This week's episode dives into COPD treatment. When considering inhaler devices, what is the best strategy for COPD patients? Host Amy Attaway, MD, MS, associate director of the COPD Center at  Cleveland Clinic welcomes Anthony Anzueto, MD, professor of medicine at the University of Texas Health Science Center and chief of the pulmonary section for the South Texas Veterans Healthcare System in San Antonio.

Support for this podcast is brought to you by Viatris and Theravance BioPharma.

This episode begins our series on "What you may have missed at ATS 2025."

We produce over 450 million tons of plastics each year, the vast majority of which has accumulated in the environment. Increasing evidence suggests that microplastics can accumulate in a number of different organs such as the brain, but what of the lungs? 

In this episode, Adam Soloff, PhD (self-described "Lorax of the Thorax"), associate professor, UPMC Hillman Cancer Center, walks us through his research to find out what these ever-present microplastics do to the lungs and the pulmonary immune system in particular. Spoiler alert: once inhaled, microplastics pass through the lung seeding many tissues of the body including the heart, brain, gut, liver, and spleen. "We found it everywhere we looked," said Dr. Soloff whose team's work begins to shed light on how microplastics damage lung immunity and may predispose us to lung disease in the future.

4:16 What is a microplastic?

6:19 Where is the most established evidence of how microplastics affects our health?

Erika Moseson, MD, of the Air Health Our Heath podcast hosts this week's episode with guest Daniel Croft, MPH, ATSF. Dr. Croft is associate professor
in the Department of Environmental Medicine at the University of Rochester Medical Center. On this episode we share insights from the Climate Change and Respiratory Health: Opportunities to Contribute to Environmental Justice: An Official American Thoracic Society Workshop Report - https://pubmed.ncbi.nlm.nih.gov/40311081/

For additional discussion on environmental health, please also view our recent Breathe Easy episode 12 “EPA Rollbacks Spell Grave Impacts on Public Health” for an up-to-date discussion of current national changes related to health care, environmental health and environmental justice:  

And for ATS members, please review the Washington Letter for up to date actions ATS is taking to protect respiratory health:  https://urldefense.proofpoint.com/v2/url?u=https-3A__site.thoracic.org_about-2Dus_news_washington-2Dletter&d=DwMFAg&c=shNJtf5dKgNcPZ6Yh64b-ALLUrcfR-4CCQkZVKC8w3o&r=cBcAqdnwqc2JZQ0oH6i362XLRsQ-_Tz-M1Wc9UELJNs&m=MdI_1W73157uyTefcBrkHA9wu2ITlxReWhEVndIGRsDlh5tkbX4XmkSOaeWSnB1a&s=yhFeE9pojesBPCkULoIjDdlcHL_vqKUR6d_rwIEVw0Y&e=

Host Patti Tripathi talks to Alpha-1 patient advocate Len Geiger ahead of his ATS 2025 International Conference plenary presentation. He was diagnosed at age 35 with a rare lung disease. He almost lost it all, but Len didn't lose his fight. 
"Everybody can do something more than they're doing right now," he says.

Patti Tripathi talks with Margot Kushel, MD,  and Robynne Rose-Haymer ahead of their keynote presentation on providing care to the unhoused population on May 18 at ATS 2025. 

Dr. Kushel is chief of the Division of Health Equity and Society and director of the UCSF Center for Vulnerable Populations and the UCSF Benioff Homelessness and Housing Initiative. 

Ms. Rose-Haymer is the director of the California Legislative Staff Education Institute at Capitol Impact Consulting.

09:36 What can the VA's initiatives among the homeless population teach clinicians?
13:25 How can we create solutions?

Register for the ATS 2025 International Conference at conference.thoracic.org

This episode is part two of our discussion on AI. Host Eddie Qian, MD, (Vanderbilt University Medical Center) and Matthew Churpek, MD, PhD, MPH
(University of Wisconsin School of Medicine and Public Health) explore the use of large language models in clinical practice, weigh the benefits vs risks and the role clinicians may play in establishing guardrails.

"Patients don't just walk out of the textbook," as Dr. Qian noted. These models still require input from experienced clinicians to ensure the best outcome for patients. 

Listen to Part I of our AI discussion: https://www.youtube.com/watch?v=eZInoIjGht0&list=PLFyO68a-Ji3lKQLBIdtgUlFkEBp3t1RA5&index=8

Like what you heard? Get more of Dr. Qian on the ICU Ed and Todd-cast wherever you listen to podcasts.

Rolling back major EPA policies that protect our health from air pollution exposure is dangerous and even fatal in some cases. This episode features the chair and vice-chair of the ATS Environmental Health Policy Committee, Alison Lee, MD, (Icahn School of Medicine, Mount Sinai) and Gillian Goobie, MD, PhD (University of British Columbia). Patti Tripathi hosts. 

09:00 What is the evidence for policy-led air pollution reductions?
14:35 Who benefits from EPA rollbacks?
22:36 How does EPA deregulation affect global health?

Resources:
The Southern California Children’s Health Study:  https://healthstudy.usc.edu/
The Ella Roberta Foundation:  https://www.ellaroberta.org/about-ella
Silent Spring by Rachel Carson:  https://www.goodreads.com/book/show/27333.Silent_Spring

Host Amy Attaway, MD, (Cleveland Clinic) is joined by two leaders in sleep medicine— Neomi Shah, MD, MPH,  (Icahn School at Mount Sinai)  and Reena Mehra, MD, MS, ATSF (University of Washington)—to discuss the recent ATS Workshop Report: “The Great Controversy of OSA Treatment for Cardiovascular Risk: Advancing the Science Through Expert Consensus.”
Together, they explore the complex relationship between obstructive sleep apnea (OSA) and cardiovascular outcomes. 

Workshop Report here: https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.202409-981ST

09:45 What gaps have past studies brought to light regarding major cardiovascular events and OSA?                 
11:59 How does the Report help inform discussions with patients?
33:24 Is CPAP the answer?

MaryLuz Fuentes, MD, a former clinician and double-lung transplant survivor will typically say this to other IPF patients: "We patients may be short of breath, but not short of hope." On this episode with host Patti Tripathi, Dr. Fuentes talks about what led up to her double-lung transplant three years ago and what's in store for her at the ATS 2025 International Conference in May. 

Nirav Bhakta, MD, was the lead author of the ATS Workshop Report on Race-Neutral Testing. He joins Meredith McCormack, MD, MHS, on the latest Breathe Easy podcast to discuss the origin of race-based algorithms and advice on implementing race-neutral testing in your pulmonary function lab. Amy Attaway, MD, Cleveland Clinic, hosts. 

ATS statement on race and ethnicity in pulmonary function test interpretation: https://www.atsjournals.org/doi/10.1164/rccm.202302-0310ST

05:03 How did adjustments for race come about?
13:08 What is the global lung function initiative and what is its relationship to race-neutral testing?
14:16 How can pulmonary function labs implement race-neutral testing recommended by ATS?