Black carbon content in airway macrophages is associated with increased severe exacerbations and worse COPD morbidity in SPIROMICS

Table 3 Association of black carbon area and black carbon percent with primary and secondary outcomes

	Black Carbon Area Effect Estimate (95% CI) Per 1 SD Rise	Black Carbon Percent Effect Estimate (95% CI) Per 1 SD Rise
Primary Outcomes
FEV₁ percent predicted	-2.17 (-3.82, -0.52)	-2.43 (-5.21, 0.35)
Any Exacerbation over one year, OR	1.02 (0.81, 1.29)	1.05 (0.77, 1.42)
Severe Exacerbation over one year, OR	1.52 (1.01, 2.28)	2.19 (1.16, 4.14)
Secondary Outcomes
CAT score	1.04 (0.39, 1.68)	1.04 (-0.03, 2.11)
mMRC score	0.11 (0.02, 0.19)	0.11 (0.03, 0.18)
SGRQ score	2.59 (1.13, 4.05)	2.95 (-0.09, 5.98)
ECSC score	0.43 (0.10, 0.75)	0.51 (0.05, 0.96)
6MWD, m	-14.17 (-17.18, -11.15)	-13.15 (-21.39, -4.92)
Chronic Bronchitis, OR	1.50 (1.04, 2.18)	1.53 (1.13, 2.08)

The effect estimates represent the predicted change in each continuous COPD outcome or the odds ratio of exacerbations or chronic bronchitis per 1 SD rise in the level of AM BC measure. The models were adjusted for batch (first vs. second), age, race (white vs. non-white), income (<$35,000, $35,000~$74,999, ≥$75,000, decline to answer), BMI, and LABA/LAMA use (yes vs. no), with random effect for study sites. For the severe exacerbation model only—due to low number of events, the covariates were limited to batch, without random site effect

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