First-of-its-kind longitudinal study launched to track and analyze lung health in millennials

Northwestern University and the American Lung Association have begun recruitment in Chicago for a first-of-its-kind longitudinal study to track and analyze lung health in millennials at the peak of their lung health.

In this national 40-site study, scientists will follow 4,000 adults (aged 25-35) for approximately five years after their initial interviews to evaluate how their environment, lifestyle and physical activity habits affect respiratory health.

About the study

Announced in June 2019, the American Lung Association Lung Health Cohort originally planned to examine how exposures to smoking, vaping, alcohol, pollution and physical activity affect participants' respiratory health, but recruitment was postponed due to the COVID-19 pandemic. Now, the investigators are uniquely positioned to add COVID-19 exposures to their existing list of study measures, which they believe will provide an even fuller picture of millennial lung health than they originally imagined.

"The COVID-19 pandemic is probably one of the greatest exposures these participants will have on their overall health," said principal study investigator Ravi Kalhan, MD, MS, professor of Medicine in the Division of Pulmonary and Critical Care and of Preventive Medicine in the Division of Epidemiology, and a Northwestern Medicine physician. "We are determined to gather information about prior infections, vaccinations and health behaviors throughout the pandemic to better understand the short- and long-term impacts of the COVID-19 pandemic on both respiratory health and overall health in U.S. millennials."

Lung disease is now a leading cause of death in the country due to the increase in COVID-19 infections and related deaths.

What we know about our health and how to promote healthy aging is based on who we include in our research studies. Lung disease remains a leading cause of death in the U.S. and we identify behaviors and other characteristics that protect or harm our lungs. We are thrilled to be able to engage young adults from around the country as partners in our investigation on how to maintain a long and healthy life."

Mercedes Carnethon, PhD, principal investigator, vice chair and  Mary Harris Thompson Professor of Preventive Medicine

With a $26 million grant from the National Institutes of Health's (NIH) National Heart, Lung and Blood Institute (NHLBI), the cohort will be the first federally funded U.S. cohort to study millennials.

The scientists will capture baseline lung health measurements of 4,000 healthy adults between the ages of 25 to 35 to identify an ideal picture of respiratory health and understand the key risk factors and biomarkers associated with impaired lung health.

Study participant explains why she enrolled

Northwestern study participant Lindy Olive, 28, is currently in good lung health, but she's experienced several pulmonary challenges throughout her life, including needing a special lung treatment as a newborn to help her breathe. Growing up on four acres of land in rural Alabama, she thrived, playing competitive sports and dancing. But in 2019, she was exposed daily to intense vinyl tile dust while working in a factory and developed a deep cough and chest pain. A month later, Olive lived and worked next to an Environmental Protection Agency superfund site and a landfill. In 2021, she got sick with COVID-19.

"I know for many young people, they compare it to the regular flu, but that was not the case for me," Olive said. "One day I was doing a high-intensity workout class, masked, and the next day, I could barely get up the stairs in my apartment without hinging at the waist to catch my breath. It was scary, and I wasn’t sure if I would fully recover after that happened."

While Olive said she originally wasn't interested in participating in the study, she said she reflected on "all the things my lungs had been through just over the past couple of years," and decided to enroll.

"I wonder how much my future lung health is going to be defined by what they have already been through," Olive said. "The consequences of rural land use on health outcomes are understudied and ignored but being part of this study means researchers get to use my lung story to determine what makes the biggest impacts on lung health later in life."

Study recruitment

Leveraging the national infrastructure of the Lung Association's Airways Clinical Research Centers (ACRC), the scientists will recruit study participants from its 17 metropolitan centers across the U.S. Chicago is one of those centers.

"Due to the persistent COVID-19 pandemic, lung disease is now a leading cause of death in the U.S., and lung cancer is still the leading cause of cancer death, which is why this groundbreaking study comes at a time where lung health is more important than ever," said Harold Wimmer, MS, president and CEO of the American Lung Association. "This study is critical to our work to help people diagnose lung disease earlier and also work to prevent it."

Scientists will follow these individuals for five years after their initial interviews to track how their environments, lifestyles and physical activity habits affect their respiratory health. The goal is to renew the grant so the scientists can continue to follow the study participants for the rest of their lives.

Northwestern is the primary recipient of the NIH grant, but scientists from Johns Hopkins Medicine, Brigham and Women's Hospital, University of Michigan, University of Alabama-Birmingham, Beth Israel Deaconess Medical Center and more also will be collaborating on the research along with other institutions from the ACRC.

Funding for this award is provided by the National Heart, Lung, and Blood Institute (grant U01 HL146408).