Abstract Background Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity in India. Newly available 2025 ambient PM2.5 snapshots and expanding Health Management Information System (HMIS) reporting to examine how current exposure and TB burden map to COPD disease burden. Methods We combined publicly reported January-May 2025 PM2.5 monthly averages from the CREA/CPCB snapshots (state capital/city aggregates) with state-level COPD DALY estimates from published India state-level disease burden reports (PHFI/IHME GBD summaries) and GBD TB incidence, where available. We harmonized state names and matched capital/city PM2.5 to their states to create a state-level table. Spearman rank correlation assessed associations between mean PM2.5 (Jan-May 2025) and COPD DALYs per 100,000; TB incidence was examined as a secondary covariate. (See Methods note below for data provenance and limitations.) Results 2025 PM2.5 snapshots indicate widespread exceedance of WHO and national guidelines, with northern/industrial states showing the highest monthly means (e.g., Delhi 150 µg/m³ in Jan 2025 on CREA snapshots). In an illustrative state-level aggregation using CREA’s Jan-May 2025 capital-city PM2.5 summaries merged with public GBD/PHFI COPD DALY estimates, PM2.5 and COPD DALYs were strongly positively associated (Spearman ρ ≈ 0.99, p 0.001 using the illustrative aggregation provided). TB incidence showed a moderate positive correlation with COPD DALYs in this aggregation (Spearman ρ ≈ 0.39, p ≈ 0.16). The accompanying figure (two panels) visualizes state COPD DALY burden and the PM2.5-DALY relationship; the CSV shows the aggregated values used. Limitations Ecological aggregation may overstate the strength of observed associations due to unmeasured confounders (e.g., age, smoking, urbanization). Individual-level causality cannot be inferred; further cohort and longitudinal studies are warranted. Policy Implications These findings underscore the urgency of PM2.5 mitigation in high-burden states and advocate scaling up systematic post-TB spirometry, alongside strengthened COPD surveillance via HMIS. Actionable priorities include strict industrial emission controls, targeted clean air campaigns in megacities, and regional COPD-TB risk screenings. Conclusions State-level 2025 PM2.5 exposure and TB burden map onto regions of higher COPD burden, suggesting that current air-quality conditions and TB sequelae remain important, interacting drivers of COPD morbidity in India. These late-breaking snapshots support urgent policies to reduce PM2.5 and implement systematic post-TB spirometry and strengthened COPD surveillance through HMIS. This abstract is funded by: None
Raval et al. (Fri,) studied this question.