreme heat exposure and increased risk of health problems and death in people with COPD. There are concerns that these problems will accelerate with the ongoing and worsening climate crisis. ,” continued Gupta.
“Therefore, it is important to quantify the health risks associated with changes in ambient temperature, while also determining who is most at risk to inform policy-makers and healthcare providers,” added Gupta.
Dr. Gupta and collaborators considered present and former smokers who had enrolled in the SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS) between 2010 and 2015. The smokers had had at least one COPD exacerbation from the time they joined the study. They evaluated the threat risk of COPD exacerbations depending based on local, ambient temperatures registered on the day of the exacerbation and in the earlier seven days before that.
The participants’ average age was around 64 years and the average time to the first exacerbation was 603 days (more than a year and a half). The threat of exacerbations went on to rise with increasing higher temperatures during the preceding six days, where the highest risk was two days following the increase in temperatures. The scientists were capable of adjusting their findings to consider humidity levels. This has been involved in the threat of exacerbations.
Our findings raise concerns about the risk of increased exacerbations with climate change. While not conclusive, the study suggests that those living with COPD may want to avoid exposure to adverse and extreme environmental conditions by limiting outdoor activities during periods of elevated temperatures relative to normal.
Dr. Supaksh Gupta, Pulmonary and Critical Care Fellow, University of Washington
“Moreover, while not within the scope of this paper but based on previously existing literature, those who reside in areas with increased temperature, or increased temperature variability, may benefit from access to indoor air cooling,” added Gupta.
The mechanisms behind the link between heat and COPD exacerbations are not yet understood completely, but this might include hyperventilation, which raises the likelihood of a process known as dynamic hyperinflation. When the process of dynamic hyperinflation is in progress, a person becomes incapable of exhaling entirely before beginning to inhale again.
This can result in less efficient and effective breaths. When dynamic hyperinflation is in the extreme stage, it could give rise to high pressure in the chest cavity and cause a consequent reduction in blood flow back to the heart. Furthermore, elderly patients are less capable of adjusting their body temperatures and retain enough hydration. A few asthma studies have denoted that breathing hot and humid air can lead to constriction of the airways.
I wanted to contribute to research involving a disease process that affects the lives of many of my patients. My goal is to help inform our understanding of the ongoing climate crisis on healthcare outcomes and utilization.
Dr. Supaksh Gupta, Pulmonary and Critical Care Fellow, University of Washington
“I hope our research will help guide public policy recommendations and promote health precaution guidelines for people with COPD during periods of increased ambient temperature,” concluded Gupta.
Zorana J. Andersen, who was not a part of the study, is the Chair of the European Respiratory Society Environment and Health Committee Chair and Professor in Environmental Epidemiology at the Department of Public Health, University of Copenhagen, Denmark.
Andersen stated, “The climate emergency is proving to have far-reaching effects in areas of everyday life where it might not necessarily be expected to have an impact. This study offers a fascinating insight into the way it could be affecting the lives of people living with COPD and is yet more proof of the urgent need to tackle climate change and the world’s rising temperatures.”
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