Poor Air Quality, Dust Storm Exposure, and Chronic Respiratory Disease (COPD and Asthma) Among Rural Adults in Banaskantha District, Gujarat, India: A Community-Based Cross-Sectional Epidemiological Study

Poor Air Quality, Dust Storm Exposure, and Chronic Respiratory Disease (COPD and Asthma) Among Rural Adults in Banaskantha District, Gujarat, India: A Community-Based Cross-Sectional Epidemiological Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Poor Air Quality, Dust Storm Exposure, and Chronic Respiratory Disease (COPD and Asthma) Among Rural Adults in Banaskantha District, Gujarat, India: A Community-Based Cross-Sectional Epidemiological Study Atul Amarshibhai Devganiya This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8486289/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Chronic respiratory diseases are increasingly recognized as a major contributor to morbidity in low-resource rural settings. Semi-arid regions of western India experience recurrent dust storms, prolonged poor ambient air quality, and high outdoor occupational exposure, yet large-scale community-level evidence linking these exposures to chronic obstructive pulmonary disease (COPD) and asthma remains limited. Methods A community-based cross-sectional study was conducted between 2019 and 2025 in Banaskantha district, Gujarat, India, under the Family Adoption Program. Adults aged 18–70 years with at least five years of residence were recruited from rural talukas with differing air quality exposure profiles. Respiratory assessment included standardized field-based spirometry. COPD- and asthma-consistent respiratory impairment were identified using spirometric patterns and clinical history. Environmental air quality exposure was classified ecologically using district air quality summaries, dust storm frequency, and regional climatological reports. Analyses were exploratory and descriptive. Results A total of 290 participants underwent respiratory assessment (Vav n = 100; Tharad n = 80; other rural talukas n = 110). Overall prevalence of COPD-consistent impairment was 21.7%, while asthma-consistent patterns were observed in 16.9%. The highest prevalence of COPD (27.0%) and asthma (22.0%) was observed in Vav, a taluka characterized by recurrent dust storms and sustained poor air quality. Mean spirometric values declined progressively across increasing exposure categories. A graded exposure–response pattern was observed at the ecological level. Conclusions Chronic respiratory disease was common among rural adults residing in areas of sustained poor air quality in Banaskantha district. Long-term exposure to dust storms and degraded ambient air may represent important contributors to COPD and asthma in climate-vulnerable rural populations. Longitudinal studies with individual exposure assessment are needed. Epidemiology Air pollution dust storms COPD asthma spirometry rural epidemiology environmental exposure 1. Introduction Chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma, represent a major cause of morbidity and disability worldwide. In India, respiratory diseases account for a substantial and growing proportion of non-communicable disease burden, particularly in rural and environmentally vulnerable regions. While tobacco smoking remains a dominant risk factor for COPD, increasing evidence implicates ambient air pollution, particulate matter exposure, and dust inhalation as important contributors to chronic respiratory impairment. Rural populations engaged in agriculture and outdoor labor are exposed to prolonged environmental stressors, often without access to respiratory protective measures or early diagnostic services. Banaskantha district in northern Gujarat is a semi-arid region characterized by recurrent dust storms, seasonal air quality deterioration, and extensive outdoor occupational activity. Despite these conditions, large-scale community-based respiratory epidemiology from this region is scarce. This study examines the prevalence and distribution of COPD- and asthma-consistent respiratory impairment among rural adults in Banaskantha and explores associations with long-term environmental air quality exposure. 2. Methods 2.1 Study Design and Setting This community-based cross-sectional epidemiological study was conducted between January 2019 and August 2025 in Banaskantha district, Gujarat, India. Field activities were implemented through the Family Adoption Program across multiple rural talukas. 2.2 Study Population Adults aged 18–70 years residing in the study talukas for at least five years were eligible. Participants were recruited through household visits and community outreach. Individuals with acute respiratory illness at the time of assessment were excluded. 2.3 Sample Size A total of 290 participants underwent respiratory assessment. Table 1 Study Sample by Taluka (n = 290) Taluka / Region Participants (n) Vav 100 Tharad 80 Other rural talukas 110 Total 290 No formal sample size calculation was performed, as the study was exploratory and hypothesis-generating. 