Prevalence Of Airflow Limitation Research Articles

Impact of Using Pre- and Post-Bronchodilator Spirometry Reference Values in a Chinese Population.

Spirometry reference equations that are derived from a large, nationally representative, general population are warranted in China and the impact of using pre- and post-BD spirometry reference values has yet to be assessed in Chinese populations. To present both the pre-BD and post-BD spirometry reference values for Chinese adults using the China Pulmonary Health (CPH) study. A reference population of 17969 healthy, non-smoking participants in the CPH study was used to calculate the pre- and post-BD reference values for the forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC. Both pre- and post-BD reference values were applied to the entire CPH population (50991 individuals) to illustrate the divergence between the use of references in determining the disease prevalence and severity grading. The prevalence of airflow limitation was 5.36% using pre-BD reference and 8.02% using the post-BD reference. Individuals who had post-BD FEV1/FVC below post-BD but higher than pre-BD reference values were found to have significantly higher rates of self-reported respiratory symptoms, and significantly lower values in spirometry indicators than those above post-BD reference values. An additional 3.51% of participants were identified as grade II-IV COPD using the post-BD FEV1 predicted values. This study generated and applied pre- and post-bronchodilator spirometry reference values in a nationally representative Chinese adult population. Post-BD reference values may serve as an additional criterion in identifying individuals at risk for obstructive pulmonary diseases, its diagnostic and prognostic values should be further investigated.

Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort

BackgroundThe burden of undiagnosed obstructive lung disease (OLD) (mainly asthma and chronic obstructive pulmonary disease) is not fully established, and targets for corrective action are yet to be identified. We assessed the underdiagnosis of OLD and its determinants in France.MethodsCONSTANCES is a French population-based cohort of adults aged 18–69 years at inception. We analysed data collected at inclusion in 2013–2014. Undiagnosed OLD was defined as spirometry-confirmed airflow limitation (FEV1/FVC < lower limit of normal) without prior diagnosis of asthma, chronic obstructive pulmonary disease, or bronchiectasis. Multivariate analysis was performed with weighted robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of undiagnosed OLD.ResultsSpirometry results were available for 19,398 participants. The prevalence of airflow limitation was 4.6%. Overall, 64.4% of adults with airflow limitation did not report a previous diagnosis of OLD. Individuals with high cumulative tobacco consumption (≥ 10 pack-years) (aPR: 1.72 [1.28–2.32]), without respiratory symptoms (aPR: 1.51 [1.28–1.78]), and with preserved lung function (aPR: 1.21 [1.04–1.41] for a 10-point increase in FEV1% predicted) had a higher risk of being undiagnosed. Half of symptomatic individuals with airflow limitation (45% of those with moderate to severe airflow limitation) were undiagnosed with OLD.ConclusionUnderdiagnosis of OLD is very common among French adults, even in patients with respiratory symptoms. Efforts should be made in France to raise awareness about OLD in the general population, improve the detection of respiratory symptoms, and increase the use of spirometry among primary care professionals.

Dust Exposure and Respiratory Health Among Workers in Primary Coffee Processing Factories in Tanzania and Ethiopia.

