Burden of Obstructive Lung Disease in Iran: Prevalence and Risk Factors for COPD in North of Iran
Abstract
Background: Globally chronic obstructive pulmonary disease (COPD) was reported as the fourth leading cause of death (5.1%) in 2004 and is projected to occupy the third position (8.6%) in 2030. The goal of the present project is to describe the prevalence and risk factors of COPD in a province in the north of Iran.
Methods: This study followed a stratified cluster sampling strategy with proportional allocation within strata. The stratification of the sample according to the 31 provinces of Iran is incorporated in the sampling process. The single most important outcome measure obtained as part of this protocol was spirometry before and after the administration of 200 mg (2 puffs) of salbutamol. The descriptive statistics for categorical variables included the number and percent and for continues variables included the mean ± SD.
Results: A total of 1007 subjects were included in the study. Among all participants, 46 (5%) subjects had COPD on the basis of symptoms and 43 (8.3%) subjects had COPD on the basis of spirometry criteria. In univariate analysis, urban inhabitants in comparison with rural inhabitants had lower COPD risk (OR: 0.48; 95% CI: 0.24–0.95), smoker had higher risk compared with nonsmokers (OR: 1.97; 95% CI: 1.01–3.82), and subjects with exposure to dust (OR: 2.07; 95% CI: 1.09–3.94) had higher risk compared with contrary status.
Conclusions: This study showed that occupational and environmental smoke exposure was associated with COPD. A new design of preventive measures must be taken to control cooking energy and cooking stoves, particularly in rural areas.
Keywords: Airway obstruction, burden of obstructive lung disease, Iran, prevalence
Keywords
Full Text:
PDFReferences
Adeloye D, Chua S, Lee C, Basquill C, Papana A,
Theodoratou E, et al. Global and regional estimates of COPD
prevalence: Systematic review and meta‑analysis. J Glob Health
;5:020415.
GOLD Executive Summary. Global Initiative for Chronic
Obstructive Lung Disease. Global strategy for the diagnosis
management and prevention of chronic obstructive pulmonary
disease. Updated 2014. Global Initiative for Chronic Obstructive
Lung Disease; 2014.
Cruz AA. Global surveillance, prevention and control of chronic
respiratory diseases: A comprehensive approach. World Health
Organization; 2007.
WORLD HEALTH ORGANIZATION. 2007. World Health
Survey Results. Available from: http://www. who.int/healthinfo/
survey/whsresults/en/index.html. [Last accessed 2007 Sep 03].
Nugmanova D, Feshchenko Y, Iashyna L, Gyrina O,
Malynovska K, Mammadbayov E, et al. The prevalence, burden
and risk factors associated with chronic obstructive pulmonary
disease in Commonwealth of Independent States (Ukraine,
Kazakhstan and Azerbaijan): Results of the CORE study. BMC
Pulm Med 2018;18:26.
Gupta D, Agarwal R, Aggarwal AN, Maturu VN, Dhooria S,
Prasad KT, et al. Guidelines for diagnosis and management of
chronic obstructive pulmonary disease: Joint recommendations
of Indian chest society and national college of chest
physicians (India). Indian J Chest Dis Allied Sci 2014;56:5‑54.
Haahtela T, Tuomisto LE, Pietinalho A, Klaukka T, Erhola M,
Kaila M, et al. A 10 year asthma programme in Finland: Major
change for the better. Thorax 2006;61:663‑70.
Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C,
Anzueto A, et al. Global strategy for the diagnosis, management,
and prevention of chronic obstructive pulmonary disease:
GOLD executive summary. Am J Respir Crit Care Med
;187:347‑65.
Eisner MD, Anthonisen N, Coultas D, Kuenzli N,
Perez‑Padilla R, Postma D, et al. An official American Thoracic
Society public policy statement: Novel risk factors and the
global burden of chronic obstructive pulmonary disease. Am J
Respir Crit Care Med 2010;182:693‑718.
Organisation mondiale de la santé. Lignes directrices OMS
relatives à la qualité de l’air intérieur: Consommation domestique
de combustibles; 2014.
Raj TJB. Altered lung function test in asymptomatic women
using biomass fuel for cooking. J Clin Diagn Res 2014;8:1‑3.
Hooper R, Burney P, Vollmer WM, McBurnie MA, Gislason T,
Tan WC, et al. Risk factors for COPD spirometrically defined
from the lower limit of normal in the BOLD project. Eur
Respir J 2012;39:1343‑53.
Salvi SS, Barnes PJ. Chronic obstructive pulmonary disease in
non‑smokers. Lancet 2009;374:733‑43.
Gilkes A, Hull S, Durbaba S, Schofield P, Ashworth M,
Mathur R, et al. Ethnic differences in smoking intensity and
COPD risk: An observational study in primary care. NPJ Prim
Care Respir Med 2017;27:50.
Wilson D, Adams R, Appleton S, Ruffin R. Difficulties identifying
and targeting COPD and population‑attributable risk of smoking
for COPD: A population study. Chest 2005;128:2035‑42.
Sharifi H, Masjedi MR, Emami H, Ghanei M, Eslaminejad A,
Radmand G, et al. Burden of obstructive lung disease study
in Tehran: Prevalence and risk factors of chronic obstructive
pulmonary disease. Lung India 2015;32:572‑7.
