Risk Factor For Respiratory Symptoms Research Articles

Loss to 5-year follow-up in the population-based Telemark Study: risk factors and potential for bias

ObjectivesThis study aimed to characterise participants lost to follow-up and identify possible factors associated with non-participation in a prospective population-based study of respiratory health in Norway. We also aimed to...

Upper and lower respiratory airway complaints among female veterinary staff

ObjectiveWorking with animals is characterized by exposure to particulate, biological or chemical matter, and respiratory complaints are common. The aim of our cross-sectional study was to assess the prevalence of respiratory symptoms and diagnoses among veterinary staff.MethodsParticipants working in veterinary practices were examined and a detailed questionnaire was used to collect data. IgE tests to common and animal allergens were performed to specify sensitization. Associations with respiratory outcomes were analysed using logistic regression models while controlling for potential confounders.ResultsAtopy was seen in 31% of the 109 female participants. Symptoms of rhinoconjunctivitis were the most frequent complaints (n = 92; 84%). In 18% the diagnosis was confirmed by physicians. Symptoms of upper and lower airways were highly correlated and an asthma diagnosis was confirmed in 11% of participants. Modelling revealed that sensitization against cats/dogs was a significant risk factor for respiratory symptoms of upper [odds ratio (OR) 4.61; 95% confidence interval (CI) 1.13–18.81] and lower airways (OR 5.14; 95% CI 1.25–21.13), physician-confirmed rhinoconjunctivitis (OR 13.43; 95% CI 1.69–106.5) and asthma (OR 9.02; 95% CI 1.16–70.39) in assistant staff of small-animal practices.ConclusionsIn several cases, rhinoconjunctivitis worsened after entering the profession. Atopy and specific sensitization to cats/dogs were risk factors for health impairments. Thus, to implement preventive measures, veterinary practice staff should be educated that upper respiratory tract symptoms are not harmless and should be diagnosed and treated early.

Prevalence of and risk factors for respiratory symptoms in an adult urban population.

OBJECTIVE: To determine prevalence of and risk factors for respiratory symptoms in an adult urban Pakistani population.METHODS: We conducted a multi-stage, community-based, cross-sectional survey from May 2014 to August 2015, comprising 1629 adults from 75 random clusters in Karachi using questionnaire-based interviews.RESULTS: Around 60% of participants were females and 43% belonged to the >37 years age group. At least one respiratory symptom was reported by 37.5% of participants. Breathlessness was the most common symptom (25.2%, 95%CI 23.1-27.3), followed by acute wheeze (10.1%, 95%CI 8.7-11.7). Multivariable models revealed that males and those aged >37 years were more likely to report acute and chronic phlegm and bronchitis, and breathlessness. Participants with a higher level of education were less likely to report acute and chronic cough. Participants with >5 years pack-years of smoking were more likely to report acute and chronic cough and breathlessness. Other risk factors included passive smoking, regular use of air conditioning and mosquito coils, wet spots and mould in the house, and exposure to dusty jobs.CONCLUSION: We found breathlessness to be the most prevalent respiratory symptom and identified various risk factors for respiratory symptoms.

Prevalence and risk factors for respiratory symptoms among children at child care centers in Malaysia

Many studies have been conducted to assess the effects of indoor air quality (IAQ) on human health. However, there is still a lack of studies available about the adverse health effects on children’s respiratory health at Child Care Centers (CCC). The aim of this paper was to investigate the risk factors for respiratory symptoms and identify the root cause of IAQ problems at CCCs in Malaysia. The Modified American Thoracic Society and the Division of Lung Diseases (ATS-DLD-82) questionnaire was used to gather information from parents regarding their children’s respiratory symptoms. The IAQ parameters measured were for air temperature, humidity, carbon dioxide, carbon monoxide, respirable particles (PM2.5), viable bacteria and fungi count while the information on CCC characteristics and potential surrounding air pollutants were collected via a combination of area monitoring, inspection and interviews. Factors found to be significantly associated with persistent cough and/or cold were age, type of ventilation, location of CCC, floor area per child (<3.5 m2) and temperature. Children attending CCCs supplied by ACMV had the highest risk for prevalence of persistent productive cough [5.56 (CI: 2.20; 14.00)]. This study provided the baseline data on IAQ and possible factors that influenced indoor air contaminants, which could aid policy makers in formulating guidelines on IAQ for CCC in Malaysia.

