Imperial College London

Professor Peter GJ Burney MA MD FRCP FFPHM FMedSci

Faculty of MedicineNational Heart & Lung Institute

Professor of Respiratory Epidemiology & Public Health
 
 
 
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Contact

 

+44 (0)20 7594 7941p.burney

 
 
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Location

 

07Emmanuel Kaye BuildingRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
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501 results found

Portas L, Pereira M, Shaheen SO, Wyss AB, London SJ, Burney PGJ, Hind M, Dean CH, Minelli Cet al., 2020, Lung development genes and adult lung function, American Journal of Respiratory and Critical Care Medicine, Vol: 202, Pages: 853-865, ISSN: 1073-449X

RATIONALE: Poor lung health in adult life may occur partly through suboptimal growth and development, as suggested by epidemiological evidence pointing to early life risk factors. OBJECTIVES: To systematically investigate the effects of lung development genes on adult lung function. METHODS: Using UK Biobank data, we tested the association of 391 genes known to influence lung development with FVC and FEV1/FVC. We split the dataset into two random subsets of 207,616 and 138,411 individuals, using the larger to select the most promising signals and the smaller for replication. MEASUREMENTS AND MAIN RESULTS: We identified 55 genes, of which 36 (16 for FVC; 19 for FEV1/FVC; 1 for both) had not been identified in the largest, most recent genome-wide study of lung function. Most of these 36 signals were intronic variants; expression data from blood and lung tissue showed that the majority affect the expression of the genes they lie within. Further testing of 34 of these 36 signals in the CHARGE and SpiroMeta consortia showed that 16 replicated after Bonferroni correction and another 12 at nominal significance level. 53 of the 55 genes fell into four biological categories whose function is to regulate organ size and cell integrity (growth factors; transcriptional regulators; cell-cell adhesion; extra-cellular matrix), suggesting that these specific processes are important for adult lung health. CONCLUSIONS: Our study demonstrates the importance of lung development genes in regulating adult lung function and influencing both restrictive and obstructive patterns. Further investigation of these developmental pathways could lead to druggable targets.

Journal article

Li J, Ogorodova LM, Mahesh PA, Wang MH, Fedorova OS, Leung TF, Fernandez-Rivas M, Mills ENC, Potts J, Kummeling I, Versteeg SA, van Ree R, Yazdanbakhsh M, Burney PGJ, Wong GWKet al., 2020, Comparative Study of Food Allergies in Children from China, India, and Russia: The EuroPrevall-INCO Surveys, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 8, Pages: 1349-+, ISSN: 2213-2198

Journal article

Amaral A, Burney P, Fuertes E, Jarvis Det al., 2020, Body mass index and weight change are associated with adult lung function trajectories: a prospective European survey, Thorax, Vol: 4, Pages: 313-320, ISSN: 0040-6376

Background: Previous studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood according to 20-years weight change profiles, using data from the population-based European Community Respiratory Health Survey (ECRHS).Methods: We included 3,673 participants recruited at age 20-44 years with repeated measurements of weight and lung function (FVC, FEV1) in three study waves (1991-93, 1999-2003, 2010-14) until they were 39-67 years. We classified subjects into weight change profiles according to baseline BMI categories and weight change over 20 years. We estimated trajectories of lung function over time as a function of weight change profiles using population-averaged generalised estimating equations.Results: In individuals with normal BMI, overweight and obesity at baseline, moderate (0.25–1kg/year) and high weight gain (>1kg/year) during follow-up were associated with accelerated FVC and FEV1 declines. Compared to participants with baseline normal BMI and stable weight (±0.25kg/year), obese with high weight gain during follow-up had -1,011 ml [95%CI: -1,259 to -763] lower estimated FVC at 65 years, despite similar estimated FVC levels at 25 years. Obese individuals at baseline who lost weight (<-0.25kg/year) exhibited an attenuation of FVC and FEV1 declines. We found no association between weight change profiles and FEV1/FVC decline. Conclusion: Moderate and high weight gain over 20-years was associated with accelerated lung function decline, while weight loss was related to its attenuation. Control of weight gain is important for maintaining good lung function in adult life.

Journal article

Accordini S, Calciano L, Marcon A, Pesce G, Antó JM, Beckmeyer-Borowko AB, Carsin A-E, Corsico AG, Imboden M, Janson C, Keidel D, Locatelli F, Svanes C, Burney PGJ, Jarvis D, Probst-Hensch NM, Minelli Cet al., 2020, Incidence trends of airflow obstruction among European adults without asthma: a 20-year cohort study, Scientific Reports, Vol: 10, ISSN: 2045-2322