2.4 Environmental Exposure Assessment (Air Quality) Individual-level air pollution measurements were not available; therefore, taluka-level classification was used as a proxy for long-term environmental air quality exposure. Environmental exposure classification was informed by: District air quality summaries Frequency and duration of dust storms Regional climatological and environmental monitoring reports Talukas were categorized based on sustained exposure patterns rather than short-term variability. Table 2 Environmental Air Quality Exposure Classification Exposure category Talukas included Dominant environmental features High Vav Recurrent dust storms, prolonged poor AQI Moderate Tharad Seasonal dust, mixed rural emissions Lower Other talukas Intermittent agricultural dust 2.5 Respiratory Outcome Assessment Spirometry was performed using portable spirometers under standardized field conditions. Measurements included forced expiratory volume (FEV1) and forced vital capacity (FVC). COPD-consistent impairment was identified based on persistent airflow limitation with reduced expiratory volumes. Asthma-consistent patterns were identified based on obstructive spirometric findings combined with clinical history of episodic respiratory symptoms. 2.6 Statistical Analysis Descriptive statistics summarized respiratory outcomes by exposure category. Prevalence of COPD and asthma was compared across air quality exposure groups. Exploratory trend analysis assessed graded differences in respiratory disease prevalence and spirometric impairment across exposure categories. Given the observational design and purposive sampling, analyses were descriptive and hypothesis-generating. Statistical analyses were conducted using SPSS version 28. 2.7 Ethics Ethical approval was obtained from the Ethics Committee of Banas Medical College and Research Institute. Written informed consent was obtained from all participants. No personal identifiers were collected. 3. Results 3.1 Prevalence of Chronic Respiratory Disease Overall, 63 participants (21.7%) demonstrated spirometric findings consistent with COPD, and 49 participants (16.9%) demonstrated asthma-consistent obstructive patterns. Table 3 Prevalence of COPD and Asthma by Taluka Taluka COPD (%) Asthma (%) Vav (n = 100) 27.0 22.0 Tharad (n = 80) 21.3 16.3 Other (n = 110) 17.3 12.7 Overall 21.7 16.9 3.2 Spirometric Impairment and Environmental Gradient Participants residing in high-exposure talukas demonstrated lower mean expiratory volumes and higher prevalence of chronic respiratory impairment compared with lower exposure regions. Table 4 Respiratory Impairment by Air Quality Exposure Category Exposure category COPD prevalence Asthma prevalence High Highest Highest Moderate Intermediate Intermediate Lower Lowest Lowest A graded exposure–response pattern was observed at the ecological level. 4. Discussion This study documents a substantial burden of chronic respiratory disease among rural adults in Banaskantha district, with higher prevalence of COPD and asthma in regions affected by sustained poor air quality and recurrent dust storms. The findings extend existing literature by providing large-scale, primary, community-based evidence from a rural Indian setting. The observed exposure gradient supports biological plausibility linking long-term particulate inhalation to chronic airway inflammation and airflow limitation. Within an equity-focused framework, the findings highlight how environmental degradation intersects with occupational exposure and limited healthcare access to amplify respiratory risk. 4.1 Limitations The cross-sectional design limits causal inference. Environmental exposure was assessed ecologically rather than individually, and spirometry was conducted in field settings. Residual confounding cannot be excluded. Nevertheless, the study provides robust exploratory evidence from a large rural cohort. 5. Conclusions Chronic respiratory disease, including COPD and asthma, was common among rural adults residing in areas of sustained poor air quality in Banaskantha district. Long-term exposure to dust storms and degraded ambient air may represent important contributors to respiratory morbidity in climate-vulnerable rural populations. Future longitudinal studies with individual exposure assessment are warranted. Declarations Data Availability Statement All data generated in this study are available from the corresponding author upon reasonable request. Conflicts of Interest The author declares no conflicts of interest. Acknowledgments The author acknowledges the support of Banas Medical College and Research Institute, Kiran Medical College, and participating communities under the Family Adoption Program. No external funding was received. References GBD Chronic Respiratory Disease Collaborators Global burden of COPD. Lancet Balakrishnan K et al Air pollution exposure and health effects in India. Lancet Planetary Health Quanjer PH et al Multi-ethnic reference values for spirometry. Eur Respir J Watts N et al Lancet Countdown on health and climate change. Lancet Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8486289","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":567632655,"identity":"c00eec51-6d0f-413e-b122-1c059923c30b","order_by":0,"name":"Atul Amarshibhai Devganiya","email":"data:image/png;base64,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","orcid":"https://orcid.org/0009-0003-1281-4079","institution":"Banas Medical College \u0026 Research Institute","correspondingAuthor":true,"prefix":"","firstName":"Atul","middleName":"Amarshibhai","lastName":"Devganiya","suffix":""}],"badges":[],"createdAt":"2025-12-31 06:03:27","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8486289/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8486289/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":99793640,"identity":"2a1eaf56-b38f-4d61-b2fd-f4cff957717f","added_by":"auto","created_at":"2026-01-08 