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1. Prevalence and Population-Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study

Author

Burney, Peter, primary, Patel, Jaymini, additional, Minelli, Cosetta, additional, Gnatiuc, Louisa, additional, Amaral, André F. S., additional, Kocabaş, Ali, additional, Cherkaski, Hamid Hacene, additional, Gulsvik, Amund, additional, Nielsen, Rune, additional, Bateman, Eric, additional, Jithoo, Anamika, additional, Mortimer, Kevin, additional, Sooronbaev, Talant M., additional, Lawin, Hervé, additional, Nejjari, Chakib, additional, Elbiaze, Mohammed, additional, El Rhazi, Karima, additional, Zheng, Jin-Ping, additional, Ran, Pixin, additional, Welte, Tobias, additional, Obaseki, Daniel, additional, Erhabor, Gregory, additional, Elsony, Asma, additional, Osman, Nada Bakri, additional, Ahmed, Rana, additional, Nizankowska-Mogilnicka, Ewa, additional, Mejza, Filip, additional, Mannino, David M., additional, Bárbara, Cristina, additional, Wouters, Emiel F. M., additional, Idolor, Luisito F., additional, Loh, Li-Cher, additional, Rashid, Abdul, additional, Juvekar, Sanjay, additional, Gislason, Thorarinn, additional, Al Ghobain, Mohamed, additional, Studnicka, Michael, additional, Harrabi, Imed, additional, Denguezli, Meriam, additional, Koul, Parvaiz A., additional, Jenkins, Christine, additional, Marks, Guy, additional, Jõgi, Rain, additional, Hafizi, Hasan, additional, Janson, Christer, additional, Tan, Wan C., additional, Aquart-Stewart, Althea, additional, Mbatchou, Bertrand, additional, Nafees, Asaad Ahmed, additional, Gunasekera, Kirthi, additional, Seemungal, Terry, additional, Anand, Mahesh Padukudru, additional, Enright, Paul, additional, Vollmer, William M., additional, Blangiardo, Marta, additional, Elfadaly, Fadlalla G., additional, Buist, A. Sonia, additional, Aliko, Anila, additional, Bardhi, Donika, additional, Tafa, Holta, additional, Thanasi, Natasha, additional, Mezini, Arian, additional, Teferici, Alma, additional, Todri, Dafina, additional, Nikolla, Jolanda, additional, Kazasi, Rezarta, additional, Bengrait, Amira, additional, Haddad, Tabarek, additional, Zgaoula, Ibtissem, additional, Ghit, Maamar, additional, Roubhia, Abdelhamid, additional, Boudra, Soumaya, additional, Atoui, Feryal, additional, Yakoubi, Randa, additional, Benali, Rachid, additional, Bencheikh, Abdelghani, additional, Ait-Khaled, Nadia, additional, Bird, Tessa, additional, Espinel, Paola, additional, Hardaker, Kate, additional, Toelle, Brett, additional, Dawes, Torkil, additional, Lamprecht, Bernd, additional, Schirhofer, Lea, additional, Islam, Akramul, additional, Ahmed, Syed Masud, additional, Islam, Shayla, additional, Islam, Qazi Shafayetul, additional, Chowdhury, Tridib Roy, additional, Chatterjee, Sukantha Kumar, additional, Mia, Dulal, additional, Das, Shyamal Chandra, additional, Rahman, Mizanur, additional, Islam, Nazrul, additional, Uddin, Shahaz, additional, Islam, Nurul, additional, Khatun, Luiza, additional, Parvin, Monira, additional, Khan, Abdul Awal, additional, Islam, Maidul, additional, Lawin, Herve, additional, Kpangon, Arsene, additional, Kpossou, Karl, additional, Agodokpessi, Gildas, additional, Ayelo, Paul, additional, Fayomi, Benjamin, additional, Ashu, Atongno Humphrey, additional, Wang, Wen, additional, Zhong, NanShan, additional, Liu, Shengming, additional, Lu, Jiachun, additional, Wang, Dali, additional, Zheng, Jin-ping, additional, Zhou, Yumin, additional, Laja, Hendrik, additional, Ulst, Katrin, additional, Zobel, Vappu, additional, Lill, Toomas-Julius, additional, Adegnika, Ayola Akim, additional, Bodemann, Isabelle, additional, Geldmacher, Henning, additional, Schweda-Linow, Alexandra, additional, Benedikdtsdottir, Bryndis, additional, Jörundsdottir, Kristin, additional, Gudmundsdottir, Lovisa, additional, Gudmundsdottir, Sigrun, additional, Gudmundsson, Gunnar, additional, Rao, Mahesh, additional, Malik, Sajjad, additional, Hakim, Nissar A., additional, Khan, Umar Hafiz, additional, Chowgule, Rohini, additional, Shetye, Vasant, additional, Raphael, Jonelle, additional, Almeda, Rosel, additional, Tawde, Mahesh, additional, Tadvi, Rafiq, additional, Katkar, Sunil, additional, Kadam, Milind, additional, Dhanawade, Rupesh, additional, Ghurup, Umesh, additional, Hirve, Siddhi, additional, Sambhudas, Somnath, additional, Chaidhary, Bharat, additional, Tambe, Meera, additional, Pingale, Savita, additional, Umap, Arati, additional, Umap, Archana, additional, Shelar, Nitin, additional, Devchakke, Sampada, additional, Chaudhary, Sharda, additional, Bondre, Suvarna, additional, Walke, Savita, additional, Gawhane, Ashleshsa, additional, Sapkal, Anil, additional, Argade, Rupali, additional, Gaikwad, Vijay, additional, Salvi, Sundeep, additional, Brashier, Bill, additional, Londhe, Jyoti, additional, Madas, Sapna, additional, Aikman, Akosua