A prospective study on the role of smoking, environmental tobacco smoke, indoor painting and living in old or new buildings on asthma, rhinitis and respiratory symptoms

We studied associations between tobacco smoke, home environment and respiratory health in a 10 year follow up of a cohort of 11,506 adults in Northern Europe. Multilevel logistic regression models were applied to estimate onset and remission of symptoms. Current smokers at baseline developed more respiratory symptoms (OR = 1.39–4.43) and rhinitis symptoms (OR = 1.35). Starting smoking during follow up increased the risk of new respiratory symptoms (OR = 1.54–1.97) and quitting smoking decreased the risk (OR = 0.34–0.60). ETS at baseline increased the risk of wheeze (OR = 1.26). Combined ETS at baseline or follow up increased the risk of wheeze (OR = 1.27) and nocturnal cough (OR = 1.22). Wood painting at baseline reduced remission of asthma (OR 95%CI: 0.61, 0.38–0.99). Floor painting at home increased productive cough (OR 95%CI: 1.64, 1.15–2.34) and decreased remission of wheeze (OR 95%CI: 0.63, 0.40–0.996). Indoor painting (OR 95%CI: 1.43, 1.16–1.75) and floor painting (OR 95%CI: 1.77, 1.11–2.82) increased remission of allergic rhinitis. Living in the oldest buildings (constructed before 1960) was associated with higher onset of nocturnal cough and doctor diagnosed asthma. Living in the newest buildings (constructed 1986–2001) was associated with higher onset of nocturnal breathlessness (OR = 1.39) and rhinitis (OR = 1.34). In conclusion, smoking, ETS and painting indoor can be risk factors for respiratory symptoms. Wood painting and floor painting can reduce remission of respiratory symptoms. Smoking can increase rhinitis. Living in older buildings can be a risk factor for nocturnal cough and doctor diagnosed asthma. Living in new buildings can increase nocturnal dyspnoea and rhinitis.

Occupational health morbidities and associated socio-demographic variables among street sweepers in a metropolitan city

BACKGROUND- In India, the traditional culture has stigmatized street sweeping as a filthy and lowly occupation. The medical problems of these workers are further compounded by various socioeconomic factors such as poverty, lack of education, poor housing conditions and poor diet. The objective of the current study was to assess the socio demographic profile of the street sweepers, the morbidities prevalent amongst them and to establish an association between socio demographic variables and various morbidities.METHODS- A cross sectional questionnaire based epidemiological study was carried out ,after taking written consent, amongst 100 street sweepers belonging to age group of 18-60 years in South Mumbai under E ward of Brihanmumbai Municipal Corporation for a period of 2 months.RESULTS- Skin problems (91%) followed by musculoskeletal disorders (88%) were the most common morbidities observed amongst street sweepers predominantly in males belonging to the age group of 40-50 years. The prevalence of anemia was found to be relatively higher in females with low socio economic background (6.7%). It was also observed that greater the duration of services, more was the risk of morbidities like musculoskeletal disorders (88.5%), respiratory disorders (11.5%), hypertension (6.4%) and cardiovascular disorders (1.3%).CONCLUSION- The most common morbidities observed were skin problems ( 91%) and musculoskeletal disorders (88%) predominantly in males belonging to age group 40-50 years. Anemia was more common in females . Additionally, illiteracy was a risk factor for respiratory symptoms (14.7%).KEYWORDS- Occupational health, Health hazards, Street sweepers,

