Article Text

Download PDFPDF

0133 Environmental and occupational triggers of copd symptoms: a case crossover study
  1. Susan Sama1,2,
  2. Rebecca DeVries1,
  3. David Kriebel1,
  4. Rebecca Gore1,
  5. Richard Rosiello2
  1. 1University of Massachusetts Lowell, Lowell, MA, USA
  2. 2Reliant Medical Group, Worcester, MA, USA


Introduction This study investigated the hypothesis that common occupational and environmental chemical exposures with known irritant or sensitising properties trigger exacerbations for patients with chronic obstructive pulmonary disease (COPD).

Methods We conducted a case crossover study in 168 COPD patients who were members of a disease management group (DMG) in central Massachusetts. Participants completed a baseline health survey and several short exposure surveys. Exposure surveys were administered by a nurse when a participant telephoned to report an exacerbation (case periods) and at a maximum of 3 randomly identified control periods when they were not experiencing an exacerbation. We compared exposures in the week preceding an exacerbation with exposures in normal (non-exacerbation) weeks. The questionnaire assessed short-term (one week) home, community and workplace activities and exposures that may be associated with COPD exacerbation.

Result Self-reported exercise was protective (OR=0.59 95% CI: 0.35–1.00). Among the chemical exposures, car and truck exhaust (OR=4.36, 95% CI: 1.76–10.80) and use of scented laundry products (OR=2.69, 95% CI: 1.31–5.52) showed strong positive effects. Self-reported respiratory infections were strongly associated with COPD exacerbation (OR=7.90, 95% CI: 4.29–14.50). Variations in outdoor temperature were associated with COPD exacerbation risk (moderate versus cold temperature OR=1.95, 95% CI: 0.26–0.70).

Discussion These results suggest that some environmental chemical exposures may play a role in triggering COPD exacerbations. If confirmed, they may provide useful guidance for COPD patients to better manage their diseases.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.