Prevalence characteristics of COPD in never smokers

Prevalence of chronic obstructive pulmonary disease in Indian nonsmokers: a systematic review & meta-analysis

INTRODUCTION

Nonsmokers with chronic obstructive pulmonary disease (COPD) are neglected despite constituting half of all cases in studies from the developed world. Herein, we systematically reviewed the prevalence of COPD among nonsmokers in India.

CONTENT

We searched Embase, Scopus, and PubMed databases for studies examining the prevalence of COPD among nonsmokers in India. We used the Joanna Briggs Institute (JBI) checklist to assess included studies' quality. Meta-analysis was performed using random-effects model.

SUMMARY

Seven studies comprising 6,903 subjects were included. The quality of the studies ranged from 5/9 to 8/9. The prevalence of COPD varied between 1.6 and 26.6 %. Studies differed considerably in demographics and biomass exposure profiles of subjects. Among the four studies that enrolled both middle-aged and elderly Indian nonsmokers not screened based on biomass fuel exposure, the pooled prevalence of COPD was 3 % (95 % CI, 2-3 %; I2=50.52 %, p=0.11). The pooled prevalence of COPD among biomass fuel-exposed individuals was 10 % (95 % CI, 2-18 %; I2=98.8 %, p<0.001).

OUTLOOK

Limited evidence suggests a sizable burden of COPD among nonsmokers and biomass fuel-exposed individuals in India. More epidemiological studies of COPD in nonsmokers are needed from low and middle-income countries.

Risk factors for chronic obstructive pulmonary disease in never‐smokers: A systematic review

Introduction

Relatively little is known about the risk factors for chronic obstructive pulmonary disease (COPD) in never‐smokers, and these factors have not yet been fully characterised. This study therefore sought to analyse COPD risk factors in never‐smokers by conducting a systematic review of the literature on the topic.

Materials and methods

We performed a search in PubMed (Medline) and Embase from 2000 onwards, to locate studies on COPD in never‐smokers. For literature search and evidence synthesis purposes, we used the PRISMA guidelines and drew up a specific quality scale to quantify the evidence of each study included.

Results

The bibliographic search retrieved a total of 557 papers, 20 of which fulfilled the designated inclusion criteria (two case–control studies, four cohort studies and 14 cross‐sectional studies). These studies were undertaken in Europe, the United States, Latin America, Asia and Africa. The risk factors for never‐smokers were varied and ranged from exposure to biomass, occupational exposure and passive smoking to having a history of asthma, tuberculosis or respiratory infections during childhood. The effect of residential radon was unclear. The highest risk was obtained for previous respiratory diseases of any type, with a magnitude much higher than that observed for other risk factors.

Conclusions

There are few studies on COPD risk factors in never‐smokers. More purpose‐designed studies in this subpopulation are thus called for, including well‐designed studies to specifically assess if indoor radon has any role on COPD onset.

COPD in the major nonsmoking adult: A systematic review and meta-analysis

Chronic Obstructive Pulmonary Disease (COPD) main cause is attributed to active smokers, but there's a small percentage that comes from risk factors that have been less considered. The aim of this research was to identify the risk factors and the clinical presentation of the population over 64 years of age that lead to the development of COPD. A systematic review and a meta-analysis was performed. From the 92 studies interpreted, we identified seven studies on the presence of COPD in nonsmokers older adults, having a universe of 14,920 patients. The primary risk factor to trigger the development of COPD was secondhand smoking. The study defined the most common risk factors that currently trigger COPD development among nonsmokers and provided an insight into the potential clinical differences between nonsmokers and smokers.

Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease among Nonsmokers: Fifth Korea National Health and Nutrition Examination Survey (2010-2012)

OBJECTIVES

The purpose of this study was to determine the prevalence of COPD among non-smoking adults, and to investigate the risk factors that affect disease occurrence.

METHODS

The data from the 5th Korea national health and nutrition examination survey (KNHNES) has been used, and 5,489 non-smoking adults aged between 40 to 79 years with diagnosable FEV1/FVC were selected therefrom as the subjects of this study.

RESULTS

The prevalence of COPD in non-smokers was observed to be 6.9%. The development of the COPD showed statistically significant difference among groups; males showed about 2.54 times (95% CI: 1.410∼146.612) higher rates compared to females, subjects aged 70-79 showed about 3.08 times (95% CI: 1.823∼11.437) higher rates compared to those aged 40-49, subjects whose education level was elementary school or less showed about 5.36 times (95% CI: 1.341∼21.393) higher rates compared to those who are college or more, and subjects who are middle school showed about 4.72 times (95% CI: 1.374∼16.217) higher rates compared to the college or more.

CONCLUSION

It is confirmed that development of the COPD in non-smokers reach significance. For the prevention of the disease, there is a need to identify COPD-related risk factors in males and the elderly and provide appropriate nursing intervention, and to develop health-related education programs for those with low educational background to take in order to promote the improvement of lung health.