Gastroesophageal Reflux Poses a Potential Risk for Late Complications of Bronchopulmonary Dysplasia: A Prospective Cohort Study

Bronchopulmonary dysplasia (BPD) is the most common respiratory disorder in extremely low birth weight infants. Although most symptoms of BPD improve, some late complications exist, even with regular treatment. Gastroesophageal reflux (GER), also common in extremely premature infants, may be related to many cardiorespiratory symptoms. However, the potential of GER as a risk factor for late complications associated with BPD is still unclear. The goal of this study was to determine if GER increases the risk of late complications of BPD in infants. A multicenter prospective cohort of 131 infants (79 male subjects, 52 female subjects) with BPD was enrolled. The development of late complications was assessed over an 18-month follow-up period. Twenty-four-hour pH-multichannel intraluminal impedance and gastric sodium concentrations were analyzed in all infants at 36weeks' postmenstrual age and at the last interview. Prevalence and risk factors of late complications of BPD were analyzed by using forward logistic regression. The prevalence of late complications in BPD infants was 63.79%and included respiratory symptoms (49.14%), vomiting (38.79%), retinopathy of prematurity (25.86%), hypoxic-ischemic injury (3.45%), rehospitalization (26.72%), and sudden death (0.86%). Respiratory diseases constituted the most frequent complication. The prevalence of GER in BPD was 42.24%and included acid GER (18.10%) and duodenogastroesophageal reflux (DGER; 24.14%). Risk factors for respiratory symptoms were gestational age≤ 30weeks (OR, 3.213; 95%CI, 1.221-8.460), birth weight< 1,500g (OR, 2.803; 95%CI, 1.014-7.749), invasive ventilation > 7days (OR, 4.952; 95%CI, 1.508-16.267), acid GER (OR, 4.630; 95%CI, 1.305-16.420), and DGER (OR, 5.588; 95%CI, 1.770-17.648). Infants with BPD and DGER were more prone to late complications than those with acid GER or no reflux. The prevalence of late complications is high in infants with BPD. GER (and in particular, DGER) poses a tentative risk for these late complications. ClinicalTrials.gov; No.: NCT03014453; URL: www.clinicaltrials.gov.

Effects of indoor air pollution on respiratory symptoms of non-smoking women in Niš, Serbia

Rationale: The aim of this study was to determine the effects of indoor air pollution exposure on respiratory symptoms and illnesses in non-smoking women in Niš, Serbia.&#x0D; Materials and methods: The study was carried out in 1,082 never-smoking females, aged 20-40 years, who were not occupationally exposed to indoor air pollution. The prevalence of respiratory symptoms and illnesses was assessed using the American Thoracic Society questionnaires. Multivariate methods were used in the analysis.&#x0D; Results: A strong association was found between respiratory symptoms and indoor air pollution. The associations between home dampness and sinusitis and bronchitis were also found to be statistically significant.&#x0D; Conclusions: Indoor air pollution exposure is an important risk factor for respiratory symptoms and illnesses in nonsmoking women in Niš, Serbia.

Epidemiology of respiratory pathogen carriage in the homeless population within 2 shelters in Marseille, France, 2015-2017: cross sectional one-day surveys