Francia, additional, Estebesova, Bermet M., additional, Akmatalieva, Meerim, additional, Usenbaeva, Saadat, additional, Kydyrova, Jypara, additional, Bostonova, Eliza, additional, Sheraliev, Ulan, additional, Marajapov, Nuridin, additional, Toktogulova, Nurgul, additional, Emilov, Berik, additional, Azilova, Toktogul, additional, Beishekeeva, Gulnara, additional, Dononbaeva, Nasyikat, additional, Tabyshova, Aijamal, additional, Nyapigoti, Wezzie, additional, Mwangoka, Ernest, additional, Kambwili, Mayamiko, additional, Chipeta, Martha, additional, Banda, Gloria, additional, Mkandawire, Suzgo, additional, Banda, Justice, additional, Sholehah, Siti, additional, Benjelloun, Mohamed C., additional, Elbiaze, Mohamed, additional, Wouters, E. F. M., additional, Wesseling, G. J., additional, Awopeju, Olayemi, additional, Adewole, Olufemi, additional, Endresen, Tina, additional, Svendsen, Lene, additional, Nafees, Asaad A., additional, de Guia, Teresita S., additional, Francisco, Norberto A., additional, Roa, Camilo C., additional, Ayuyao, Fernando G., additional, Tady, Cecil Z., additional, Tan, Daniel T., additional, Banal-Yang, Sylvia, additional, Balanag, Vincent M., additional, Reyes, Maria Teresita N., additional, Dantes, Renato. B., additional, Dantes, Renato B., additional, Amarillo, Lourdes, additional, Berratio, Lakan U., additional, Fernandez, Lenora C., additional, Garcia, Gerard S., additional, Naval, Sullian S., additional, Reyes, Thessa, additional, Sanchez, Ma. Flordeliza, additional, Simpao, Leander P., additional, Frey, Jakub, additional, Harat, Rafal, additional, Nastalek, Pawel, additional, Pajak, Andrzej, additional, Skucha, Wojciech, additional, Szczeklik, Andrzej, additional, Twardowska, Magda, additional, Rodrigues, Fátima, additional, Dias, Hermínia, additional, Cardoso, João, additional, Almeida, João, additional, Matos, Maria João, additional, Simão, Paula, additional, Santos, Moutinho, additional, Ferreira, Reis, additional, Al Ghobain, M., additional, Alorainy, H., additional, El-Hamad, E., additional, Al Hajjaj, M., additional, Hashi, A., additional, Dela, R., additional, Fanuncio, R., additional, Doloriel, E., additional, Marciano, I., additional, Safia, L., additional, Adams, Desiree, additional, Barnes, Edward, additional, Freeman, Jasper, additional, Hayes, Anton, additional, Hlengwa, Sipho, additional, Johannisen, Christine, additional, Koopman, Mariana, additional, Louw, Innocentia, additional, Ludick, Ina, additional, Olckers, Alta, additional, Ryck, Johanna, additional, Storbeck, Janita, additional, Wickremasinghe, Rajitha, additional, Elsadig, Hana A., additional, Osman, Nada Bakery, additional, Noory, Bandar Salah, additional, Mohamed, Monjda Awad, additional, Osman, Hasab Alrasoul Akasha Ahmed, additional, ed Elhassan, Namarig Moham, additional, Mu‘is El Zain, Abdel, additional, Mohamaden, Marwa Mohamed, additional, Khalifa, Suhaiba, additional, Elhadi, Mahmoud, additional, Hassan, Mohand, additional, Abdelmonam, Dalia, additional, Olafsdottir, Inga Sif, additional, Nisser, Katarina, additional, Spetz-Nyström, Ulrike, additional, Hägg, Gunilla, additional, Lund, Gun-Marie, additional, Seemungal, Terence, additional, Lutchmansingh, Fallon, additional, Conyette, Liane, additional, Denguezli, Myriam, additional, Tabka, Zouhair, additional, Daldoul, Hager, additional, Boukheroufa, Zaki, additional, Chouikha, Firas, additional, Khalifa, Wahbi Belhaj, additional, Hancioglu, Attila, additional, Hanta, Ismail, additional, Kuleci, Sedat, additional, Turkyilmaz, Ahmet Sinan, additional, Umut, Sema, additional, Unalan, Turgay, additional, Burney, Peter G. J., additional, Azar, Hadia, additional, Amor, Caron, additional, Potts, James, additional, Tumilty, Michael, additional, McLean, Fiona, additional, Dudhaiya, Risha, additional, McBurnie, Mary Ann, additional, Gillespie, Suzanne, additional, Sullivan, Sean, additional, Lee, Todd A., additional, Weiss, Kevin B., additional, Jensen, Robert L., additional, Crapo, Robert, additional, Cain, John, additional, Copeland, Rebecca, additional, Hazen, Dana, additional, and Methvin, Jennifer, additional