Sharifi H, Ghanei M, Jamaati H, Masjedi MR, Aarabi M,
Sharifpour A, et al. Burden of obstructive lung disease study in
Iran: First report of the prevalence and risk factors of copd in
five provinces. Lung India: Official Organ of Indian Chest Soc
;36:14.
Sharifi H, Sadr M, Emami H, Ghanei M, Eslaminejad A,
Radmand G, et al. Prevalence of tobacco use and associated
factors in Tehran: Burden of obstructive lung disease study. Lung
India 2017;34:225‑31.
Barnes PJ. Chronic obstructive pulmonary disease: A growing
but neglected global epidemic. PLoS Med 2007;4:e112.
Mehrotra A, Oluwole AM, Gordon SB. The burden of COPD
in Africa: A literature review and prospective survey of the
availability of spirometry for COPD diagnosis in Africa. Trop
Med Int Health 2009;14:840‑8.
Buist AS, Vollmer WM, Sullivan SD, Weiss KB, Lee TA,
Menezes AM, et al. The burden of obstructive lung disease
initiative (BOLD): Rationale and design. COPD 2005;2:277‑83.
Sharifi H, Masjedi MR, Emami H, Ghanei M, Buist S. Burden
of obstructive lung disease study in Tehran: Research design and
lung spirometry protocol. Int J Prev Med 2014;5:1439‑45.
Binson D, Catania JA. Random selection in a national telephone
survey: A comparison of the Kish, next-birthday, and lastbirthday methods. J Official Statistics 2000;16:53.
Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P,
Mannino DM, et al. International variation in the prevalence of
COPD (the BOLD Study): A population‑based prevalence study.
Lancet 2007;370:741‑50.
Soriano JB, Zielinski J, Price D. Screening for and early
detection of chronic obstructive pulmonary disease. Lancet
;374:721-32.
Menezes AM, Perez‑Padilla R, Jardim JR, Muiño A, Lopez MV,
Valdivia G, et al. Chronic obstructive pulmonary disease in five
Latin American cities (the PLATINO study): A prevalence study.
Lancet 2005;366:1875‑81.
Regional COPD Working Group. COPD prevalence in 12
Asia‑Pacific countries and regions: Projections on the basis of the
COPD prevalence estimation model. Respirology 2003;8:192‑8.
Kim SJ, Suk MH, Choi HM, Kimm KC, Jung KH, Lee SY, et al.
The local prevalence of COPD by post‑bronchodilator GOLD
criteria in Korea. Int J Tuberc Lung Dis 2006;10:1393‑8.
Teckle P, Hannaford P, Sutton M. Is the health of people living
in rural areas different from those in cities? Evidence from
routine data linked with the Scottish Health Survey. BMC Health
Serv Res 2012;12:43.
Liu XL, Lessner L, Carpenter DO. Association between
residential proximity to fuel‑fired power plants and
hospitalization rate for respiratory diseases. Environ Health
Perspect 2012;120:807‑10.
Greskevitch M, Kullman G, Bang KM, Mazurek JM. Respiratory
disease in agricultural workers: Mortality and morbidity statistics.
J Agromedicine 2007;12:5‑10.
Jackson BE, Coultas DB, Suzuki S, Singh KP, Bae S.
Rural-Urban disparities in quality of life among patients with
COPD. J Rural Health 2013;29:s62‑9.
Abrams TE, Vaughan‑Sarrazin M, Fan VS, Kaboli PJ.
Geographic isolation and the risk for chronic obstructive
pulmonary disease–related mortality: A cohort study. Ann Inter
Med 2011;155:80‑6.
Brachier B, Londhe J, Madas S, Vincent V, Salvi S. Prevalence
of self reported respiratory symptoms asthma and chronic
bronchitis in a slum area of a rapidly developing Indian city.
Open J Respir Dis 2012;2:73‑81.
Carlsson AC, Wändell P, Ösby U, Zarrinkoub R, Wettermark B,
Ljunggren G. High prevalence of diagnosis of diabetes,
depression, anxiety, hypertension, asthma and COPD in the total
population of Stockholm, Sweden–A challenge for public health.
BMC Public Health 2013;13:670.
LeVan TD, Koh WP, Lee HP, Koh D, Yu MC, London SJ. Vapor,
dust, and smoke exposure in relation to adult‑onset asthma and
chronic respiratory symptoms: The Singapore Chinese Health
Study. Am J Epidemiol 2006;163:1118‑28.
Bjartveit K, Tverdal A. Health consequences of smoking 1–4
cigarettes per day. Tob Control 2005;14:315‑20.
Chhabra SK, Rajpal S, Gupta R. Patterns of smoking in Delhi
and comparison of chronic respiratory morbidity among
beedi and cigarette smokers. Indian J Chest Dis Allied Sci
;43:19‑26.
Mahesh PA, Jayaraj BS, Prahlad ST, Chaya SK, Prabhakar AK,
Agarwal AN, et al. Validation of a structured questionnaire for
COPD and prevalence of COPD in rural area of Mysore: A pilot
study. Lung India 2009;26:63.
Lange P, Celli B, Agustí A, Boje Jensen G, Divo M, Faner R,
et al. Lung‑function trajectories leading to chronic obstructive
pulmonary disease. New Eng J Med 2015;373:111‑22.