{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:57:16Z","timestamp":1790873836678,"version":"4.1.0"},"reference-count":41,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2017,3,29]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Population-based epidemiological evidence suggests that exposure to ambient air pollutants increases hospitalisations and mortality from chronic obstructive pulmonary disease (COPD), but less is known about the impact of exposure to air pollutants on patient-reported outcomes, morbidity and progression of COPD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>The Subpopulations and Intermediate Outcome Measures in COPD (SPIROMICS) Air Pollution Study (SPIROMICS AIR) was initiated in 2013 to investigate the relation between individual-level estimates of short-term and long-term air pollution exposures, day-to-day symptom variability and disease progression in individuals with COPD. SPIROMICS AIR builds on a multicentre study of smokers with COPD, supplementing it with state-of-the-art air pollution exposure assessments of fine particulate matter, oxides of nitrogen, ozone, sulfur dioxide and black carbon. In the parent study, approximately 3000 smokers with and without airflow obstruction are being followed for up to 3 years for the identification of intermediate biomarkers which predict disease progression. Subcohorts undergo daily symptom monitoring using comprehensive daily diaries. The air monitoring and modelling methods employed in SPIROMICS AIR will provide estimates of individual exposure that incorporate residence-specific infiltration characteristics and participant-specific time-activity patterns. The overarching study aim is to understand the health effects of short-term and long-term exposures to air pollution on COPD morbidity, including exacerbation risk, patient-reported outcomes and disease progression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The institutional review boards of all the participating institutions approved the study protocols. The results of the trial will be presented at national and international meetings and published in peer-reviewed journals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2017-000186","type":"journal-article","created":{"date-parts":[[2017,5,19]],"date-time":"2017-05-19T20:10:16Z","timestamp":1495224616000},"page":"e000186","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Design of the Subpopulations and Intermediate Outcome Measures in COPD (SPIROMICS) AIR Study"],"prefix":"10.1136","volume":"4","author":[{"given":"Nadia N","family":"Hansel","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M","family":"Paulin","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J","family":"Gassett","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger D","family":"Peng","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Alexis","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent S","family":"Fan","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, Washington, USA"},{"name":"VA Puget Sound Health Care System, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Bleecker","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Bowler","sequence":"additional","affiliation":[{"name":"National Jewish Health, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro P","family":"Comellas","sequence":"additional","affiliation":[{"name":"University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Dransfield","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MeiLan K","family":"Han","sequence":"additional","affiliation":[{"name":"University of Michigan School of Medicine, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Kim","sequence":"additional","affiliation":[{"name":"Temple University School of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry A","family":"Krishnan","sequence":"additional","affiliation":[{"name":"University of Illinois, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Pirozzi","sequence":"additional","affiliation":[{"name":"University of Utah Health Sciences Center, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B","family":"Cooper","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Martinez","sequence":"additional","affiliation":[{"name":"Weill Medical College, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prescott G","family":"Woodruff","sequence":"additional","affiliation":[{"name":"University of California San Francisco School of Medicine, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J","family":"Breysse","sequence":"additional","affiliation":[{"name":"National Center for Environmental Health\/Agency for Toxic Substances & Disease Registry, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Graham","family":"Barr","sequence":"additional","affiliation":[{"name":"Columbia University Medicine Center, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel D","family":"Kaufman","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,5,18]]},"reference":[{"key":"2025083110243821000_4.1.e000186.1","doi-asserted-by":"crossref","first-page":"020415","DOI":"10.7189\/jogh.05.020415","article-title":"Global and regional estimates of COPD prevalence: systematic review and meta\u2013analysis","volume":"5","author":"Adeloye","year":"2015","journal-title":"J Glob Health"},{"key":"2025083110243821000_4.1.e000186.2","doi-asserted-by":"crossref","first-page":"372","DOI":"10.3109\/15412555.2015.1089846","article-title":"The effects of air pollution and temperature on COPD","volume":"13","author":"Hansel","year":"2016","journal-title":"COPD"},{"key":"2025083110243821000_4.1.e000186.3","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1289\/ehp.1408145","article-title":"A unified spatiotemporal modeling approach for predicting concentrations of multiple air pollutants in the multi-ethnic study of atherosclerosis and air pollution","volume":"123","author":"Keller","year":"2015","journal-title":"Environ Health Perspect"},{"key":"2025083110243821000_4.1.e000186.4","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201005-0762OC"},{"key":"2025083110243821000_4.1.e000186.5","doi-asserted-by":"crossref","unstructured":"American Thoracic Society. Standardization