Peter Burney1, Jaymini Patel1, Cosetta Minelli1, Louisa Gnatiuc2, André F S Amaral1, Ali Kocabaş3, Hamid Hacene Cherkaski4, Amund Gulsvik5, Rune Nielsen5, Eric Bateman6, Anamika Jithoo6, Kevin Mortimer7, Talant M Sooronbaev8, Hervé Lawin9, Chakib Nejjari10, Mohammed Elbiaze11, Karima El Rhazi10, Jin-Ping Zheng12, Pixin Ran12, Tobias Welte13, Daniel Obaseki14, Gregory Erhabor14, Asma Elsony15, Nada Bakri Osman15, Rana Ahmed15, Ewa Nizankowska-Mogilnicka16, Filip Mejza17, David M Mannino18, Cristina Bárbara19, Emiel F M Wouters20, Luisito F Idolor21, Li-Cher Loh22, Abdul Rashid22, Sanjay Juvekar23, Thorarinn Gislason24,25, Mohamed Al Ghobain26, Michael Studnicka27, Imed Harrabi28, Meriam Denguezli28, Parvaiz A Koul29, Christine Jenkins30,31,32, Guy Marks30,31,32, Rain Jõgi33, Hasan Hafizi34, Christer Janson35, Wan C Tan36, Althea Aquart-Stewart37, Bertrand Mbatchou38, Asaad Ahmed Nafees39, Kirthi Gunasekera40, Terry Seemungal41, Mahesh Padukudru Anand42, Paul Enright43, William M Vollmer44, Marta Blangiardo45, Fadlalla G Elfadaly46, A Sonia Buist47. 1. National Heart and Lung Institute and. 2. Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. 3. Department of Chest Diseases, Cukurova University School of Medicine, Adana, Turkey. 4. Department of Pulmonology, Faculty of Medicine and University Hospital Annaba, Annaba, Algeria. 5. Department of Thoracic Medicine, Institute of Medicine, University of Bergen, Bergen, Norway. 6. University of Cape Town Lung Institute, Cape Town, South Africa. 7. The Malawi Liverpool Wellcome Trust, Blantyre, Malawi. 8. Pulmonology and Allergology Department, National Centre of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan. 9. Unit of Teaching and Research in Occupational and Environmental Health, Cotonou, Benin. 10. Laboratoire d'épidémiologie, Recherche Clinique et Santé Communautaire, Fès, Morocco. 11. Department of Respiratory Medicine, Faculty of Medicine, University Hospital, Fes, Morocco. 12. State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China. 13. Department of Pneumology, Hannover Medical School and German Center of Lung Research, Hannover, Germany. 14. Obafemi Awolowo University, Ile-Ife, Nigeria. 15. The Epidemiological Laboratory, Khartoum, Sudan. 16. Division of Pulmonary Diseases, Department of Medicine, Jagiellonian University School of Medicine, Kraków, Poland. 17. 2nd Department of Internal Medicine, Center for Evidence Based Medicine, Jagiellonian University Medical College, Kraków, Poland. 18. University of Kentucky, Lexington, Kentucky. 19. Institute of Environmental Health, Lisbon Medical School, Lisbon University, Lisbon, Portugal. 20. Maastricht University Medical Center, Maastricht, the Netherlands. 21. Philippine College of Chest Physicians, Manila, Philippines. 22. Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Penang, Malaysia. 23. Vadu Health and Demographic Surveillance System, KEM Hospital Research Centre Pune, Pune, India. 24. Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland. 25. Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 26. Saudi Thoracic Society, Riyadh, Saudi Arabia. 27. Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria. 28. Faculté de Médecine, Sousse, Tunisia. 29. Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India. 30. Woolcock Institute of Medical Research, Sydney, New South Wales, Australia. 31. University of Sydney, Sydney, New South Wales, Australia. 32. University of New South Wales, Sydney, New South Wales, Australia. 33. Lung Clinic, Tartu University Hospital, Tartu, Estonia. 34. Tirana University Hospital "Shefqet Ndroqi", Tirana, Albania. 35. Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden. 36. Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada. 37. University of the West Indies, Kingston, Jamaica. 38. Douala General Hospital, Douala, Cameroon. 39. Aga Khan Univeristy, Karachi, Pakistan. 40. Medical Research Institute, Central Chest Clinic, Colombo, Sri Lanka. 41. University of the West Indies, Saint Augustine, Trinidad and Tobago. 42. JSS University, Mysore, India. 43. University of Arizona, Tucson, Arizona. 44. Kaiser-Permanente Center for Health Research, Portland, Oregon. 45. School of Public Health, Imperial College London, London, United Kingdom. 46. School of Mathematics and Statistics, Faculty of Science, Technology, Engineering & Mathematics, The Open University, Milton Keynes, United Kingdom; and. 47. Oregon Health & Science University, Portland, Oregon.
Abstract
Rationale: The Global Burden of Disease program identified smoking and ambient and household air pollution as the main drivers of death and disability from chronic obstructive pulmonary disease (COPD). Objectives: 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 postbronchodilator FEV1-to-FVC ratio less than the lower limit of normal, and the relative risks associated with different risk factors. Local relative risks were estimated using a Bayesian hierarchical model borrowing information from across sites. From these relative risks and the prevalence of risk factors, we estimated local population attributable risks. Measurements and Main Results: The mean prevalence of CAO was 11.2% in men and 8.6% in women. The mean population attributable risk 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, and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites. Conclusions: Although smoking remains the most important risk factor for CAO, in some areas, poor education, low body mass index, and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.
Rationale: The Global Burden of Disease program identified smoking and ambient and household air pollution as the main drivers of death and disability from chronic obstructive pulmonary disease (COPD). Objectives: 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 postbronchodilator FEV1-to-FVC ratio less than the lower limit of normal, and the relative risks associated with different risk factors. Local relative risks were estimated using a Bayesian hierarchical model borrowing information from across sites. From these relative risks and the prevalence of risk factors, we estimated local population attributable risks. Measurements and Main Results: The mean prevalence of CAO was 11.2% in men and 8.6% in women. The mean population attributable risk 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, and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites. Conclusions: Although smoking remains the most important risk factor for CAO, in some areas, poor education, low body mass index, and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.
Authors: Max Jonathan Stumpf; Christian Alexander Schaefer; Thorsten Mahn; Anna Elisabeth Wolf; Leonie Biener; Doris Hendig; Georg Nickenig; Nadjib Schahab; Carmen Pizarro; Dirk Skowasch Journal: Intractable Rare Dis Res Date: 2022-02
Authors: A B Binegdie; H Meme; A El Sony; T Haile; R Osman; B Miheso; L Zurba; M Lesosky; J Balmes; P J Burney; K Mortimer; G Devereux Journal: Int J Tuberc Lung Dis Date: 2022-01-01 Impact factor: 2.373
Authors: Martin W Njoroge; Patrick Mjojo; Catherine Chirwa; Sarah Rylance; Rebecca Nightingale; Stephen B Gordon; Kevin Mortimer; Peter Burney; John Balmes; Jamie Rylance; Angela Obasi; Louis W Niessen; Graham Devereux Journal: EClinicalMedicine Date: 2021-10-18