Introduction: In primary coffee factories the coffee beans are cleaned and sorted. Studies from the 80- and 90-ties indicated respiratory health effects among the workers, but these results may not represent the present status. Our aim was to review recent studies on dust exposure and respiratory health among coffee factory workers in Tanzania and Ethiopia, two major coffee producing countries in Africa.Methods: This study merged data from cross-sectional studies from 2010 to 2019 in 4 and 12 factories in Tanzania and Ethiopia, respectively. Personal samples of “total” dust and endotoxin were taken in the breathing zone. Chronic respiratory symptoms were assessed using the American Thoracic Society (ATS) questionnaire. Lung function was measured by a spirometer in accordance with ATS guidelines.Results: Dust exposure among male production workers was higher in Ethiopia (GM 12 mg/m3; range 1.1–81) than in Tanzania (2.5; 0.24–36). Exposure to endotoxins was high (3,500; 42–75,083) compared to the Dutch OEL of 90 EU/m3. The male workers had higher prevalence of respiratory symptoms than controls. The highest symptom prevalence and odds ratio were found for cough (48.4%; OR = 11.3), while for breathlessness and wheezing the odds ratios were 3.2 and 2.4, respectively. There was a significant difference between the male coffee workers and controls in the adjusted FEV1 (0.26 l/s) and FVC (0.21 l) and in the prevalence of airflow limitation (FEV1/FVC < 0.7) (6.3 vs. 0.9%). Among the male coffee workers, there was a significant association between cumulative dust exposure and the lung function variables FEV1 and FVC, respectively.Conclusions: The results suggest that coffee production workers are at risk of developing chronic respiratory symptoms and reduced lung function, and that the findings are related to high dust levels. Measures to reduce dust exposure should be targeted to factors identified as significant determinants of exposure.

Prevalence and Characteristics of Individuals with Preserved Ratio Impaired Spirometry (PRISm) and/or Impaired Lung Function in Japan: The OCEAN Study.

PurposeMany individuals with obstructive airway disease (OAD), including chronic obstructive pulmonary disease (COPD) and asthma, remain undiagnosed, despite the potential for reducing disease burden through early detection and treatment. OCEAN aimed to determine the prevalence of, and characteristics associated with, impaired lung function in a Japanese population, with the goal of improving strategies for early OAD detection.MethodsOCEAN was an observational, cross-sectional study in sequentially recruited Japanese individuals ≥40 years of age undergoing routine health examinations. Participants completed screening questionnaires and spirometry testing. Airflow limitation was defined as forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) <0.7 by pre-bronchodilator spirometry. Preserved ratio impaired spirometry (PRISm) was defined as FEV1/FVC ≥0.7 and FEV1 <80% predicted. The primary endpoint was prevalence of spirometry-based airflow limitation and PRISm. The characteristics of study participants were reported as secondary endpoints.ResultsOverall, 2518 individuals were included; 79% were <60 years of age (mean 52.0 years). Airflow limitation and PRISm were observed in 52 (2.1%) and 420 (16.7%) participants, respectively. FEV1 in the PRISm group was between that in the no airflow limitation/PRISm and airflow limitation groups, FVC was similar in the PRISm and airflow limitation groups. The PRISm group had higher mean body mass index and a higher proportion of comorbid metabolic disease compared with the airflow limitation group. The prevalence of airflow limitation and PRISm was highest among current smokers (3.9% and 21.3%, respectively) versus former or never smokers.ConclusionA significant proportion of Japanese individuals <60 years of age attending their annual health examination had impaired lung function (airflow limitation and PRISm); prevalence was highest among current smokers. These findings support screening of current or former smokers ≥40 years of age using patient-reported questionnaires to inform the need for spirometry to confirm an OAD diagnosis.

Factors affecting the development of airflow limitation among South Korean smokers.

INTRODUCTIONConsidering that only some and not all smokers develop chronic obstructive pulmonary disease (COPD), there may be other factors responsible for the development of COPD among smokers. Previous researchers have reported that ethnicity could be one of factors associated with the development of COPD. This study aimed to examine the factors associated with the development of airflow limitation, suggestive of having COPD, among Korean smokers using data from the Korea National Health and Nutrition Examination Survey conducted over the past 3 years.METHODSA total of 2569 current and former smokers ≥40 years of age were included. Most studies exploring risk factors for COPD have compared smokers and non-smokers with smoking as only one of the independent variables. In this study, we took a different approach, studying only smokers and comparing those with or without airflow limitation.RESULTSThe prevalence of airflow limitation among the study participants was 19.2% and 22.1% in current and former smokers, respectively. There was no significant correlation between the severity of airflow limitation and total lifetime smoking amount. Among the many variables examined, only age, male gender and total lifetime smoking amount (pack-years) were significant factors associated with the development of cigarette smoke-induced airflow limitation.CONSLUSIONSOlder Korean men who are heavy smokers may be at a higher risk of developing COPD. Our findings support the importance of smoking cessation as the best way to prevent the development of COPD.