Published
2021
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2. Airflow Obstruction and Use of Solid Fuels for Cooking or Heating BOLD (Burden of Obstructive Lung Disease) Results

Author

André F. S. Amaral, Jaymini Patel, Bernet S. Kato, Daniel O. Obaseki, Hervé Lawin, Wan C. Tan, Sanjay K. Juvekar, Imed Harrabi, Michael Studnicka, Emiel F. M. Wouters, Li-Cher Loh, Eric D. Bateman, Kevin Mortimer, A. Sonia Buist, Peter G. J. Burney, NanShan Zhong, Shengming Liu, Jiachun Lu, Pixin Ran, Dali Wang, Jingping Zheng, Yumin Zhou, Ali Kocabaş, Attila Hancioglu, Ismail Hanta, Sedat Kuleci, Ahmet Sinan Turkyilmaz, Sema Umut, Turgay Unalan, Torkil Dawes, Bernd Lamprecht, Lea Schirhofer, Eric Bateman, Anamika Jithoo, Desiree Adams, Edward Barnes, Jasper Freeman, Anton Hayes, Sipho Hlengwa, Christine Johannisen, Mariana Koopman, Innocentia Louw, Ina Ludick, Alta Olckers, Johanna Ryck, Janita Storbeck, Thorarinn Gislason, Bryndis Benedikdtsdottir, Kristin Jörundsdottir, Lovisa Gudmundsdottir, Sigrun Gudmundsdottir, Gunnar Gundmundsson, Ewa Nizankowska-Mogilnicka, Jakub Frey, Rafal Harat, Filip Mejza, Pawel Nastalek, Andrzej Pajak, Wojciech Skucha, Andrzej Szczeklik, Magda Twardowska, Tobias Welte, Isabelle Bodemann, Henning Geldmacher, Alexandra Schweda-Linow, Amund Gulsvik, Tina Endresen, Lene Svendsen, Wen Wang, David M. Mannino, John Cain, Rebecca Copeland, Dana Hazen, Jennifer Methvin, Renato B. Dantes, Lourdes Amarillo, Lakan U. Berratio, Lenora C. Fernandez, Norberto A. Francisco, Gerard S. Garcia, Teresita S. de Guia, Luisito F. Idolor, Sullian S. Naval, Thessa Reyes, Camilo C. Roa, Ma. Flordeliza Sanchez, Leander P. Simpao, Christine Jenkins, Guy Marks, Tessa Bird, Paola Espinel, Kate Hardaker, Brett Toelle, Peter GJ Burney, Caron Amor, James Potts, Michael Tumilty, Fiona McLean, E. F. M. Wouters, G. J. Wesseling, Cristina Bárbara, Fátima Rodrigues, Hermínia Dias, João Cardoso, João Almeida, Maria João Matos, Paula Simão, Moutinho Santos, Reis Ferreira, Christer Janson, Inga Sif Olafsdottir, Katarina Nisser, Ulrike Spetz-Nyström, Gunilla Hägg, Gun-Marie Lund, Rain Jõgi, Hendrik Laja, Katrin Ulst, Vappu Zobel, Toomas-Julius Lill, Parvaiz A Koul, Sajjad Malik, Nissar A Hakim, Umar Hafiz Khan, Rohini Chowgule, Vasant Shetye, Jonelle Raphael, Rosel Almeda, Mahesh Tawde, Rafiq Tadvi, Sunil Katkar, Milind Kadam, Rupesh