of spirometry, 1994 update. Am J Respir Crit Care Med;1995:1107\u201336 .doi:10.1164\/ajrccm.152.3.7663792","DOI":"10.1164\/ajrccm.152.3.7663792"},{"key":"2025083110243821000_4.1.e000186.6","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/145.6.1321"},{"key":"2025083110243821000_4.1.e000186.7","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00102509"},{"key":"2025083110243821000_4.1.e000186.8","doi-asserted-by":"publisher","DOI":"10.1136\/thx.54.7.581"},{"key":"2025083110243821000_4.1.e000186.9","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.166.1.at1102"},{"key":"2025083110243821000_4.1.e000186.10","doi-asserted-by":"crossref","unstructured":"Sieren JP , Newell JD , Barr RG , et al . SPIROMICS Protocol for multicenter quantitative computed tomography to phenotype the Lungs. Am J Respir Crit Care Med 2016;194.doi:10.1164\/rccm.201506-1208PP","DOI":"10.1164\/rccm.201506-1208PP"},{"key":"2025083110243821000_4.1.e000186.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2004.10.016"},{"key":"2025083110243821000_4.1.e000186.12","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.envres.2016.06.025","article-title":"Indoor particulate matter exposure is associated with increased black carbon content in airway macrophages of former smokers with COPD","volume":"150","author":"Belli","year":"2016","journal-title":"Environ Res"},{"key":"2025083110243821000_4.1.e000186.13","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-7-37"},{"key":"2025083110243821000_4.1.e000186.14","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1038\/jes.2015.29","article-title":"Time-location patterns of a diverse population of older adults: the multi-ethnic study of atherosclerosis and air pollution (MESA Air)","volume":"26","author":"Spalt","year":"2016","journal-title":"J Expo Sci Environ Epidemiol"},{"key":"2025083110243821000_4.1.e000186.15","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1104447"},{"key":"2025083110243821000_4.1.e000186.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.atmosenv.2011.04.073"},{"key":"2025083110243821000_4.1.e000186.17","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1002\/env.1014","article-title":"Predicting intra-urban variation in air pollution concentrations with complex Spatio-temporal dependencies","volume":"21","author":"Szpiro","year":"2009","journal-title":"Environmetrics"},{"key":"2025083110243821000_4.1.e000186.18","doi-asserted-by":"publisher","DOI":"10.1038\/jes.2012.126"},{"key":"2025083110243821000_4.1.e000186.19","doi-asserted-by":"publisher","DOI":"10.1021\/es8030837"},{"key":"2025083110243821000_4.1.e000186.20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.10.1127"},{"key":"2025083110243821000_4.1.e000186.21","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199601000-00005"},{"key":"2025083110243821000_4.1.e000186.22","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.01.17510240"},{"key":"2025083110243821000_4.1.e000186.23","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.1.9001300"},{"key":"2025083110243821000_4.1.e000186.24","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1289\/ehp.1307951","article-title":"Air pollution and percent emphysema identified by computed tomography in the Multi-Ethnic study of Atherosclerosis","volume":"123","author":"Adar","year":"2015","journal-title":"Environ Health Perspect"},{"key":"2025083110243821000_4.1.e000186.25","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.076166"},{"key":"2025083110243821000_4.1.e000186.26","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.155358"},{"key":"2025083110243821000_4.1.e000186.27","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwk016"},{"key":"2025083110243821000_4.1.e000186.28","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201006-0937OC"},{"key":"2025083110243821000_4.1.e000186.29","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2009.047589"},{"key":"2025083110243821000_4.1.e000186.30","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/147.6_Pt_1.1336"},{"key":"2025083110243821000_4.1.e000186.31","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2008.040857"},{"key":"2025083110243821000_4.1.e000186.32","first-page":"75","article-title":"Particulate matter air pollution and respiratory symptoms in individuals having either asthma or chronic obstructive pulmonary disease: a European multicentre panel study","volume":"11","author":"Karakatsani","year":"2012","journal-title":"Environ\u00a0Health"},{"key":"2025083110243821000_4.1.e000186.33","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200708-1290OC"},{"key":"2025083110243821000_4.1.e000186.34","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3182572563"},{"key":"2025083110243821000_4.1.e000186.35","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2011-200768"},{"key":"2025083110243821000_4.1.e000186.36","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jea.7500165"},{"key":"2025083110243821000_4.1.e000186.37","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jea.7500452"},{"key":"2025083110243821000_4.1.e000186.38","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200605-589OC"},{"key":"2025083110243821000_4.1.e000186.39","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201211-1987OC"},{"key":"2025083110243821000_4.1.e000186.40","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.12.932"},{"key":"2025083110243821000_4.1.e000186.41","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.09623","article-title":"Nanoparticulate carbon black in cigarette smoke induces DNA cleavage and Th17-mediated emphysema","volume":"4","author":"You","year":"2015","journal-title":"Elife"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2017-000186","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T17:24:48Z","timestamp":1756661088000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2017-000186"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,18]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,5,18]]},"published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1136\/bmjresp-2017-000186"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2017-000186","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,18]]}}}