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dc.contributor.authorLamprecht, Bernd
dc.contributor.authorMcBurnie, Mary Ann
dc.contributor.authorVollmer, William M
dc.contributor.authorGudmundsson, Gunnar
dc.contributor.authorWelte, Tobias
dc.contributor.authorNizankowska-Mogilnicka, Ewa
dc.contributor.authorStudnicka, Michael
dc.contributor.authorBateman, Eric
dc.contributor.authorAnto, Josep M
dc.contributor.authorBurney, Peter
dc.contributor.authorMannino, David M
dc.contributor.authorBuist, Sonia A
dc.date.accessioned2012-06-04T11:16:08Z
dc.date.available2012-06-04T11:16:08Z
dc.date.issued2011-04
dc.date.submitted2012-06-04
dc.identifier.citationChest 2011, 139(4):752-63en_GB
dc.identifier.issn1931-3543
dc.identifier.pmid20884729
dc.identifier.doi10.1378/chest.10-1253
dc.identifier.urihttp://hdl.handle.net/2336/227414
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractBACKGROUND: Never smokers comprise a substantial proportion of patients with COPD. Their characteristics and possible risk factors in this population are not yet well defined. METHODS: We analyzed data from 14 countries that participated in the international, population-based Burden of Obstructive Lung Disease (BOLD) study. Participants were aged ≥ 40 years and completed postbronchodilator spirometry testing plus questionnaires about respiratory symptoms, health status, and exposure to COPD risk factors. A diagnosis of COPD was based on the postbronchodilator FEV₁/FVC ratio, according to current GOLD (Global Initiative for Obstructive Lung Disease) guidelines. In addition to this, the lower limit of normal (LLN) was evaluated as an alternative threshold for the FEV₁/FVC ratio. RESULTS: Among 4,291 never smokers, 6.6% met criteria for mild (GOLD stage I) COPD, and 5.6% met criteria for moderate to very severe (GOLD stage II+) COPD. Although never smokers were less likely to have COPD and had less severe COPD than ever smokers, never smokers nonetheless comprised 23.3% (240/1,031) of those classified with GOLD stage II+ COPD. This proportion was similar, 20.5% (171/832), even when the LLN was used as a threshold for the FEV₁/FVC ratio. Predictors of COPD in never smokers include age, education, occupational exposure, childhood respiratory diseases, and BMI alterations. CONCLUSION: This multicenter international study confirms previous evidence that never smokers comprise a substantial proportion of individuals with COPD. Our data suggest that, in addition to increased age, a prior diagnosis of asthma and, among women, lower education levels are associated with an increased risk for COPD among never smokers.
dc.description.sponsorshipALTANA Aventis AstraZeneca Boehringer-Ingleheim Chiesi GlaxoSmithKline Merck Novartis Pfizer Inc Schering-Plough Sunovion Pharmaceuticals Inc University of Kentucky Schering Plough Sepracor AstraZeneca, Spainen_GB
dc.language.isoenen
dc.publisherAmerican College of Chest Physiciansen_GB
dc.relation.urlhttp://dx.doi.org/10.1378/chest.10-1253en_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168866/?tool=pubmeden_GB
dc.rightsArchived with thanks to Chesten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIncidenceen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPulmonary Disease, Chronic Obstructiveen_GB
dc.subject.meshQuestionnairesen_GB
dc.subject.meshRespiratory Function Testsen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshSmokingen_GB
dc.subject.meshWorld Healthen_GB
dc.titleCOPD in never smokers: results from the population-based burden of obstructive lung disease study.en
dc.typeArticleen
dc.contributor.departmentDepartment of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria. b.lamprecht@salk.aten_GB
dc.identifier.journalChesten_GB
html.description.abstractBACKGROUND: Never smokers comprise a substantial proportion of patients with COPD. Their characteristics and possible risk factors in this population are not yet well defined. METHODS: We analyzed data from 14 countries that participated in the international, population-based Burden of Obstructive Lung Disease (BOLD) study. Participants were aged ≥ 40 years and completed postbronchodilator spirometry testing plus questionnaires about respiratory symptoms, health status, and exposure to COPD risk factors. A diagnosis of COPD was based on the postbronchodilator FEV₁/FVC ratio, according to current GOLD (Global Initiative for Obstructive Lung Disease) guidelines. In addition to this, the lower limit of normal (LLN) was evaluated as an alternative threshold for the FEV₁/FVC ratio. RESULTS: Among 4,291 never smokers, 6.6% met criteria for mild (GOLD stage I) COPD, and 5.6% met criteria for moderate to very severe (GOLD stage II+) COPD. Although never smokers were less likely to have COPD and had less severe COPD than ever smokers, never smokers nonetheless comprised 23.3% (240/1,031) of those classified with GOLD stage II+ COPD. This proportion was similar, 20.5% (171/832), even when the LLN was used as a threshold for the FEV₁/FVC ratio. Predictors of COPD in never smokers include age, education, occupational exposure, childhood respiratory diseases, and BMI alterations. CONCLUSION: This multicenter international study confirms previous evidence that never smokers comprise a substantial proportion of individuals with COPD. Our data suggest that, in addition to increased age, a prior diagnosis of asthma and, among women, lower education levels are associated with an increased risk for COPD among never smokers.


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