Nathania A J B Cooksley1, David Atkinson2, Guy B Marks3, Brett G Toelle3,4, David Reeve5, David P Johns6, Michael J Abramson7, Deborah L Burton8, Alan L James9, Richard Wood-Baker6, E Haydn Walters6, A Sonia Buist10, Graeme P Maguire11. 1. Cairns Hospital, The Esplanade, Cairns, Queensland, Australia. 2. Rural Clinical School Of Western Australia, University of WA and Kimberley Aboriginal Medical Services Council, Broome, Western Australia, Australia. 3. Department of Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia. 4. Sydney Local Health District, Sydney, New South Wales, Australia. 5. Health Promotion Strategy Unit, Northern Territory Government, Darwin, Northern Territory, Australia. 6. School of Medicine, University of Tasmania, Hobart, Tasmania, Australia. 7. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 8. School of Biomedical Sciences, Charles Sturt University, Orange, New South Wales, Australia. 9. Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. 10. School of Medicine, Oregon Health and Sciences University, Portland, Oregon, USA. 11. Baker IDI Central Australia, Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
Abstract
BACKGROUND AND OBJECTIVE: Mortality and hospital separation data suggest a higher burden of chronic obstructive pulmonary disease (COPD) in indigenous than non-indigenous subpopulations of high-income countries. This study sought to accurately measure the true prevalence of post-bronchodilator airflow obstruction and forced vital capacity reduction in representative samples of Indigenous and non-Indigenous Australians. METHODS: This study applies cross-sectional population-based survey of Aboriginal and non-Indigenous residents of the Kimberley region of Western Australia aged 40 years or older, following the international Burden Of Lung Disease (BOLD) protocol. Quality-controlled spirometry was conducted before and after bronchodilator. COPD was defined as Global initiative for chronic Obstructive Lung Disease (GOLD) Stage 2 and above (post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1 /FVC) ratio <0.7 and FEV1 < 80% predicted). RESULTS: Complete data were available for 704 participants. The prevalence of COPD, adjusted for age, gender and body weight in Aboriginal participants (7.2%, 95% confidence interval (CI) 3.9 to 10.4) was similar to that seen in non-Indigenous Kimberley participants (8.2%, 95% CI 5.7 to 10.7) and non-Indigenous residents of the remainder of Australia (7.1%, 95% CI 6.1 to 8.0). The prevalence of low FVC (<80% predicted) was substantially higher in Aboriginal compared with non-Indigenous participants (74.0%, 95% CI 69.1 to 78.8, vs 9.7%, 95% CI 7.1 to 12.4). CONCLUSIONS: Low FVC, rather than airflow obstruction, characterizes the impact of chronic lung disease previously attributed to COPD in this population subject to significant social and economic disadvantage. Environmental risk factors other than smoking as well as developmental factors must be considered. These findings require further investigation and have implications for future prevention of chronic lung disease in similar populations.
BACKGROUND AND OBJECTIVE: Mortality and hospital separation data suggest a higher burden of chronic obstructive pulmonary disease (COPD) in indigenous than non-indigenous subpopulations of high-income countries. This study sought to accurately measure the true prevalence of post-bronchodilator airflow obstruction and forced vital capacity reduction in representative samples of Indigenous and non-Indigenous Australians. METHODS: This study applies cross-sectional population-based survey of Aboriginal and non-Indigenous residents of the Kimberley region of Western Australia aged 40 years or older, following the international Burden Of Lung Disease (BOLD) protocol. Quality-controlled spirometry was conducted before and after bronchodilator. COPD was defined as Global initiative for chronic Obstructive Lung Disease (GOLD) Stage 2 and above (post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1 /FVC) ratio <0.7 and FEV1 < 80% predicted). RESULTS: Complete data were available for 704 participants. The prevalence of COPD, adjusted for age, gender and body weight in Aboriginal participants (7.2%, 95% confidence interval (CI) 3.9 to 10.4) was similar to that seen in non-Indigenous Kimberley participants (8.2%, 95% CI 5.7 to 10.7) and non-Indigenous residents of the remainder of Australia (7.1%, 95% CI 6.1 to 8.0). The prevalence of low FVC (<80% predicted) was substantially higher in Aboriginal compared with non-Indigenous participants (74.0%, 95% CI 69.1 to 78.8, vs 9.7%, 95% CI 7.1 to 12.4). CONCLUSIONS: Low FVC, rather than airflow obstruction, characterizes the impact of chronic lung disease previously attributed to COPD in this population subject to significant social and economic disadvantage. Environmental risk factors other than smoking as well as developmental factors must be considered. These findings require further investigation and have implications for future prevention of chronic lung disease in similar populations.
Authors: Daniel O Obaseki; Gregory E Erhabor; Olayemi F Awopeju; Olufemi O Adewole; Bamidele O Adeniyi; Emerita A Sonia Buist; Peter G Burney Journal: Ann Am Thorac Soc Date: 2017-05
Authors: Timothy Howarth; Helmi Ben Saad; Ara J Perez; Charmain B Atos; Elisha White; Subash S Heraganahally Journal: PLoS One Date: 2021-04-02 Impact factor: 3.240
Authors: Dorothy F L Sze; Timothy P Howarth; Clair D Lake; Helmi Ben Saad; Subash S Heraganahally Journal: Int J Chron Obstruct Pulmon Dis Date: 2022-04-21