Abstract
The prevalence of chronic obstructive pulmonary disease (COPD) among urban populations is generally lower than rural residents, but the disease burden is still high. We conducted a cross-sectional prevalence survey of COPD among residents aged ≥40 years in an emerging city Shenzhen, China from September 2018 to June 2019. Through multi-stage stratified random sampling, a total of 4157 eligible participants were invited to complete a questionnaire and to take the spirometry test; 3591 with available data were enrolled in the final analysis. Individuals were diagnosed with COPD if the post-bronchodilator FEV1/FVC ratio was less than 0.7. The estimated standardized prevalence of COPD among residents over 40 years old in Shenzhen was 5.92% (95% confidential intervals[CI] 4.05-8.34). Risk factors for COPD included elder age (adjusted odds ratio 1.206, 95% CI 1.120-1.299 per 10-year increase), smoking over 20 pack-years (1.968, 1.367-2.832), history of chronic bronchitis (1.733, 1.036-2.900) or asthma (4.920, 2.425-9.982), and exposure to higher annual minimum concentrations of ambient SO2 (1.156, 1.053-1.270 per 1-μg/m3 increase). Among 280 spirometry-diagnosed patients, most (221, 78.93%) patients were classified as mild COPD (GOLD stage I). This survey found thatthe prevalence of COPD in Shenzhenis low and most patients had mild symptoms, thus recommended screening using spirometry in primary health care to detect early-stage COPD. Increased risk from the exposure to air pollutants also indicated the urgent need for environmental improvement in city settings.
Highlights
Lower is the prevalence of chronic obstructive pulmonary disease (COPD) among urban populations, but still high is the total burden
A total of 4157 individuals were invited to participate in this survey and 3591 who had available spirometry results and epidemiological data were enrolled in the final analysis
Risk factors for COPD included elder age, smoking over 20 pack-years (1.968, 1.367–2.832), history of chronic bronchitis (1.733, 1.036-2.900) or asthma (4.920, 2.425–9.982), and exposure to higher annual minimum concentrations of ambient SO2 (1.156, 1.053–1.270 per 1-μg/m3 increase)
Summary
We conducted a prevalence cross-sectional survey of COPD among residents aged ≥ 40 years in an emerging city Shenzhen, China. Patients’ demographic and clinical characteristics, as well as estimates of the exposure to air pollutants, were included in the univariable and multivariable logistic regression models to assess the risk factors for COPD. In this COPD prevalence survey from September 2018 to June 2019, we enrolled eligible participants ≥ 40 years old with residence at least six months in Shenzhen using the multi-stage stratified cluster random sampling method. Excluded were patients with mental illness or cognitive impairment, cancer, high paraplegia, pregnant or breastfeeding women and other subjects who cannot cooperate to complete the epidemiological investigation This survey assumes that the prevalence rate is 9.6% based on the previous survey in Shenzhen [7]. Stratified by gender and considering the non-response rate of 15%, the total sample size of the survey is estimated to be 4260
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