Co-Morbidities as Predictors of Airflow Limitation among Smokers in England.

The prevalence of co-morbidities among patients with Chronic Obstructive Pulmonary Disease (COPD) is well documented in the literature. Therefore, this pilot study aimed to identify whether co-morbidities screening would enhance COPD case-finding. Smoking patients were approached at Croydon University Hospital and two local community pharmacies (CPs). Their co-morbidities, respiratory symptoms, smoking pack-years and exercise capacity were collected. Airflow limitation was determined using handheld spirometry (COPD-6) device. The prevalence of airflow limitation was 42% (n = 21/50). The main identified predictors of airflow limitation were: co-morbidities (OR = 9, CI: 1.04–77.81, p = 0.025), respiratory symptoms (OR = 33.54, CI: 1.06–11.77, p = 0.039) and smoking history of ≥20 pack-years (OR = 3.94, CI: 1.13–13.64, p = 0.029). CPs were the main location for case-finding. This study demonstrated the need to screen for co-morbidities for COPD case-finding within CPs.

Airflow limitation in people living with HIV and matched uninfected controls

IntroductionWhether HIV influences pulmonary function remains controversial. We assessed dynamic pulmonary function in people living with HIV (PLWHIV) and uninfected controls.MethodsA total of 1098 PLWHIV from the Copenhagen Co-morbidity in...

Reply: Lung Function Abnormalities in Smokers with Ischemic Heart Disease.

Rationale: The aim of the ALICE (Airflow Limitation in Cardiac Diseases in Europe) study was to investigate the prevalence of airflow limitation in patients with ischemic heart disease and the effects on quality of life, healthcare use, and future health risk.Objectives: To examine prebronchodilator and post-bronchodilator spirometry in outpatients aged greater than or equal to 40 years with clinically documented ischemic heart disease who were current or former smokers.Methods: This multicenter, cross-sectional study was conducted in 15 cardiovascular outpatient clinics in nine European countries. Airflow limitation was defined as post-bronchodilator FEV1/FVC less than 0.70.Measurements and Main Results: Among the 3,103 patients with ischemic heart disease who were recruited, lung function was defined for 2,730 patients. Airflow limitation was observed in 30.5% of patients with ischemic heart disease: 11.3% had mild airflow limitation, 15.8% moderate airflow limitation, 3.3% severe airflow limitation, an...

Prevalence of airflow limitation in subjects undergoing comprehensive health examination in Japan: Survey of Chronic Obstructive pulmonary disease Patients Epidemiology in Japan.

PurposeThere are still evidence gaps on the prevalence of airflow limitation in Japan. The purpose of this survey was to estimate the prevalence of airflow limitation among healthy subjects in Japan and to show what proportion of subjects with airflow limitation had been diagnosed with chronic obstructive pulmonary disease (COPD).Subjects and methodsThis was an observational, cross-sectional survey targeting multiple regions of Japan. Subjects aged 40 years or above who were undergoing comprehensive health examination were recruited from 14 centers in Japan. Airflow limitation was defined as having forced expiratory volume in 1 second/forced vital capacity less than 70%.ResultsIn a total of 22,293 subjects, airflow limitation was most prevalent in subjects aged over 60 years (8.7%), but was also observed in subjects aged 50–59 years (3.1%) and 40–49 years (1.7%). Overall prevalence was 4.3%. Among subjects with smoking history (n=10,981), the prevalence of airflow limitation in each age group (12.8% in those aged over 60 years, 4.4% in those aged 50–59 years, and 2.2% in those aged 40–49 years) and overall prevalence (6.1%) were higher than that of total subjects. Of the smokers with airflow limitation, 9.4% had been diagnosed with COPD/emphysema and 27.3% with other respiratory diseases.ConclusionAmong smokers undergoing comprehensive health examination, prevalence of airflow limitation reached 12.8% in those aged over 60 years and airflow limitation was observed in subjects aged 40–59 years as well, though their prevalence was lower than that in subjects aged over 60 years. We demonstrated that a significant proportion of smokers with airflow limitation had not been diagnosed with COPD/emphysema, suggesting that some of them can be diagnosed with COPD or other respiratory diseases by a detailed examination after comprehensive health examination. Screening for subjects at risk of COPD by spirometry in comprehensive health examination starting at 40 years of age, followed by a detailed examination, may be an effective approach to increase the diagnosis of COPD.