Purpose: To assess risk factors for respiratory tract infection symptoms and signs in sheltered homeless people in Marseille during the winter season, including pathogen carriage. Methods & Materials: Data on 479 participants within 2 shelters who completed questionnaires and a total of 950 nasal and pharyngeal samples were collected during the winters of 2015–2017. Respiratory pathogen carriage including 7 viruses and 4 bacteria was assessed by quantitative polymerase chain reaction. Results: The homeless population was characterized by a majority of males (2260/2365, 95.6%) of North African origin (1156/2360, 49.0%) with a relatively high prevalence of chronic homelessness (175/465, 37.6%). We evidenced a high prevalence of respiratory symptoms and signs (168/476, 35.3%), a very high prevalence of bacterial carriage (313/477, 65.6%), especially Haemophilus influenzae (280/477, 58.7%) and a lower prevalence of virus carriage (51/473, 10.8%) with human rhinovirus being the most frequent (25/473, 5.3%). Differences were observed between the microbial communities of the nose and throat. Duration of homelessness (OR = 1.77, p = 0.017), chronic respiratory diseases (OR = 5.27, p < 0.0001) and visiting countries of origin for migrants (OR = 1.68, p = 0.035) were identified as independent risk factors for respiratory symptoms and signs. A strong association between virus (OR = 2.40, p = 0.012) or Streptococcus pneumoniae (OR = 2.32, p = 0.014) carriage and respiratory symptoms and signs was also found. Conclusion: These findings allowed identifying the individuals at higher risk for contracting respiratory tract infections to better target preventive measures aiming at limiting the transmission of these diseases in this setting (such as against influenza and S. pneumoniae infections).

Epidemiology of respiratory pathogen carriage in the homeless population within two shelters in Marseille, France, 2015–2017: cross sectional 1-day surveys

ObjectivesTo assess risk factors for respiratory tract infection symptoms and signs in sheltered homeless people in Marseille during the winter season, including pathogen carriage. MethodsData on 479 male participants within two shelters who completed questionnaires and a total of 950 nasal and pharyngeal samples were collected during the winters of 2015–2017. Respiratory pathogen carriage including seven viruses and four bacteria was assessed by quantitative PCR. ResultsThe homeless population was characterized by a majority of individuals of North African origin (300/479, 62.6%) with a relatively high prevalence of chronic homelessness (175/465, 37.6%). We found a high prevalence of respiratory symptoms and signs (168/476, 35.3%), a very high prevalence of bacterial carriage (313/477, 65.6%), especially Haemophilus influenzae (280/477, 58.7%), and a lower prevalence of virus carriage (51/473, 10.8%) with human rhinovirus being the most frequent (25/473, 5.3%). Differences were observed between the microbial communities of the nose and throat. Duration of homelessness (odds ratio (OR) 1.77, p 0.017), chronic respiratory diseases (OR 5.27, p <0.0001) and visiting countries of origin for migrants (OR 1.68, p 0.035) were identified as independent risk factors for respiratory symptoms and signs. A strong association between virus (OR 2.40, p 0.012) or Streptococcus pneumoniae (OR 2.32, p 0.014) carriage and respiratory symptoms and signs was also found. ConclusionsThese findings allowed identification of the individuals at higher risk for contracting respiratory tract infections to better target preventive measures aimed at limiting the transmission of these diseases in this setting.

Pulmonary disease in HIV-infected adults in the era of antiretroviral therapy.

: HIV in the antiretroviral therapy era is characterized by multimorbidity and the frequent occurrence of HIV-associated non-AIDS chronic health conditions. Respiratory symptoms and chronic pulmonary diseases, including chronic obstructive pulmonary disease, asthma, and cardiopulmonary dysfunction, are among the conditions that may present in persons living with HIV. Tobacco smoking, which is disproportionately high among persons living HIV, strongly contributes to the risk of pulmonary disease. Additionally, features associated with and at times unique to HIV, including persistent inflammation, immune cell activation, oxidative stress, and dysbiosis, may also contribute. This review summarizes the available literature regarding epidemiology of and risk factors for respiratory symptoms and chronic pulmonary disease in the current era.

