London Underground Study - Health Effects of Particulate Matter

Imperial College London83 enrolled

Overview

An average of 4.8 million journeys are made on the London Underground every day and as the 'Tube' has elevated airborne particulate matter concentrations compared to ambient air, this raises concern about the potential health impact of this environment. This study explores the health effects of particulate matter from the London Underground on patients with COPD and healthy volunteers. Patients with COPD and healthy participants will be invited to undertake a set 90 min journey on the London Underground, and on a separate occasion (3-8 weeks apart), a 90 min journey on the London Overground (as a proxy for a clean air London area while maintaining other aspects of a train journey). A series of clinical, physiological and inflammatory data will be collected before, during and after (at different time points) each of the sessions in order to compare their response in relation to exposure and/or to disease status.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

Conditions

Chronic Obstructive Pulmonary Disease

Interventions

Eligibility

Sex: ALLMin age: 40 YearsMax age: 90 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria for both groups: * Give informed consent * London resident For participants with COPD: * GOLD stage 2 COPD (FEV1/FVC\<70%; 50%\>FEV1\<80% predicted), GOLD stage 3 COPD (FEV1/FVC\<70%; 30%\>FEV1\<50%) and GOLD stage 4 (FEV1/FVC\<70%;FEV1\<30%) * No history of ischaemic heart disease For healthy volunteers: * No history of ischaemic heart disease. * Normal lung function with no evidence of airflow obstruction. Exclusion Criteria for both participants with COPD and healthy volunteers: * Those with unstable ischaemic heart disease or COPD. * Current smokers and those who are ex-smokers of \<12 months duration. * Those who work in the London Underground or are occupationally exposed to - - high levels of vehicle traffic exposure on a frequent basis. * Those who cannot walk for 30 mins. * Involvement in another research study * Those unable to give consent.

Outcomes

Primary Outcomes

The difference (London Underground vs control exposure) in post exposure pulse wave velocity in healthy vs COPD participants.

Measurement of arterial stiffness

Time frame: -2 hours, +2 hours, +5 hours, +6 hours, +24 hours

Secondary Outcomes

Other clinical responses on the London Underground vs control exposure

Symptom questionnaire

Time frame: -2 hours, 0 hours, +45 minutes +90 minutes, +4 hours, +5 hours, +6 hours, +24 hours

Other clinical responses on the London Underground vs control exposure

Spirometry (FEV1)

Time frame: -2 hours, 0 hours, +45 minutes, +90 minutes, +2 hours, +4 hours, +6 hours, +24 hours

Other clinical responses on the London Underground vs control exposure

Spirometry (FVC)

Time frame: -2 hours, 0 hours, +45 minutes, +90 minutes, +2 hours, +4 hours, +6 hours, +24 hours

Other clinical responses on the London Underground vs control exposure

Spirometry (FEF 25-75)

Time frame: -2 hours, 0 hours, +45 minutes, +90 minutes, +2 hours, +4 hours, +6 hours, +24 hours

Other clinical responses on the London Underground vs control exposure

Single breath transfer factor for carbon monoxide (TLCO)

Time frame: -2 hours, +7 hours, +24 hours