Associations of lifelong cigarette consumption and hypertension with airflow limitation in primary care clinic outpatients in Japan.

Underdiagnosis is a critical problem in the management of chronic obstructive pulmonary disease (COPD). It is important to screen patients at risk for COPD among those with lifestyle-related diseases such as hypertension, diabetes mellitus, and dyslipidemia, since these diseases promote the development of cardiovascular diseases closely associated with increased COPD mortality. Thirteen primary care clinics in a suburb of Tokyo participated in the current study. A total of 950 patients from these clinics were enrolled in the study between 2010 and 2012; the patients ranged in age from 40 to 79 years, and they had no diagnosed respiratory diseases at the time of enrollment. Patients fulfilling the selection criteria were recruited to undergo spirometry and then completed a self-report questionnaire about comorbid diseases and smoking habits. Spirometry was performed 15 min after inhalation of 200 μg of salbutamol sulfate. The prevalence of airflow limitation was 12.7% in the 950 primary care clinic patients. Lifelong cigarette consumption was the most significant risk factor for airflow limitation, e.g., patients who smoked 60 pack-years or more had a 40% likelihood of airflow limitation. Among common lifestyle-related diseases, hypertension was associated with the severity of airflow limitation (p=0.03), whereas dyslipidemia appeared to be inversely correlated with the severity of airflow limitation (p=0.004) on multiple regression analysis including lifelong cigarette consumption as a factor. Undiagnosed airflow limitation was detected in 12.7% of outpatients at the primary care clinics. Since most patients with lifestyle-related diseases are treated by primary care physicians, it is essential for the physicians to obtain an accurate history of smoking and comorbid diseases to screen patients for COPD.

Impact of Airflow Limitation on Carotid Atherosclerosis in Coronary Artery Disease Patients

Background: Both airflow limitation and smoking are established cardiovascular risk factors. However, their interaction as risk factors for the development of atherosclerosis in coronary artery disease patients remains unclear. Objectives: To evaluate the effect of the interaction between airflow limitation and smoking status on the severity of carotid atherosclerosis. Methods: We categorized the 234 enrolled patients with coronary artery disease into four groups: never-smokers with normal pulmonary function (group A), never-smokers with airflow limitation (group B), ever-smokers with normal pulmonary function (group C), and ever-smokers with airflow limitation (group D). Results: The prevalence of airflow limitation in the enrolled patients was 23.1% (ever-smokers: 15.8%, never-smokers: 7.3%). The prevalence of severe carotid atherosclerosis was 28.2, 29.4, 41.3, and 45.9%, respectively, in the four groups (group D vs. group A, p = 0.035). Even after multivariate adjusting for confounding factors, ever-smokers with airflow limitation were independently associated with severe carotid atherosclerosis (odds ratio 2.89, 95% confidence interval, 1.19-7.00, p = 0.019). Conclusions: Ever-smokers with airflow limitation were significantly associated with severe carotid atherosclerosis among patients with coronary artery disease. These findings also provide additional insight into the correlation between airflow limitation and poor cardiovascular clinical outcomes.

