A staggering percentage of the world’s population is exposed to unsafe air. Unfortunately, the burden of this generally falls hardest on the poorest communities, which suffer a higher prevalence of lung disease and associated health effects.

Personal exposure modification provides a means to target susceptible populations and reduce pollutant exposure. This Sunday session will investigate emerging methods of exposure mitigation and how to apply appropriate techniques to reduce environmental exposures in unique patient populations.

The ATS Bulletin asked panel co-chairs Juan Celedón, MD, DrPH, from the University of Pittsburgh School of Medicine, and Emily Brigham, MD, MHS, from Johns Hopkins University School of Medicine, about findings related to certain populations and improvements that can be employed to mitigate lung disease.

Q: In North America, what are the most common household environmental concerns?

A: Allergens, which can worsen lung diseases such as asthma, are an important exposure in the indoor environment. Such allergens include those present in dust mite, cockroach, mouse, mold, and pets. Levels of particulate matter, traditionally thought of as an outdoor pollutant, can be elevated in the indoor environment and are not regulated by the EPA. Tobacco smoke often contributes heavily to particulate matter in the indoor environment.

Q: Which populations will you focus on for this panel?  

A: Racial or ethnic minorities, children, and economically disadvantaged individuals are disproportionately affected by respiratory diseases. We have deliberately focused the panel on these populations, as well as others who may be affected.

Q: What are the occupational exposure disparities of greatest concern?

A: Industries and job titles that carry the greatest risk of exposure to respiratory toxins remain staffed disproportionately by minorities and economically disadvantaged individuals. This includes miners, foundry and textile mill workers, and factory employees. The latency period that is often present between exposure and disease means that, even with improvement in working conditions and changes in workforce, disparities will persist for some time.

Q: Is the U.S. looking to regulate/deregulate common household and occupational concerns?

A: Currently, there are no U.S. regulations regarding household air pollution. While environmental regulations are in place for occupational safety, it remains unclear whether U.S. administration deregulation plans will affect these precautions.

Q: Do home air purifiers address the concerns in a meaningful way?

A: Home air purifiers have been proven to reduce levels of indoor particulate matter. An air purifier intervention has been associated with commensurate improvements in symptoms among children with asthma, and a study is underway looking at the effects of an air purifier intervention in COPD.

Q: You have invited a patient to participate on the panel. What will her role be? 

A: Our patient speaker will present her powerful story in advocating for her son’s respiratory health. Her experience involved unsafe rental housing conditions linked to her son’s asthma, recognition of his disease by herself and his health care provider, activation of resources available for legal advocacy, and ultimate resolution of the case with rehousing. She will provide insight into the effect of environmental health on the lives of those affected and their caregivers. She will share her personal experience with use of available legal resources to achieve a necessary step in her son’s treatment: change of environment.