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Residents of Poor Neighborhoods May Have More Respiratory Problems Associated With Ozone Exposure

New York, NY – May 12, 2020  – In the first large study to look at chronic obstructive pulmonary disease (COPD), air pollution and poor neighborhoods, researchers found that residents of high-poverty neighborhoods are more susceptible to negative respiratory effects of ozone exposure.   The study, which looked at former and current smokers, was posted online in the Abstract Issue of the American Journal of Respiratory and Critical Care Medicine (Abstract #7731.  TITLE: Former and Current Smokers Living in High Poverty Neighborhoods Experience Heightened adverse Respiratory Impacts of Ambient Ozone Exposure: An Analysis of Spiromics Air).

This research is part of the SPIROMICS AIR study, a multicenter research project to collect data on various aspects of COPD.

“Our research group recently published a study that found that long-term exposure to ozone air pollution was associated with shortness of breath, but also with reduced lung function, and respiratory exacerbations for people with a history of heavy smoking, including people with COPD,” said study author Daniel C. Belz, MD, MPH, postdoctoral fellow, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University. “The current study shows that these effects were worse for people living in low-income neighborhoods, even if they were exposed to the same amount of ozone as someone living in a higher-income neighborhood. This was true even when we accounted for factors like age, race and personal income. These results suggest that certain aspects of someone’s neighborhood – lack of green space, poor housing quality, limited access to health care – can significantly affect their susceptibility to air pollution from ozone.”

Ozone located in the stratosphere -- about 10-20 miles above the earth’s surface -- forms the “ozone layer,” an important barrier to ultraviolet (UV) light from the sun. However, ozone located closer to the earth’s surface, called “ground-level ozone,” is a form of air pollution produced by emissions from power plants, cars and industrial processes. Short-term exposure to ground-level ozone has been shown to cause shortness of breath, especially in people with lung diseases such as asthma and COPD.

While previous studies have shown that pollutant effects are greater in many low-income communities, it remains unknown whether ozone’s effects on respiratory health are greater among smokers living in poor neighborhoods.  Dr. Belz and colleagues sought to answer this question.

The team used various tests and questionnaires to measure neighborhood residents’ lung health as they entered the SPIROMICS study.  Statistical analyses were done to estimate historical ozone concentrations outside of study participants’ homes and the association of ozone exposure to respiratory illness.  Neighborhood poverty was defined as the percentage of families living below the federal poverty line in census tracts from the 2010 census.   

“This study helps us understand that the same level of air pollution from ozone can have a more significant effect on people living in low-income neighborhoods,” said Dr. Belz.  As one example of how major this effect can be, a five parts per billion (ppb) increase in ambient ozone concentration was found in the study to be associated with 81 percent greater odds of COPD exacerbations in the poorest neighborhoods.

While Dr. Belz believes national and international policies need to be enacted to reduce ozone levels, he also thinks local actions can help: “Cities and communities can implement policies that decrease ozone production by increasing public transportation, decreasing car exhaust, and embracing wind and solar energy.  Better public transportation can also increase access to health care, especially for people with lung disease who may have trouble getting to doctor’s visits.”