Prevalence of Airflow Limitation in Women Exposed to Biomass Fuel in Rural Parts of Belgaum District- a Cross Sectional Study

Prevalence of Airflow Limitation in Women Exposed to Biomass Fuel in Rural Parts of Belgaum District- a Cross Sectional Study

Clinical relevance of fixed ratio vs lower limit of normal of FEV1/FVC in COPD: patient-reported outcomes from the CanCOLD cohort.

The way in which spirometry is interpreted can lead to misdiagnosis of chronic obstructive pulmonary disease (COPD) resulting in inappropriate treatment. We compared the clinical relevance of 2 criteria for defining a low ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC): the fixed ratio and the lower limit of normal. We analyzed data from the cross-sectional phase of the population-based Canadian Cohort of Obstructive Lung Disease (CanCOLD) study. We determined associations of the spirometric criteria for airflow limitation with patient-reported adverse outcomes, including respiratory symptoms, disability, health status, exacerbations, and cardiovascular disease. Sensitivity analyses were used to explore the impact of age and severity of airflow limitation on these associations. We analyzed data from 4,882 patients aged 40 years and older. The prevalence of airflow limitation was 17% by fixed ratio and 11% by lower limit of normal. Patients classified as having airflow limitation by fixed ratio only had generally small, nonsignificant increases in the odds of adverse outcomes. Patients having airflow limitation based on both fixed ratio and lower limit of normal had larger, significant increases in odds. But strongest associations were seen for patients who had airflow limitation by both fixed ratio and lower limit of normal and also had a low FEV1, defined as one less than 80% of the predicted value. Our results suggest that use of the fixed ratio alone may lead to misdiagnosis of COPD. A diagnosis established by both a low FEV1/FVC (according to fixed ratio and/or lower limit of normal) and a low FEV1 is strongly associated with clinical outcomes. Guidelines should be reconsidered to require both spirometry abnormalities so as to reduce overdiagnosis of COPD.

The physiological characteristics of community-dwelling elderly Japanese with airflow limitation: a cross-sectional study.

The aim of this study was to investigate the physiological characteristics of community-dwelling elderly subjects, aged ≥65years, with airflow limitation in the Japanese community. Subjects were recruited through local press advertisement, and 180 individuals were enrolled. Data on age, body mass index (BMI), gender, smoking history, and past medical history were obtained, as were pulmonary function parameters, skeletal muscle mass index, and physical activity. The final study population comprised 161 participants from whom we obtained valid spirometry results. The mean age of this population was 73.4±4.4years, and 78 participants (48.4%) were men. The prevalence of airflow limitation was 29.2% (n=47). Subjects with airflow limitation were significantly older (P=0.01) and had poorer pulmonary function (P<0.01), lower BMI (P<0.01), and lower skeletal muscle mass index (P=0.03) than healthy elderly subjects. Furthermore, skeletal muscle mass index was significantly correlated with the percentage of predicted forced vital capacity (r=0.45, P<0.05) and forced expiratory volume in 1s (r=0.50, P<0.05) only in men with airflow limitation. We found that the skeletal muscle mass index was significantly reduced in community-dwelling elderly with airflow limitation, and the skeletal muscle mass index was correlated with pulmonary function only in men with airflow limitation.

Occupational Risk Factors for COPD Phenotypes in the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study

