Abstract
Spirometry is recommended in symptomatic smokers to identify obstructive lung diseases. However, it is unknown whether there are certain characteristics that can be used to identify the individual risk of developing obstructive lung diseases. The aim of this study was to examine the association between lung function in adults and burden of lung diseases throughout 27 years of follow-up. We performed a cohort study among individuals aged 30–49 years at baseline (1991). Spirometry measurements were divided into three groups: (1) FEV1/FVC < 70, (2) FEV1/FVC: 70–75, (3) FEV1/FVC > 75 (reference). Using negative binominal regression, the burden of lung diseases was measured by contacts to general practice, hospitalisations, redeemed respiratory medicine and socioeconomic parameters between 1991 and 2017. A total of 905 citizens were included; mean age of 40.3 years, 47.5% were males and 51.2% were smokers at baseline. The group with an FEV1/FVC: 70–75 received more respiratory medicine (IRR = 3.37 (95% CI: 2.69–4.23)), had lower income (IRR = 0.96 (95% CI: 0.93–0.98)), and had more contacts to general practice (IRR = 1.14 (95% CI: 1.07–1.21)) and hospitals for lung diseases (IRR = 2.39 (95% CI: 1.96–5.85)) compared to the reference group. We found an association between lung function and the future burden of lung diseases throughout 27 years of follow-up. In particular, adults with an FEV1/FVC: 70–75 need extra attention in the case finding.
Highlights
Obstructive lung diseases (OLDs) are common and serious diseases, representing a growing public health challenge worldwide[1]
For individuals with an forced expiratory volume in 1 s (FEV1)/ forced vital capacity (FVC): 70–75, we only found a statistically significant association at the end of the study period between 2004 and 2017 (aIRR = 1.24 where individuals were aged 43–63 years (Table 2, Figs 1a, b and 2a)
The main finding of this study is that individuals with an FEV1/FVC: 70–75 have a higher risk of developing OLD, have a lower level of income and a higher degree of unemployment in a longitudinal perspective compared with individuals with an FEV1/FVC > 75
Summary
Obstructive lung diseases (OLDs) are common and serious diseases, representing a growing public health challenge worldwide[1]. Chronic obstructive pulmonary disease (COPD) is estimated to become the third most prevalent cause of death worldwide in 2030, but longitudinal studies of the socioeconomic consequences of individuals at risk of developing COPD are sparse[3,4,5]. This is remarkable, as COPD is known to be a substantial burden for healthcare system, the patients and their relatives[3,4,5,6]. There are no available studies that follow younger individuals in a longitudinal perspective with respect to both clinical, healthcare and sociodemographic parameters
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