Current asthma, respiratory symptoms and airway infections among students in relation to the school and home environment in Japan

ABSTRACTObjective: To study associations between the school and home environment and current asthma, respiratory symptoms and airway infections among Japanese students. Methods: Japanese students (12–15 y) (N = 1048) in four schools responded to a questionnaire on respiratory health, allergy and the home environment. Temperature, relative air humidity (RH) and student density (students/m2 floor area) was measured in the classrooms: dust was collected from floors and in classroom air and analysed for cat (Fel d 1) and dog (Can f 1) allergens. Health associations were analysed by multi-level logistic regression. Results: Doctor's diagnosed asthma was common (13.4%), 8.8% reported cat allergy and 6.1% dog allergy. The median level in floor dust was 41 ng/g (IQR 23–92) for Fel d 1 and 101 ng/g (IQR 54–101) for Can f 1. The median level in air was 18.6 ng/ m2/ day (IQR5.9–25.1) for Fel d 1 and 18.6 ng/ m2/ day (IQR 6.0–13.3) for Can f 1. High RH, high student density and airborne cat allergen was associated with airway infections. In the home environment, recent indoor painting, new floor materials, odour, having cats as pets, window pane condensation in winter, and dampness in floor construction were associated with respiratory illness. Conclusion: High relative air humidity, high student density and airborne cat allergens at school may increase the risk of airway infections. Having cats as pets, chemical emissions from paint and new floor materials, odour and dampness can constitute domestic risk factors for respiratory symptoms while having dogs as pets could be protective.

No convincing association between genetic markers and respiratory symptoms: results of a GWA study

BackgroundRespiratory symptoms are associated with accelerated lung function decline, and increased hospitalization and mortality rates in the general population. Although several environmental risk factors for respiratory symptoms are known, knowledge on genetic risk factors is lacking. We aim to identify genetic variants associated with respiratory symptoms by genome-wide association (GWA) analyses.MethodsWe conducted the first GWA study on cough, dyspnea and phlegm among 7,976 participants in the LifeLines I cohort and used the LifeLines II cohort (n = 5,260) and the Vlagtwedde-Vlaardingen cohort (n = 1,529) for replication.ResultsWe identified 50 SNPs that were assessed for replication. Rs16918212, located in the alpha-2-macroglobulin pseudogene 1 (A2MP1), was associated with cough in both the identification (odds ratio (OR) = 0.72, p = 5.41 × 10−5) and the meta-analyzed replication cohorts (OR = 0.83, p = 0.033). No other significant replicated associations were found.ConclusionsGiven that only 1 out of 50 SNPs showed significant replication (i.e. 2%) we conclude that we did not find a convincing association between genetic markers and respiratory symptoms. Since, environmental exposures are important risk factors for respiratory symptoms, the next step is to perform a genome-wide interaction (GWI) study to identify genetic susceptibility loci for respiratory symptoms in interaction with known harmful environmental exposures.

Non-response in a cross-sectional study of respiratory health in Norway

ObjectivesDeclining participation in epidemiological studies has been reported in recent decades and may lead to biased prevalence estimates and selection bias. The aim of the study was to identify possible...

Posttraumatic stress disorder and the risk of respiratory problems in World Trade Center responders: longitudinal test of a pathway.

Posttraumatic stress disorder (PTSD) is associated with high medical morbidity, but the nature of this association remains unclear. Among responders to the World Trade Center (WTC) disaster, PTSD is highly comorbid with lower respiratory symptoms (LRS), which cannot be explained by exposure alone. We sought to examine this association longitudinally to establish the direction of the effects and evaluate potential pathways to comorbidity. 18,896 responders (8466 police and 10,430 nontraditional responders) participating in the WTC-Health Program were first evaluated between 2002 and 2010 and assessed again 2.5 years later. LRS were ascertained by medical staff, abnormal pulmonary function by spirometry, and probable WTC-related PTSD with a symptom inventory. In both groups of responders, initial PTSD (standardized regression coefficient: β = 0.20 and 0.23) and abnormal pulmonary function (β = 0.12 and 0.12) predicted LRS 2.5 years later after controlling for initial LRS and covariates. At follow-up, LRS onset was 2.0 times more likely and remission 1.8 times less likely in responders with initial PTSD than in responders without. Moreover, PTSD mediated, in part, the association between WTC exposures and development of LRS (p < .0001). Initial LRS and abnormal pulmonary function did not consistently predict PTSD onset. These analyses provide further evidence that PTSD is a risk factor for respiratory symptoms and are consistent with evidence implicating physiological dysregulation associated with PTSD in the development of medical conditions. If these effects are verified experimentally, treatment of PTSD may prove helpful in managing physical and mental health of disaster responders.