Dhanawade, Umesh Ghurup, Myriam Denguezli, Zouhair Tabka, Hager Daldoul, Zaki Boukheroufa, Firas Chouikha, Wahbi Belhaj Khalifa, Fernando G. Ayuyao, Cecil Z. Tady, Daniel T. Tan, Sylvia Banal-Yang, Vincent M. Balanag, Maria Teresita N. Reyes, Renato. B. Dantes, Sanjay Juvekar, Siddhi Hirve, Somnath Sambhudas, Bharat Chaidhary, Meera Tambe, Savita Pingale, Arati Umap, Archana Umap, Nitin Shelar, Sampada Devchakke, Sharda Chaudhary, Suvarna Bondre, Savita Walke, Ashleshsa Gawhane, Anil Sapkal, Rupali Argade, Vijay Gaikwad, Sundeep Salvi, Bill Brashier, Jyoti Londhe, Sapna Madas, Mohamed C Benjelloun, Chakib Nejjari, Mohamed Elbiaze, Karima El Rhazi, Daniel Obaseki, Gregory Erhabor, Olayemi Awopeju, Olufemi Adewole, M. Al Ghobain, H. Alorainy, E. El-Hamad, M. Al Hajjaj, H. Ayan, D. Rowena, F. Rofel, E. Elizabeth, I. Imelda, H. Safia, null Lyla, Talant M. Sooronbaev, Bermet M. Estebesova, Meerim Akmatalieva, Saadat Usenbaeva, Jypara Kydyrova, Eliza Bostonova, Ulan Sheraliev, Nuridin Marajapov, Nurgul Toktogulova, Berik Emilov, Toktogul Azilova, Gulnara Beishekeeva, Nasyikat Dononbaeva, null AijamalTabyshova, Wezzie Nyapigoti, Ernest Mwangoka, Mayamiko Kambwili, Martha Chipeta, Gloria Banda, Suzgo Mkandawire, Justice Banda, Asma Elsony, Hana A. Elsadig, Nada Bakery Osman, Bandar Salah Noory, Monjda Awad Mohamed, Hasab Alrasoul Akasha Ahmed Osman, Namarig Moham ed Elhassan, Abdel Mu‘is El Zain, Marwa Mohamed Mohamaden, Suhaiba Khalifa, Mahmoud Elhadi, Mohand Hassan, Dalia Abdelmonam, Hasan Hafizi, Anila Aliko, Donika Bardhi, Holta Tafa, Natasha Thanasi, Arian Mezini, Alma Teferici, Dafina Todri, Jolanda Nikolla, Rezarta Kazasi, Hamid Hacene Cherkaski, Amira Bengrait, Tabarek Haddad, Ibtissem Zgaoula, Maamar Ghit, Abdelhamid Roubhia, Soumaya Boudra, Feryal Atoui, Randa Yakoubi, Rachid Benali, Abdelghani Bencheikh, Nadia Ait-Khaled, Akramul Islam, Syed Masud Ahmed, Shayla Islam, Qazi Shafayetul Islam, null Mesbah-Ul-Haque, Tridib Roy Chowdhury, Sukantha Kumar Chatterjee, Dulal Mia, Shyamal Chandra Das, Mizanur Rahman, Nazrul Islam, Shahaz Uddin, Nurul Islam, Luiza Khatun, Monira Parvin, Abdul Awal Khan, Maidul Islam, Abdul Rashid, Siti Sholehah, Herve Lawin, Arsene Kpangon, Karl Kpossou, Gildas Agodokpessi, Paul Ayelo, Benjamin Fayomi, Pulmonologie, MUMC+: MA Longziekten (3), and RS: NUTRIM - R3 - Respiratory & Age-related Health