Introduction: The contribution of occupational exposure to the risk of chronic obstructive pulmonary disease COPD in population-based studies is of interest. We compared the performance of self-reported exposure to a newly developed JEM in exposure-response evaluation. Methods: We used cross-sectional data from Multi-Ethnic Study of Atherosclerosis (MESA), a population-based sample of 45–84 year olds free of clinical cardiovascular disease at baseline. MESA ascertained the most recent job and employment, and the MESA Lung Study measured spirometry, and occupational exposures for 3686 participants. Associations between health outcomes (spirometry defined airflow limitation and Medical Research Council-defined chronic bronchitis) and occupational exposure [self-reported occupational exposure to vapor-gas, dust, or fumes (VGDF), severity of exposure, and a job-exposure matrix (JEM)-derived score] were evaluated using logistic regression models adjusted for non-occupational risk factors. Results: The prevalence of airflow limitation was associated with self-reported exposure to vapor-gas (OR 2.6, 95%CI 1.1–2.3), severity of VGDF exposure (P-trend < 0.01), and JEM dust exposure (OR 2.4, 95%CI 1.1–5.0), and with organic dust exposure in females; these associations were generally of greater magnitude among never smokers. The prevalence of chronic bronchitis and wheeze was associated with exposure to VGDF. The association between airflow limitation and the combined effect of smoking and VGDF exposure showed an increasing trend. Self-reported vapor-gas, dust, fumes, years and severity of exposure were associated with increased prevalence of chronic bronchitis and wheeze (P < 0.001). Conclusions: Airflow limitation was associated with self-reported VGDF exposure, its severity, and JEM-ascertained dust exposure in smokers and never-smokers in this multiethnic study.

Chronic Obstructive Pulmonary Disease in Ulaanbaatar: the Japan and Mongolia international study

[Background]: The rapid economic growth in Mongolia is worsening its air pollution problem. In addition to the common use of smoky fuel such as coal in the small traditional houses (Ger), smoking rate is considered to be high. Despite these conditions, few prevalence studies of COPD have been performed in Mongolia. [Aims]: International study of Japan and Mongolia using spirometer was conducted to measure the prevalence of air flow limitation among Mongolian adults. [Methods]: Clinical, spirometric data, and the data of exposure to risk factor were collected from 381 subjects aged &gt;40 years from the populations living in Ger district and urban area of Ulaanbaatar. Airflow limitation was defined according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. [Results]: Severity of airway obstruction according to GOLD criteria was: 44.7% mild; 50.0% moderate; 5.3% severe; and no very severe when subjects with COPD combined with restrictive lung disease were excluded. Smoking rate of participants was 27.0% current smoker and 5.8% former smoker. The 66.4% of male and 16.4% of female were ever smoker. Prevalence of COPD among ever smoker was 5.5% (13.6% of male; 1.6% of female). Meanwhile, prevalence of COPD among never smoker was 4.5%. Furthermore, prevalence of COPD among ever smoker excluding possible asthmatic patient was 3.1% (8.0% of male; 0.8% of female). On the other hand, prevalence of COPD among never smoker excluding possible asthmatic patient was 1.8%. In contrast to COPD, prevalence of restrictive lung disease was almost the same in both genders. [Conclusions]: Prevalence of airflow limitation in Mongolia was relatively low when compared with those in other Asian countries. The prevalence of COPD was higher among ever smoked male subjects. The ratio of male to female was approximately 1:10 among ever smoker. These results suggest that the prevalence of COPD was largely attributable to smoking rate in Mongolian adults.

Detection of Airflow Limitation Using the 11-Q and Pulmonary Function Tests

To investigate whether chronic obstructive pulmonary disease (COPD) screening that combines screening with questionnaires and pulmonary function testing is a useful method for the early detection of COPD. A total of 3,367 subjects over 50 years of age underwent COPD screening. Two thousand five hundred and seventy-two of these subjects underwent "Ningen Dock" (a Japanese-English term for annual health checkup) examinations, regularly-scheduled checkups or screenings in outpatient clinics. Of these subjects, 795 lived in one city and one town in Nagasaki Prefecture and exhibited a score of at least 5 points on the Eleven-item pre-interview questionnaire (11-Q). The prevalence of airflow limitation in each type of examination was calculated for each gender, and the odds ratios of airflow limitation with each type of examination were obtained using the subjects who underwent "Ningen Dock" examinations as the reference group. The COPD prevalence was 6.5% in the "Ningen Dock" group (7.9% men, 1.8% women), 5.8% in the regularly-scheduled checkup group (7.4% men, 4.1% women), 9.8% in the screening in outpatient clinics group (12.1% men, 7.2% women) and 22.3% in the COPD screening group (31.1% men, 8.1% women), with the COPD screening group showing the highest prevalence. The odds ratios of the COPD prevalence confirmed that COPD screening is more effective for identifying airflow limitation than other types of examinations. Conducting COPD screening with questionnaires and pulmonary function testing among the general population is a useful examination method for the early detection and treatment of COPD.

