A comparative study of chest CT findings regarding the effects of regional dust exposure on patients with COPD living in urban areas and rural areas near cement plants

• Published in: Respiratory research 2021-02, Vol.22 (1), p.43-9, Article 43
• Main Authors: Kim, Junghyun, Kim, Bom, Bak, So Hyeon, Oh, Yeon-Mok, Kim, Woo Jin
• Format: Article
• Language: English
• Subjects: Airway management; Biomass; Body mass index; Body size; Cement; Cement plants; Charcoal; Chronic obstructive pulmonary disease; Clinical outcomes; Comparative analysis; Comparative studies; Computed tomography; COPD; CT imaging; Diagnosis; Dust; Emphysema; Environmental aspects; Exposure; Generalized linear models; Health aspects; Inflammation; Lung diseases; Lung diseases, Obstructive; Mean; Metropolitan areas; Multivariate analysis; Normal distribution; Obstructive lung disease; Phenotypes; Questionnaires; Respiratory function; Risk factors; Rural areas; Rural population; Smoking; Spirometry; Urban areas; Urban population
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-021-01649-4

The clinical and radiological presentation of chronic obstructive pulmonary disease (COPD) is heterogenous depending on the characterized sources of inflammation. This study aimed to evaluate COPD phenotypes associated with specific dust exposure. This study was designed to compare the characteristics, clinical outcomes and radiological findings between two prospective COPD cohorts representing two distinguishing regions in the Republic of Korea; COPD in Dusty Area (CODA) and the Korean Obstructive Lung Disease (KOLD) cohort. A total of 733 participants (n = 186 for CODA, and n = 547 for KOLD) were included finally. A multivariate analysis to compare lung function and computed tomography (CT) measurements of both cohort studies after adjusting for age, sex, education, body mass index, smoking status, and pack-year, Charlson comorbidity index, and frequency of exacerbation were performed by entering the level of FEV1(%), biomass exposure and COPD medication into the model in stepwise. The mean wall area (MWA, %) became significantly lower in COPD patients in KOLD from urban and metropolitan area than those in CODA cohort from cement dust area (mean ± standard deviation [SD]; 70.2 ± 1.21% in CODA vs. 66.8 ± 0.88% in KOLD, p = 0.028) after including FEV1 in the model. COPD subjects in KOLD cohort had higher CT-emphysema index (EI, 6.07 ± 3.06 in CODA vs. 20.0 ± 2.21 in KOLD, p