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Chronic bronchitis, solid fuels (biomass), Pulmonary disease, Biomass smoke, urologic and male genital diseases, Critical Care and Intensive Care Medicine, Airflow obstruction, airflow obstruction, Lower limit, chronic obstructive pulmonary disease, LOWER LIMIT, 03 medical and health sciences, 0302 clinical medicine, BIOMASS SMOKE, POLLUTION, low-income countries, Internal medicine, YOUNG-ADULTS, PULMONARY-DISEASE, Medicine, 030212 general & internal medicine, CHIMNEY STOVE INTERVENTION, COPD, business.industry, Original Articles, medicine.disease, Solid fuel, REFERENCE VALUES, respiratory tract diseases, CHRONIC-BRONCHITIS, 030228 respiratory system, NEVER-SMOKERS, Reference values, Cardiology, RISK-FACTORS, business
Abstract

Rationale: Evidence supporting the association of chronic obstructive pulmonary disease or airflow obstruction with use of solid fuels is conflicting and inconsistent. Objectives: To assess the association of airflow obstruction with self-reported use of solid fuels for cooking or heating. Methods: We analyzed 18,554 adults from the BOLD (Burden of Obstructive Lung Disease) study, who had provided acceptable post-bronchodilator spirometry measurements, and information on use of solid fuels. The association of airflow obstruction with use of solid fuels for cooking or heating was assessed by sex, within each site, using regression analysis. Estimates were stratified by national income and meta-analyzed. We performed similar analyses for spirometric restriction, chronic cough, and chronic phlegm. Measurements and Main Results: We found no association between airflow obstruction and use of solid fuels for cooking or heating (odds ratio [OR] for men, 1.20 [95% confidence interval (CI), 0.94–1.53]; OR for women, 0.88 [95% CI, 0.67–1.15]). This was true for low-/middle- and high-income sites. Among never-smokers, there was also no evidence of an association of airflow obstruction with use of solid fuels (OR for men, 1.00 [95% CI, 0.57–1.76]; OR for women, 1.00 [95% CI, 0.76–1.32]). Overall, we found no association of spirometric restriction, chronic cough, or chronic phlegm with the use of solid fuels. However, we found that chronic phlegm was more likely to be reported among female never-smokers and those who had been exposed for 20 years or longer. Conclusions: Airflow obstruction assessed from post-bronchodilator spirometry was not associated with use of solid fuels for cooking or heating.