An epidemiological study of the effects of statin use on airflow limitation in patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is considered to be a systemic inflammatory disease, and systemic inflammation has been noted as a factor contributing to cardiovascular disease, which is one of the comorbidities associated with COPD. On the other hand, pleiotropic effects, such as the anti-inflammatory effects of statins, have attracted attention in recent years, and there have been a variety of reports regarding the usefulness of statins for patients with COPD. We investigated whether the use or non-use of statins influenced the prevalence of airflow limitation. All outpatients who were over the age of 40 years and who regularly visited a primary health care facility were invited to participate. Each participant underwent spirometry and completed a questionnaire regarding their clinical status, which was used to screen for COPD. A variety of factors that are potentially related to airflow limitation were assessed. Of the 853 patients included in the study, 81 (9.5%) had airflow limitation. The prevalence of airflow limitation was 2.3% among the 89 patients with a history of statin use, which was five times lower than the prevalence of airflow limitation among patients who had not used statins (10.5%). Among the 347 patients with a history of past or current smoking, airflow limitation was not observed in the 30 patients who had used statins. However, by multivariate analysis, statin use was not significantly associated with a lower prevalence of airflow limitation. This is the first cross-sectional study from Japan that has demonstrated that statin use has a potential impact on airflow limitation in patients with COPD.

Prevalence of Airflow Limitation in Patients Diagnosed and Treated for Symptoms of Chronic Bronchitis by General Practitioners in Tochigi Prefecture, Japan

Physicians have provided care to only 0.2 million of the 5.3 million Japanese over the age of 40 years old who have chronic obstructive pulmonary disease (COPD). Among such individuals, many patients with respiratory symptoms diagnosed as chronic bronchitis (CB) are prescribed mainly expectorants. To determine the current status of COPD subjects diagnosed with and treated for CB, we investigated the prevalence of airflow limitation (AFL) in CB patients diagnosed by general practitioners (GPs) and the therapies administered to them. Patients receiving treatment by GPs as CB completed a questionnaire and the FEV(1)/FEV(6) ratio was measured by their GPs with a Piko-6. The prevalence of AFL (FEV(1)/FEV(6) <73%) and the correlation between FEV(1)/FEV(6) and FEV(1)/FVC were examined. Prescription behavior and comorbid lifestyle diseases were also examined. Data from 197 patients with CB were analyzed. Among those who underwent spirometry, the correlation between FEV(1)/FVC and FEV(1)/FEV(6) was r(2)=0.38 (p<0.0001), and the sensitivity and specificity of the Piko-6 were 85.7% and 61.1%, respectively. The prevalence of AFL was 47.2% and increased to 54.1% among patients aged 70-79 years. Expectorants were prescribed for 39.8% of CB patients with AFL, but inhaled bronchodilators were prescribed for only 22.6%. Smoking history and age were significantly higher in the group with AFL than in those without AFL (p<0.05). The prevalence of comorbid lifestyle diseases was 73.1% in patients with AFL. AFL was prevalent among patients with CB. Therefore, GPs should test pulmonary function in CB patients to ensure that the appropriate therapy is administered.

Prevalence of airflow limitation among employees in Norwegian smelters: a longitudinal study

AimsTo investigate the association between airflow limitation and occupational exposure and to compare a fixed limit with an age adjusted limit for airflow limitation.Methods3924 employees in 24 Norwegian smelters and...