Exposure to parental smoking in childhood is associated with persistence of respiratory symptoms into young adult life

Exposure to environmental tobacco smoke (ETS) has been established as a significant risk factor for respiratory symptoms and diseases in children. However, it is unclear whether the effects of childhood exposure to ETS track into adult life. By using data from the long-term population-based cohort of the TESAOD study, this study found that parental ETS exposure in childhood significantly increases the risk of persistent cough, chronic cough, and wheeze into young adult life.

Are children׳s asthmatic symptoms related to ambient temperature? A panel study in Australia

ObjectivesTo examine the short-term effects of ambient temperature on respiratory symptoms for school children with asthma across Australia. MethodsA panel of 270 children (7–12 years) with asthma was recruited from six Australian cities. They were asked to record their respiratory symptoms every day in the morning (for night-time symptoms) and evening (for daytime symptoms) for four weeks. Daily ambient temperature, relative humidity and air pollution data were obtained from fixed monitors nearby. A mixed logistic regression model was used to examine the effects of ambient temperature on respiratory symptoms adjusted for children׳s sex, age, standing height, weight and air pollution. Subjects were specified as random effects. ResultsThe relationships between ambient temperature and respiratory symptoms were linear. Increasing temperatures induced the risks of children׳s asthmatic symptoms, especially for “wheeze/chest tightness” and to a lesser extent for “cough/phlegm”. The effects were acute and lasted for four days (lag 0–3) in general. With increasing ambient temperature, boys were more at risk than girls. ConclusionsHigh ambient temperature is a risk factor for respiratory symptoms in children with asthma. As ambient temperature increases, policies and strategies for rising temperatures will be necessary to protect asthmatic children.

Prevalence trends in respiratory symptoms and asthma in relation to smoking - two cross-sectional studies ten years apart among adults in northern Sweden

Background Smoking is considered to be the single most important preventable risk factor for respiratory symptoms. Estimating prevalence of respiratory symptoms is important since they most often precede a diagnosis of an obstructive airway disease, which places a major burden on the society. The aim of this study was to estimate prevalence trends of respiratory symptoms and asthma among Swedish adults, in relation to smoking habits. A further aim was to estimate the proportion of respiratory symptom and asthma prevalence attributable to smoking.Methods Data from two large-scale cross-sectional surveys among adults performed in northern Sweden in 1996 and 2006 were analysed. Identical methods and the same questionnaire were used in both surveys. The association between smoking, respiratory symptoms and asthma was analysed with multiple logistic regression analyses. Changes in prevalence of respiratory symptoms and asthma from 1996 to 2006 were expressed as odds ratios. Additionally, the population attributable risks of smoking were estimated.Results The prevalence of most respiratory symptoms decreased significantly from 1996 to 2006. Longstanding cough decreased from 12.4 to 10.1%, sputum production from 19.0 to 15.0%, chronic productive cough from 7.3 to 6.2%, and recurrent wheeze from 13.4 to 12.0%. Any wheeze and asthmatic wheeze remained unchanged. This parallels to a decrease in smoking from 27.4 to 19.1%. In contrast, physician-diagnosed asthma increased from 9.4 to 11.6%. The patterns were similar after correction for confounders. All respiratory symptoms were highly associated with smoking, and the proportion of respiratory symptoms in the population attributed to smoking (PAR) ranged from 9.8 to 25.5%. In 2006, PAR of smoking was highest for recurrent wheeze (20.6%).Conclusions In conclusion, we found that respiratory symptoms, in particular symptoms common in bronchitis, decreased among adults in northern Sweden, parallel to a decrease in smoking from 1996 to 2006. In contrast, the prevalence of physician-diagnosed asthma increased during the same time-period. Up to one fourth of the respiratory symptom prevalence in the population was attributable to smoking.