Published
2018
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4. Prevalence and Population Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study

Author

Burney, Peter, Patel, Jaymini, Minelli, Cosetta, Gnatiuc, Louisa, Amaral, André F. S., Kocabaş, Ali, Cherkaski, Hamid Hacene, Gulsvik, Amund, Nielsen, Rune, Bateman, Eric, Jithoo, Anamika, Mortimer, Kevin, Sooronbaev, Talant M., Lawin, Hervé, Nejjari, Chakib, Elbiaze, Mohammed, El Rhazi, Karima, Zheng, Jin-Ping, Ran, Pixin, Welte, Tobias, Obaseki, Daniel, Erhabor, Gregory, Elsony, Asma, Osman, Nada Bakri, Ahmed, Rana, Nizankowska-Mogilnicka, Ewa, Mejza, Filip, Mannino, David M, Bárbara, Cristina, Wouters, Emiel F.M., Idolor, Luisito F., Loh, Li-Cher, Rashid, Abdul, Juvekar, Sanjay, Gislason, Thorarinn, Al Ghobain, Mohamed, Studnicka, Michael, Harrabi, Imed, Denguezli, Meriam, Koul, Parvaiz A, Jenkins, Christine, Marks, Guy, Jõgi, Rain, Hafizi, Hasan, Janson, Christer, Tan, Wan C, Aquart-Stewart, Althea, Mbatchou, Bertrand, Nafees, Asaad, Gunasekera, Kirthi, Seemungal, Terry, Padukudru Anand, Mahesh, Enright, Paul, Vollmer, William M., Blangiardo, Marta, Elfadaly, Fadlalla G., Buist, A. Sonia, Burney, Peter, Patel, Jaymini, Minelli, Cosetta, Gnatiuc, Louisa, Amaral, André F. S., Kocabaş, Ali, Cherkaski, Hamid Hacene, Gulsvik, Amund, Nielsen, Rune, Bateman, Eric, Jithoo, Anamika, Mortimer, Kevin, Sooronbaev, Talant M., Lawin, Hervé, Nejjari, Chakib, Elbiaze, Mohammed, El Rhazi, Karima, Zheng, Jin-Ping, Ran, Pixin, Welte, Tobias, Obaseki, Daniel, Erhabor, Gregory, Elsony, Asma, Osman, Nada Bakri, Ahmed, Rana, Nizankowska-Mogilnicka, Ewa, Mejza, Filip, Mannino, David M, Bárbara, Cristina, Wouters, Emiel F.M., Idolor, Luisito F., Loh, Li-Cher, Rashid, Abdul, Juvekar, Sanjay, Gislason, Thorarinn, Al Ghobain, Mohamed, Studnicka, Michael, Harrabi, Imed, Denguezli, Meriam, Koul, Parvaiz A, Jenkins, Christine, Marks, Guy, Jõgi, Rain, Hafizi, Hasan, Janson, Christer, Tan, Wan C, Aquart-Stewart, Althea, Mbatchou, Bertrand, Nafees, Asaad, Gunasekera, Kirthi, Seemungal, Terry, Padukudru Anand, Mahesh, Enright, Paul, Vollmer, William M., Blangiardo, Marta, Elfadaly, Fadlalla G., and Buist, A. Sonia

Abstract

Rationale: The Global Burden of Disease programme identified smoking, and ambient and household air pollution as the main drivers of death and disability from Chronic Obstructive Pulmonary Disease (COPD). Objective: To estimate the attributable risk of chronic airflow obstruction (CAO), a quantifiable characteristic of COPD, due to several risk factors. Methods: The Burden of Obstructive Lung Disease study is a cross-sectional study of adults, aged≥40, in a globally distributed sample of 41 urban and rural sites. Based on data from 28,459 participants, we estimated the prevalence of CAO, defined as a post-bronchodilator one-second forced expiratory volume to forced vital capacity ratio < lower limit of normal, and the relative risks associated with different risk factors. Local RR were estimated using a Bayesian hierarchical model borrowing information from across sites. From these RR and the prevalence of risk factors, we estimated local Population Attributable Risks (PAR). Measurements and Main Results: Mean prevalence of CAO was 11.2% in men and 8.6% in women. Mean PAR for smoking was 5.1% in men and 2.2% in women. The next most influential risk factors were poor education levels, working in a dusty job for ≥10 years, low body mass index (BMI), and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites. Conclusions: While smoking remains the most important risk factor for CAO, in some areas poor education, low BMI and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.

