Power Outage: An Ignored Risk Factor for COPD Exacerbations

Overview

Journal Chest

Publisher Elsevier

Specialty Pulmonary Medicine

Date 2020 Jun 6

PMID 32502591

Citations 12

Authors

Wangjian Zhang

Scott C Sheridan

Guthrie S Birkhead

Daniel P Croft

Jerald A Brotzge

John G Justino

Neil A Stuart

Zhicheng Du

Xiaobo X Romeiko

Bo Ye

Guanghui Dong

Yuantao Hao

Shao Lin

Affiliations

Soon will be listed here.

Abstract

Background: COPD is the third leading cause of death in the United States, with 16 million Americans currently experiencing difficulty with breathing. Power outages could be life-threatening for those relying on electricity. However, significant gaps remain in understanding the potential impact of power outages on COPD exacerbations.

Research Question: The goal of this study was to determine how power outages affect COPD exacerbations.

Study Design And Methods: Using distributed lag nonlinear models controlling for time-varying confounders, the hospitalization rate during a power outage was compared vs non-outage periods to determine the rate ratio (RR) for COPD and its subtypes at each of 0 to 6 lag days in New York State from 2001 to 2013. Stratified analyses were conducted according to sociodemographic characteristics, season, and clinical severity; changes were investigated in numerous critical medical indicators, including length of stay, hospital cost, the number of comorbidities, and therapeutic procedures between the two periods.

Results: The RR of COPD hospitalization following power outages ranged from 1.03 to 1.39 across lag days. The risk was strongest at lag and lag days and lasted significantly for 7 days. Associations were stronger for the subgroup with acute bronchitis (RR, 1.08-1.69) than for cases of acute exacerbation (RR, 1.03-1.40). Compared with non-outage periods, the outage period was observed to be $4.67 thousand greater in hospital cost and 1.38 greater in the number of comorbidities per case. The average cost (or number of comorbidities) was elevated in all groups stratified according to cost (or number of comorbidities). In contrast, changes in the average length of stay (-0.43 day) and the average number of therapeutic procedures (-0.09) were subtle.

Interpretation: Power outages were associated with a significantly elevated rate of COPD hospitalization, as well as greater costs and number of comorbidities. The average cost and number of comorbidities were elevated in all clinical severity groups.

Citing Articles

Use, limitations, and future directions of mixtures approaches to understand the health impacts of weather- and climate change-related exposures, an under-studied aspect of the exposome.

Do V, Parks R, Casey J, Goin D, Kioumourtzoglou M Exposome. 2024; 4(1):osae007.

PMID: 39444644 PMC: 11495863. DOI: 10.1093/exposome/osae007.

A spatial analysis of power-dependent medical equipment and extreme weather risk in the southeastern United States.

Spurlock T, Sewell K, Sugg M, Runkle J, Mercado R, Tyson J Int J Disaster Risk Reduct. 2024; 95.

PMID: 39309639 PMC: 11414598. DOI: 10.1016/j.ijdrr.2023.103844.

Association of social vulnerability factors with power outage burden in Washington state: 2018-2021.

Richards C, Amiri S, Walden V, Postma J, Heidari Kapourchali M, Zuur A PLoS One. 2024; 19(9):e0307742.

PMID: 39231141 PMC: 11373849. DOI: 10.1371/journal.pone.0307742.

The Joint Effects of Thunderstorms and Power Outages on Respiratory-Related Emergency Visits and Modifying and Mediating Factors of This Relationship.

Lin S, Qi Q, Liu H, Deng X, Trees I, Yuan X Environ Health Perspect. 2024; 132(6):67002.

PMID: 38829734 PMC: 11166412. DOI: 10.1289/EHP13237.

Power outages and pediatric unintentional injury hospitalizations in New York State.

Northrop A, Flores N, Do V, Sheffield P, Casey J Environ Epidemiol. 2024; 8(1):e287.

PMID: 38343741 PMC: 10852386. DOI: 10.1097/EE9.0000000000000287.

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