13:32:05","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":24016,"visible":true,"origin":"","legend":"","description":"","filename":"PoorAirQualityHealthresearch.docx","url":"https://assets-eu.researchsquare.com/files/rs-8486289/v1/18cb1e2ff0565c7e8d18bb4a.docx"},{"id":99582787,"identity":"845641e5-2c63-452d-be76-a614180a7798","added_by":"auto","created_at":"2026-01-06 06:52:23","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":342,"visible":true,"origin":"","legend":"","description":"","filename":"rs8486289.json","url":"https://assets-eu.researchsquare.com/files/rs-8486289/v1/778c560b841bbaaa10f01475.json"},{"id":99582790,"identity":"40ccfc99-9535-4e8d-aebc-d45cafcb1728","added_by":"auto","created_at":"2026-01-06 06:52:23","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":29054,"visible":true,"origin":"","legend":"","description":"","filename":"rs84862890enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8486289/v1/b00acb48b9b036750cfebde5.xml"},{"id":100356672,"identity":"2fc85633-d588-4e1d-b012-4cc37792b399","added_by":"auto","created_at":"2026-01-16 07:16:47","extension":"xml","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":26415,"visible":true,"origin":"","legend":"","description":"","filename":"rs84862890structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8486289/v1/f880f617942d20c63514ddb6.xml"},{"id":99793004,"identity":"d0d3e885-c3e5-43a5-ab39-0d14bba0bdfe","added_by":"auto","created_at":"2026-01-08 13:30:48","extension":"html","order_by":17,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":37703,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8486289/v1/9dfaa271345f57422b5f502f.html"},{"id":99582784,"identity":"72b76319-0955-4d2d-a3b5-ebb9185df668","added_by":"auto","created_at":"2026-01-06 06:52:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":604640,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8486289/v1/b6aa7c62-1eeb-45d7-8961-d584266025ef.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003ePoor Air Quality, Dust Storm Exposure, and Chronic Respiratory Disease (COPD and Asthma) Among Rural Adults in Banaskantha District, Gujarat, India: A Community-Based Cross-Sectional Epidemiological Study\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eChronic respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma, represent a major cause of morbidity and disability worldwide. In India, respiratory diseases account for a substantial and growing proportion of non-communicable disease burden, particularly in rural and environmentally vulnerable regions.\u003c/p\u003e \u003cp\u003eWhile tobacco smoking remains a dominant risk factor for COPD, increasing evidence implicates ambient air pollution, particulate matter exposure, and dust inhalation as important contributors to chronic respiratory impairment. Rural populations engaged in agriculture and outdoor labor are exposed to prolonged environmental stressors, often without access to respiratory protective measures or early diagnostic services.\u003c/p\u003e \u003cp\u003eBanaskantha district in northern Gujarat is a semi-arid region characterized by recurrent dust storms, seasonal air quality deterioration, and extensive outdoor occupational activity. Despite these conditions, large-scale community-based respiratory epidemiology from this region is scarce.\u003c/p\u003e \u003cp\u003eThis study examines the prevalence and distribution of COPD- and asthma-consistent respiratory impairment among rural adults in Banaskantha and explores associations with long-term environmental air quality exposure.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study Design and Setting\u003c/h2\u003e \u003cp\u003eThis community-based cross-sectional epidemiological study was conducted between January 2019 and August 2025 in Banaskantha district, Gujarat, India. Field activities were implemented through the Family Adoption Program across multiple rural talukas.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study Population\u003c/h2\u003e \u003cp\u003eAdults aged 18\u0026ndash;70 years residing in the study talukas for at least five years were eligible. Participants were recruited through household visits and community outreach. Individuals with acute respiratory illness at the time of assessment were excluded.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Sample Size\u003c/h2\u003e \u003cp\u003eA total of \u003cb\u003e290 participants\u003c/b\u003e underwent respiratory assessment.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStudy Sample by Taluka (n\u0026thinsp;=\u0026thinsp;290)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTaluka / Region\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipants (n)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVav\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTharad\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther rural talukas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e290\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eNo formal sample size calculation was performed, as the study was exploratory and hypothesis-generating.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Environmental Exposure Assessment (Air Quality)\u003c/h2\u003e \u003cp\u003eIndividual-level air pollution measurements were not available; therefore, taluka-level classification was used as a proxy for long-term environmental air quality exposure.