5. Prevalence and Population Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study

Author

Burney, Peter, Patel, Jaymini, Minelli, Cosetta, Gnatiuc, Louisa, Amaral, André F. S., Kocabaş, Ali, Cherkaski, Hamid Hacene, Gulsvik, Amund, Nielsen, Rune, Bateman, Eric, Jithoo, Anamika, Mortimer, Kevin, Sooronbaev, Talant M., Lawin, Hervé, Nejjari, Chakib, Elbiaze, Mohammed, El Rhazi, Karima, Zheng, Jin-Ping, Ran, Pixin, Welte, Tobias, Obaseki, Daniel, Erhabor, Gregory, Elsony, Asma, Osman, Nada Bakri, Ahmed, Rana, Nizankowska-Mogilnicka, Ewa, Mejza, Filip, Mannino, David M, Bárbara, Cristina, Wouters, Emiel F.M., Idolor, Luisito F., Loh, Li-Cher, Rashid, Abdul, Juvekar, Sanjay, Gislason, Thorarinn, Al Ghobain, Mohamed, Studnicka, Michael, Harrabi, Imed, Denguezli, Meriam, Koul, Parvaiz A, Jenkins, Christine, Marks, Guy, Jõgi, Rain, Hafizi, Hasan, Janson, Christer, Tan, Wan C, Aquart-Stewart, Althea, Mbatchou, Bertrand, Nafees, Asaad, Gunasekera, Kirthi, Seemungal, Terry, Padukudru Anand, Mahesh, Enright, Paul, Vollmer, William M., Blangiardo, Marta, Elfadaly, Fadlalla G., Buist, A. Sonia, Burney, Peter, Patel, Jaymini, Minelli, Cosetta, Gnatiuc, Louisa, Amaral, André F. S., Kocabaş, Ali, Cherkaski, Hamid Hacene, Gulsvik, Amund, Nielsen, Rune, Bateman, Eric, Jithoo, Anamika, Mortimer, Kevin, Sooronbaev, Talant M., Lawin, Hervé, Nejjari, Chakib, Elbiaze, Mohammed, El Rhazi, Karima, Zheng, Jin-Ping, Ran, Pixin, Welte, Tobias, Obaseki, Daniel, Erhabor, Gregory, Elsony, Asma, Osman, Nada Bakri, Ahmed, Rana, Nizankowska-Mogilnicka, Ewa, Mejza, Filip, Mannino, David M, Bárbara, Cristina, Wouters, Emiel F.M., Idolor, Luisito F., Loh, Li-Cher, Rashid, Abdul, Juvekar, Sanjay, Gislason, Thorarinn, Al Ghobain, Mohamed, Studnicka, Michael, Harrabi, Imed, Denguezli, Meriam, Koul, Parvaiz A, Jenkins, Christine, Marks, Guy, Jõgi, Rain, Hafizi, Hasan, Janson, Christer, Tan, Wan C, Aquart-Stewart, Althea, Mbatchou, Bertrand, Nafees, Asaad, Gunasekera, Kirthi, Seemungal, Terry, Padukudru Anand, Mahesh, Enright, Paul, Vollmer, William M., Blangiardo, Marta, Elfadaly, Fadlalla G., and Buist, A. Sonia

Abstract

Rationale: The Global Burden of Disease programme identified smoking, and ambient and household air pollution as the main drivers of death and disability from Chronic Obstructive Pulmonary Disease (COPD). Objective: To estimate the attributable risk of chronic airflow obstruction (CAO), a quantifiable characteristic of COPD, due to several risk factors. Methods: The Burden of Obstructive Lung Disease study is a cross-sectional study of adults, aged≥40, in a globally distributed sample of 41 urban and rural sites. Based on data from 28,459 participants, we estimated the prevalence of CAO, defined as a post-bronchodilator one-second forced expiratory volume to forced vital capacity ratio < lower limit of normal, and the relative risks associated with different risk factors. Local RR were estimated using a Bayesian hierarchical model borrowing information from across sites. From these RR and the prevalence of risk factors, we estimated local Population Attributable Risks (PAR). Measurements and Main Results: Mean prevalence of CAO was 11.2% in men and 8.6% in women. Mean PAR for smoking was 5.1% in men and 2.2% in women. The next most influential risk factors were poor education levels, working in a dusty job for ≥10 years, low body mass index (BMI), and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites. Conclusions: While smoking remains the most important risk factor for CAO, in some areas poor education, low BMI and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.

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