Respiratory abnormalities, smoking habits and ventilatory capacity in a highland community in Papua New Guinea: prevalence and effect on mortality.

The prevalence of chronic lung disease was investigated in 1284 adult residents of 11 villages situated at 1800 m in the Highlands of Papua New Guinea. Chronic cough, shortness of breath on exertion, bronchial hypersecretion, and adventitious chest sounds were increasingly common in both sexes from middle life onwards, and were associated with an irreversible obstructive ventilatory defect. Over the age of 45 years, 20% of men and 10% of women had an FEV1/FVC % less than 60%. The prevalence of active asthma was 0.25%. The smoking of home-grown, air-cured tobacco was not associated with chronic respiratory symptoms or reduction of ventilatory capacity. Smoking was, however, associated with recent cough symptom, bronchial hypersecretion and adventitiae. Mortality over the subsequent 5 years was increased 2--3 fold in those with adventitiae, but was not related to smoking status. The aetiological relevance of wood smoke in the houses and acute chest infections remains to be clarified.