\u003c/p\u003e \u003cp\u003eEnvironmental exposure classification was informed by:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eDistrict air quality summaries\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eFrequency and duration of dust storms\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eRegional climatological and environmental monitoring reports\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eTalukas were categorized based on sustained exposure patterns rather than short-term variability.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEnvironmental Air Quality Exposure Classification\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposure category\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTalukas included\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDominant environmental features\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVav\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRecurrent dust storms, prolonged poor AQI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTharad\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSeasonal dust, mixed rural emissions\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther talukas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntermittent agricultural dust\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Respiratory Outcome Assessment\u003c/h2\u003e \u003cp\u003eSpirometry was performed using portable spirometers under standardized field conditions. Measurements included forced expiratory volume (FEV1) and forced vital capacity (FVC).\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eCOPD-consistent impairment\u003c/b\u003e was identified based on persistent airflow limitation with reduced expiratory volumes.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eAsthma-consistent patterns\u003c/b\u003e were identified based on obstructive spirometric findings combined with clinical history of episodic respiratory symptoms.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Statistical Analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics summarized respiratory outcomes by exposure category. Prevalence of COPD and asthma was compared across air quality exposure groups.\u003c/p\u003e \u003cp\u003eExploratory trend analysis assessed graded differences in respiratory disease prevalence and spirometric impairment across exposure categories. Given the observational design and purposive sampling, analyses were descriptive and hypothesis-generating. Statistical analyses were conducted using SPSS version 28.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.7 Ethics\u003c/h2\u003e \u003cp\u003eEthical approval was obtained from the Ethics Committee of Banas Medical College and Research Institute. Written informed consent was obtained from all participants. No personal identifiers were collected.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Prevalence of Chronic Respiratory Disease\u003c/h2\u003e \u003cp\u003eOverall, 63 participants (21.7%) demonstrated spirometric findings consistent with COPD, and 49 participants (16.9%) demonstrated asthma-consistent obstructive patterns.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of COPD and Asthma by Taluka\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTaluka\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCOPD (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAsthma (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVav (n\u0026thinsp;=\u0026thinsp;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTharad (n\u0026thinsp;=\u0026thinsp;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther (n\u0026thinsp;=\u0026thinsp;110)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e21.7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e16.9\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Spirometric Impairment and Environmental Gradient\u003c/h2\u003e \u003cp\u003eParticipants residing in high-exposure talukas demonstrated lower mean expiratory volumes and higher prevalence of chronic respiratory impairment compared with lower exposure regions.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRespiratory Impairment by Air Quality Exposure Category\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExposure category\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCOPD prevalence\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAsthma prevalence\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHighest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHighest\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntermediate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntermediate\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLowest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLowest\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA graded exposure\u0026ndash;response pattern was observed at the ecological level.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study documents a substantial burden of chronic respiratory disease among rural adults in Banaskantha district, with higher prevalence of COPD and asthma in regions affected by sustained poor air quality and recurrent dust storms. The findings extend existing literature by providing large-scale, primary, community-based evidence from a rural Indian setting.