Risk factors for respiratory symptoms in adults: The Busselton Health Study

The prevalence of reported doctor-diagnosed 'asthma' increased between 1990 and 2005-2007 in Busselton, Western Australia, accompanied by increased reported cough and phlegm but not recent wheeze. Possible reasons for the increase in diagnosed asthma include environmental exposures and diagnostic transfer. The aim of this study was to relate subject characteristics and exposures to the presence of wheeze and/or current cough/phlegm in the 2005-2007 survey. A gender- and age-stratified random sample of 2862 adults from the Busselton shire completed questionnaires regarding doctor-diagnosed asthma, respiratory symptoms and environmental exposures; and measures of anthropometry, spirometry, exhaled nitric oxide (eNO), airway hyperresponsiveness (AHR) and atopy. Associations between respiratory symptoms and subject characteristics were assessed in 2656 subjects. Wheeze was reported by 23% of subjects, cough/phlegm by 22% and both by 9%. The significant and independent correlates of wheeze were reflux symptoms, lung function, AHR, eNO, atopy, body mass index and smoking. The significant and independent correlates of cough/phlegm were reflux symptoms, lung function, smoking and dusty job. Subjects more likely to report only wheeze than only cough/phlegm were female, aged <40 years, atopic, had lower percentage predicted forced expiratory volume in one second (FEV1) or higher percentage predicted force vital capacity. A variety of risk factors was associated with wheeze or cough/phlegm or both. Increased non-allergic exposures may account for increased prevalence of reported cough and phlegm and may contribute to increased reported asthma in adults.

Atopy is a risk factor for respiratory symptoms in COPD patients: results from the EUROSCOP study.

BackgroundThe pathogenesis of COPD is complex and remains poorly understood. The European Respiratory Society Study on Chronic Obstructive Pulmonary Disease (EUROSCOP) investigated long-term effects of budesonide; 18% of the COPD participants were atopic. So far effects of atopy on the long-term course of COPD have not been elucidated.MethodsFactors related to the presence of atopy (positive phadiatop) in 1277 mild-to-moderate COPD patients participating in EUROSCOP were analysed using regression analysis. Incidence and remission of respiratory symptoms during 3-year follow-up were analysed using generalised estimating equations models, and association of atopy with lung function decline using linear mixed effects models.ResultsIndependent predisposing factors associated with the presence of atopy were: male gender (OR: 2.21; 95% CI: 1.47–3.34), overweight/obese (OR: 1.41; 95% CI: 1.04–1.92) and lower age (OR: 0.98; 95% CI: 0.96–0.99). Atopy was associated with a higher prevalence of cough (OR: 1.71; 95% CI: 1.26–2.34) and phlegm (OR: 1.50; 95% CI: 1.10–2.03), but not with lung function levels or FEV1 decline. Atopic COPD patients not treated with budesonide had an increased incidence of cough over time (OR: 1.79, 95% CI: 1.03–3.08, p = 0.038), while those treated with budesonide had increased remission of cough (OR: 1.93, 95% CI: 1.11–3.37, p = 0.02) compared to non-atopic COPD patients.ConclusionsAtopic COPD patients are more likely male, have overweight/obesity and are younger as compared with non-atopic COPD patients. Atopy in COPD is associated with an increased incidence and prevalence of respiratory symptoms. If atopic COPD patients are treated with budesonide, they more often show remission of symptoms compared to non-atopic COPD patients who are treated with budesonide. We recommend including atopy in the diagnostic work-up and management of COPD.