Approved research

Built Environment and Obstructive Lung Disease

Lay summary

This study aims to primarily answer the question: ?where does or does not chronic obstructive lung disease (COPD) and asthma arise, persist and progress in the UK??, describing location in detail through measurable attributes of the built environment in which subjects reside. Secondarily, we aim to generate hypotheses to test regarding the relationship between the built environment and respiratory outcomes. Finally, we aim to use historical and prospective data on patients who meet the case definition of COPD and asthma to test our hypotheses about the effect that the built environment has on patients with COPD and asthma. While asthma can be chronic but reversible, COPD is an irreversible illness affecting an estimated 3 million adults in the UK, with two-thirds of these as yet undiagnosed. We plan to study the relationship of the built environment and respiratory outcomes (COPD & asthma), meeting the UK Biobank?s stated purpose of improving the prevention, diagnosis and treatment of a serious, high-burden disease in the UK. We will draw applications to how urban and environmental choices impact those who suffer from respiratory disease, and assist health professionals to improve diagnosis, counseling and health maintenance for their patients. This study is a collaboration between the University of Hong Kong Faculty of Architecture and School of Public Health. We will take descriptive and analytic approaches, utilizing data from the UK Biobank and the UK Biobank Urban Morphometric Platform (UKBUMP). The UK BUMP is an individual-level built environment database of approximately 750 health-specific built environment metrics for all participants in the UK Biobank prospective cohort. We propose to include the 350,000 participants across 14 UKB collection centres for whom the UKBUMP data will be available by 31st December 2015. Over the duration of the project, data on full cohort will be requested as the complete UKBUMP database becomes available. Once primary care data is also available we will also conduct similar analyses for asthma outcomes.

Scope extension

This study aims to primarily answer the question: "where does or does not chronic obstructive lung disease (COPD) and asthma arise, persist and progress in the UK", describing location in detail through measurable attributes of the built environment in which subjects reside. Secondarily, we aim to generate hypotheses to test regarding the relationship between the built environment and respiratory outcomes. Finally, we aim to use historical and prospective data on patients who meet the case definition of COPD and asthma to test our hypotheses about the effect that the built environment has on patients with COPD and asthma.

Since this project was proposed, UK Biobank collected many new datasets which were linked to the individual cohort participants. We therefore wish to modify our main outcome from just COPD to respiratory health in general. We shall request data from all hospital records, cancer registry and death record that has been linked to UK Biobank. This will enable us to conduct research exploring prospective associations between built environment, air pollution and incident respiratory mortality and respiratory health (including asthma, respiratory allergies, acute upper and local respiratory infections, influenza and pneumonia, lung disease, lung cancer). We will request access to participants residential address coordinates at a resolution of 100m (this have been kindly agreed upon by Megan Conroy of the Access Team). We wish to create built and air pollution metrics from open data sources as has also been approved in the sister project UKB 11730. We shall also request access to physiological biomarker, biological age (telomere length) and polygenic risk score (26211) data (for asthma).