High Levels of Ozone, Wood Burning Linked to Chronic Obstructive Pulmonary Disease Among Smokers, Nonsmokers


Two studies linked ozone levels and wood burning as a source of heat to an increased risk of developing chronic obstructive pulmonary disease.

High levels of ozone and wood smoke increased the risk for lung disease such as chronic obstructive pulmonary disease (COPD) among smokers and nonsmokers alike, according to 2 new studies published in JAMA Internal Medicine and the American Journal of Respiratory and Critical Care Medicine, respectively.

The first study included approximately 1900 participants. The study authors found that exposure to high levels of ozone over a decade increased the likelihood of COPD. Specifically, for every 5-parts-per-billion increase in 10-year ozone exposure, the risk for COPD increased by 16%. The same increase in ozone was linked with greater odds of emphysema and a worse quality of life.1

"What really stood out was that the effect was apparent even among current heavy smokers. This means that active smoking doesn't outweigh this effect of ozone," Nadia Hansel, MD, director of the pulmonary and critical care division at Johns Hopkins University School of Medicine said in a press release.

She added that those at risk for COPD had an additional increased risk with ozone exposure. “I think this adds to increasing evidence that there is probably no healthy level of ozone,” Hansel said.

In the second study, a research team that included Hansel found that the use of wood as a main heating source was associated with an increased prevalence of lung disease among patients who had never smoked.1

Among 8500 adults in the US National Health and Nutrition Examination Surveys for 2007 to 2012, the study authors found that the prevalence of COPD among participants living in rural areas was 12%. This was double the prevalence of the disease in urban areas.1

The study authors then linked coal or wood burning as a form of heat to lead to a greater risk of developing COPD. A 1% increase in the number of homes using wood for heat was tied with a 12% increase in the chance of developing COPD among participants who had never smoked.1

According to the CDC, chronic lower respiratory disease, primarily COPD, was the third leading cause of death in the United States in 2014. Approximately 15.7 million Americans (6.4%) reported being diagnosed with COPD. It primarily affects women, aged 65 to 74 years. Patients with COPD often have frequent coughing, excess phlegm, and shortness of breath.2


  • Reinberg, Steven. Ozone, Wood Smoke Raise Odds of COPD in Smokers and NonSmokers [press release]. US News & World Report. Published January 5, 2020. https://www.usnews.com/news/health-news/articles/2020-01-05/ozone-wood-smoke-raise-odds-of-copd-in-smokers-and-nonsmokers. Accessed January 13, 2020.
  • COPD. CDC website. https://www.cdc.gov/copd/basics-about.html. Accessed January 13, 2020.

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