Investigating COPD trends may help healthcare providers to forecast future disease burden. We estimated sex- and smoking-specific incidence trends of pre-bronchodilator airflow obstruction (AO) among adults without asthma from 11 European countries within a 20-year follow-up (ECRHS and SAPALDIA cohorts). We also quantified the extent of misclassification in the definition based on pre-bronchodilator spirometry (using post-bronchodilator measurements from a subsample of subjects) and we used this information to estimate the incidence of post-bronchodilator AO (AOpost-BD), which is the primary characteristic of COPD. AO incidence was 4.4 (95% CI: 3.5-5.3) male and 3.8 (3.1-4.6) female cases/1,000/year. Among ever smokers (median pack-years: 20, males; 12, females), AO incidence significantly increased with ageing in men only [incidence rate ratio (IRR), 1-year increase: 1.05 (1.03-1.07)]. A strong exposure-response relationship with smoking was found both in males [IRR, 1-pack-year increase: 1.03 (1.02-1.04)] and females [1.03 (1.02-1.05)]. The positive predictive value of AO for AOpost-BD was 59.1% (52.0-66.2%) in men and 42.6% (35.1-50.1%) in women. AOpost-BD incidence was 2.6 (1.7-3.4) male and 1.6 (1.0-2.2) female cases/1,000/year. AO incidence was considerable in Europe and the sex-specific ageing-related increase among ever smokers was strongly related to cumulative tobacco exposure. AOpost-BD incidence is expected to be half of AO incidence.

Journal article

Burney P, Atassi M, Kava A, Nejjari C, Benjelloun M, El Biaze M, El Kinany K, Patel J, El Rhazi Ket al., 2020, Association between chronic airflow obstruction and socio-economic position in Morocco: BOLD results., International Journal of Tuberculosis and Lung Disease, Vol: 24, Pages: 202-206, ISSN: 1027-3719

Objective. Chronic Obstructive Lung Disease (COPD) is the third most common cause of death in the world. Other factors than smoking could be involved in the development of COPD such as socio-economic status. The aim of this study was to investigate the association between chronic airflow obstruction and socio-economic status in Morocco. Design. In the BOLD (Burden of Obstructive Lung Disease) study carried out in Fez Morocco, questionnaires and spirometry tests were performed. Socio-economic status was evaluated using a wealth score (0-10) based on household assets. The forced expiratory volume in 1s (FEV1)/ forced vital capacity (FVC) ratio was used to measure airflow obstruction. Results. In total, 760 subjects were included in the analysis. The mean age was 55.3 years (SD=10.2); the wealth score was on average 7.54 (SD=1.63). After controlling for other factors and potential confounders, the FEV1/ FVC increased by 0.4% (95% CI: 0.01, 0.78; p<0.04) per unit increase in wealth score. Aging, tobacco-smoking, underweight, history of tuberculosis and asthma were also independently associated with a higher risk of airflow obstruction. Conclusion. Our findings suggest that airflow obstruction is associated with poverty in Morocco. Further investigations are needed to better understand the mechanisms of this association.

Journal article

Ulrich S, Furian M, Estebesova B, Toktogulova N, Beishekeeva G, Ulrich S, Burney PGJ, Sooronbaev TM, Bloch KEet al., 2020, Spirometry in Central Asian Lowlanders and Highlanders, a Population Based Study, FRONTIERS IN MEDICINE, Vol: 6

Journal article

Ratanachina J, De Matteis S, Cullinan P, Burney Pet al., 2019, Pesticide exposure and lung function: a systematic review and meta-analysis., Occupational Medicine, Vol: 70, Pages: 14-23, ISSN: 0962-7480

BACKGROUND: Epidemiological studies have reported associations between pesticide exposure and respiratory health effects, but the quantitative impact on lung function is unclear. To fill this gap, we undertook a systematic review of the available literature on the association between pesticide exposure and pulmonary function. AIMS: To examine all available literature regarding the relationship between occupational and environmental exposure to pesticides and lung function. METHODS: We searched MEDLINE, EMBASE and Web of Science databases to 1 October 2017 without any date or language restrictions using a combination of MeSH terms and free text for 'pesticide exposure' and 'lung function'. We included studies that met the criteria of our research protocol registered in PROSPERO, and we assessed their quality using a modified Newcastle-Ottawa scale. RESULTS: Of 2356 articles retrieved, 56 articles were included in the systematic review and pooled in meta-analyses for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), FVC and FEV1. There was tentative evidence that exposure to cholinesterase (ChE) inhibiting pesticides reduced FEV1/FVC and no evidence that paraquat exposure affected lung function in farmers. CONCLUSIONS: Respiratory surveillance should be enhanced in those exposed to ChE-inhibiting pesticides which reduced FEV1/FVC according to the meta-analysis. Our study is limited by heterogeneity between studies due to different types of exposure assessment to pesticides and potential confounders. Further studies with a more accurate exposure assessment are suggested.

