Black patients are dying of pulmonary fibrosis, a devastating disease marked by progressive scarring of the lungs, at significantly younger ages than white patients.
A new study probes factors contributing to earlier onset of disease, hospitalization and death in Black patients.
The disease involves a thickening and scarring of lung tissue, making it hard to breathe. It could come from exposure to toxins, medications or autoimmune disorders. About half of patients die within five years of a pulmonary fibrosis diagnosis.
“Pulmonary fibrosis is a deadly disease, and people are often diagnosed right around the time they retire,” said lead author Dr. Ayodeji Adegunsoye, assistant professor of medicine at University of Chicago Medical Center.
“You can imagine how devastating it would be, to work diligently all your life and then as you are about to retire, you're diagnosed with a disease with a life expectancy of around three years," he said in a center news release.
The researchers looked at data from four U.S. hospitals, following outcomes of more than 4,500 patients between January 2003 and April 2021.
On average, Black patients were diagnosed at 57.9 years of age, white patients at 68.6.
Black patients were more likely to be female and more likely to be hospitalized than white and Hispanic patients, researchers found. Black patients were consistently younger at the time of their first hospitalization, lung transplant and death.
Adegunsoye said his work with patients on Chicago's impoverished South Side prompted the study.
“This disease has no clear cause and no cure, but it is not a cancer; the poor prognosis made me wonder if Black patients are as affected by this disease as whites, and whether or not they experienced different outcomes," Adegunsoye said. "And we saw that Black patients' experience with the disease is accelerated by about 10 years.”
The disparities may be linked to lifestyle and socioeconomic factors that put Black patients at higher risk, according to the study.
“For example, Black people are more likely to live along transit corridors, exposing them to more air pollution,” Adegunsoye said. “They're also more likely to be underinsured or uninsured. Being Black is not the health risk; it's the environmental and societal factors that make it difficult for Black patients to access high-quality care.”
Risk factors for the disease include air pollution, jobs in which there is a higher risk of inhaling particulate matter and smoking.
Adegunsoye called the findings so profound that everyone should be screened earlier for the disease, especially those who have risk factors.
“If you can pick up the disease sooner, the outcomes will improve,” he said. “We know more about the disease now than we did even 10 years ago, and while there is no cure, there are treatments available -- some of them are as simple as changing your environment or wearing a mask to reduce environmental exposure, but there are also drugs that can slow the progression of the disease.”
While not all coughs are a sign of pulmonary fibrosis, patients and their care teams need to evaluate symptoms carefully, he said.
His team is now investigating the role of molecular mechanisms and environmental exposures play in the racial disparities.
Understanding how pollution, diet and stress can alter human biology may help clarify why and how certain patients end up with pulmonary fibrosis, researchers said.
They are also investigating whether having COVID-19 adds to pulmonary fibrosis risk.
Adegunsoye said he simply wants patients to get what they need when they need it, including information about how protecting their lungs from pollutants and irritants is an easy way to preventing many types of pulmonary fibrosis.
“Something as simple as wearing a mask if you're working in a refinery or factory could help,” he said. “People should understand that breathing clean air, as simple as it sounds, can make a huge difference.”
Study findings were published March 10 in JAMA Network Open.
The American Lung Association has more on pulmonary fibrosis.
SOURCE: University of Chicago Medical Center, news release, March 10, 2023