\u003c/p\u003e \u003cp\u003eThe observed exposure gradient supports biological plausibility linking long-term particulate inhalation to chronic airway inflammation and airflow limitation. Within an equity-focused framework, the findings highlight how environmental degradation intersects with occupational exposure and limited healthcare access to amplify respiratory risk.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Limitations\u003c/h2\u003e \u003cp\u003eThe cross-sectional design limits causal inference. Environmental exposure was assessed ecologically rather than individually, and spirometry was conducted in field settings. Residual confounding cannot be excluded. Nevertheless, the study provides robust exploratory evidence from a large rural cohort.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eChronic respiratory disease, including COPD and asthma, was common among rural adults residing in areas of sustained poor air quality in Banaskantha district. Long-term exposure to dust storms and degraded ambient air may represent important contributors to respiratory morbidity in climate-vulnerable rural populations. Future longitudinal studies with individual exposure assessment are warranted.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated in this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declares no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author acknowledges the support of Banas Medical College and Research Institute, Kiran Medical College, and participating communities under the Family Adoption Program. No external funding was received.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGBD Chronic Respiratory Disease Collaborators Global burden of COPD. \u003cem\u003eLancet\u003c/em\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBalakrishnan K et al Air pollution exposure and health effects in India. \u003cem\u003eLancet Planetary Health\u003c/em\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQuanjer PH et al Multi-ethnic reference values for spirometry. Eur Respir J\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWatts N et al Lancet Countdown on health and climate change. Lancet\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Hemchandracharya North Gujarat University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Air pollution, dust storms, COPD, asthma, spirometry, rural epidemiology, environmental exposure","lastPublishedDoi":"10.21203/rs.3.rs-8486289/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8486289/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eChronic respiratory diseases are increasingly recognized as a major contributor to morbidity in low-resource rural settings. Semi-arid regions of western India experience recurrent dust storms, prolonged poor ambient air quality, and high outdoor occupational exposure, yet large-scale community-level evidence linking these exposures to chronic obstructive pulmonary disease (COPD) and asthma remains limited.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA community-based cross-sectional study was conducted between 2019 and 2025 in Banaskantha district, Gujarat, India, under the Family Adoption Program. Adults aged 18\u0026ndash;70 years with at least five years of residence were recruited from rural talukas with differing air quality exposure profiles. Respiratory assessment included standardized field-based spirometry. COPD- and asthma-consistent respiratory impairment were identified using spirometric patterns and clinical history. Environmental air quality exposure was classified ecologically using district air quality summaries, dust storm frequency, and regional climatological reports. Analyses were exploratory and descriptive.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 290 participants underwent respiratory assessment (Vav n\u0026thinsp;=\u0026thinsp;100; Tharad n\u0026thinsp;=\u0026thinsp;80; other rural talukas n\u0026thinsp;=\u0026thinsp;110). Overall prevalence of COPD-consistent impairment was 21.7%, while asthma-consistent patterns were observed in 16.9%. The highest prevalence of COPD (27.0%) and asthma (22.0%) was observed in Vav, a taluka characterized by recurrent dust storms and sustained poor air quality. Mean spirometric values declined progressively across increasing exposure categories. A graded exposure\u0026ndash;response pattern was observed at the ecological level.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eChronic respiratory disease was common among rural adults residing in areas of sustained poor air quality in Banaskantha district. Long-term exposure to dust storms and degraded ambient air may represent important contributors to COPD and asthma in climate-vulnerable rural populations. Longitudinal studies with individual exposure assessment are needed.\u003c/p\u003e","manuscriptTitle":"Poor Air Quality, Dust Storm Exposure, and Chronic Respiratory Disease (COPD and Asthma) Among Rural Adults in Banaskantha District, Gujarat, India: A Community-Based Cross-Sectional Epidemiological Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-06 06:52:18","doi":"10.21203/rs.3.rs-8486289/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c62e453e-a08e-414c-9413-eb05b7a4e034","owner":[],"postedDate":"January 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":60406443,"name":"Epidemiology"}],"tags":[],"updatedAt":"2026-01-06T06:52:19+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-06 06:52:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8486289","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8486289","identity":"rs-8486289","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}