Journal article

Nafees AA, De Matteis S, Kadir MM, Burney P, Coggon D, Semple S, Cullinan Pet al., 2019, MultiTex RCT - a multifaceted intervention package for protection against cotton dust exposure among textile workers - a cluster randomized controlled trial in Pakistan: study protocol, Trials, Vol: 20, ISSN: 1745-6215

BACKGROUND: In the Pakistani textile industry the prevalence of workplace respiratory illnesses, including byssinosis, is high. The MultiTex RCT study aims to determine the effectiveness of a multifaceted intervention package in reducing dust levels in cotton mills, decreasing the frequency of respiratory symptoms among cotton textile workers, and improving their lung function. METHODS/DESIGN: We will conduct a cluster-randomized controlled trial at 28 textile mills in Karachi. The intervention will comprise: training in occupational health for all workers and managers reinforced by regular refresher sessions; the formation of workplace committees to draw up, agree and promote a health and safety plan that includes wet mopping, safe disposal of cotton dust, and the use of simple face-masks, as well as further publicity about the risks from cotton dust; and provision of adequate supplies of face-masks to support the health and safety plan. Participating mills will be randomized to intervention and control arms following a baseline survey. The impact of the intervention will be determined through follow-up surveys conducted at 3, 12 and 18 months. Data collection in the surveys will include spirometry, questionnaire-based interviews and cotton-dust measurements. DISCUSSION: If successful, the study may pave the way for simple, low-cost interventions that can help reduce cotton-dust levels in textile mills, and improve the respiratory health of textile workers in developing countries such as Pakistan. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03738202. Registered on 12 November 2018.

Journal article

Burney P, Amaral A, 2019, Air pollution and chronic airway disease: is the evidence always clear?, The Lancet, Vol: 394, Pages: 2198-2200, ISSN: 0140-6736

Journal article

Janson C, Malinovschi A, Amaral A, Accordini S, Bousquet J, Buist AS, Garcia-Aymerich J, Gnatiuc L, Tan W, Toren K, Zuberbier T, Burney Pet al., 2019, Testing bronchodilator responsiveness, European Respiratory Journal, Vol: 54, ISSN: 0903-1936

Journal article

Miller MR, 2019, Testing bronchodilator responsiveness, EUROPEAN RESPIRATORY JOURNAL, Vol: 54, ISSN: 0903-1936

Journal article

Marcon A, Locatelli F, Corsico A, Anto JM, Burney P, Dharmage SC, Gislason T, Heinrich J, Janson C, Jogi R, Leynaert B, Lytras T, Probst-Hensch N, Svanes C, Toren K, Weyler J, Garcia-Aymerich J, Jarvis D, Accordini Set al., 2019, A 20-year population-based study of the asthma-COPD overlap (ACO), European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Burney P, Patel J, 2019, Variation in "normal values" of forced vital capacity (FVC) and ratio of one-second Forced Expiratory Volume (FEV1)/FVC between 42 Burden of Obstructive Lung Disease (BOLD) sites, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Ratanachina J, De Matteis S, Cullinan P, Burney Pet al., 2019, Pesticide exposure and lung function: a systematic review and meta-analysis, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Janson C, Malinovschi A, Amaral A, Accordini S, Bousquet J, Buist S, Canonica G, Dahlen B, Garcia Aymerich J, Gnatiuc L, Kowalski M, Patel J, Tan W, Toren K, Zuberbier T, Burney P, Jarvis Det al., 2019, Bronchodilator reversibility in asthma and COPD: Findings from three large population studies, European Respiratory Journal, Vol: 54, ISSN: 0903-1936

Bronchodilator response (BDR) testing is used as a diagnostic method in obstructive airway diseases. The aim of this investigation was to compare different methods for measuring BDR in participants with asthma and COPD and to study to the extent to which BDR was related to symptom burden and phenotypic characteristics.Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was measured before and 15 min after 200 μg of salbutamol in 35 628 subjects aged 16 years and older from three large international population studies. The subjects were categorised in three groups: current asthma (n=2833), COPD (n=1146), and no airway disease (n=31 649). Three definitions for flow related (increase in FEV1) and three for volume related (increase in FVC) were used.The prevalence of bronchodilator reversibility expressed as increase FEV1≥12% and 200 mL was 17.3% and 18.4% in participants with asthma and COPD, respectively, while the corresponding prevalence was 5.1% in those with no airway disease. In asthma, bronchodilator reversibility was associated with wheeze (OR (95% CI): 1.36 (1.04–1.79)), atopy (OR 1.36 (1.04–1.79)) and higher FeNO while in COPD neither flow nor volume related bronchodilator reversibility was associated with symptom burden, exacerbations or health status after adjusting for prebronchodilator FEV1.Bronchodilator reversibility was at least as common in participants with COPD as those with asthma. This indicates that measures of reversibility are of limited value for distinguishing asthma from COPD in population studies. In asthma, however, bronchodilator reversibility may be a phenotypic marker.

Journal article

Lyons SA, Burney PGJ, Ballmer-Weber BK, Fernandez-Rivas M, Barreales L, Clausen M, Dubakiene R, Fernandez-Perez C, Fritsche P, Jedrzejczak-Czechowicz M, Kowalski ML, Kralimarkova T, Kummeling I, Lebens AFM, Mustakov T, Van Os-Medendorp H, Papadopoulos NG, Popov TA, Sakellariou A, Welsing PMJ, Potts J, Mills ENC, Van Ree R, Knulst AC, Le TTMet al., 2019, Substantial variation in food allergy prevalence and causative foods in adults across Europe, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI), Publisher: WILEY, Pages: 503-503, ISSN: 0105-4538

Conference paper

Sator L, Horner A, Studnicka M, Lamprecht B, Kaiser B, McBurnie MA, Buist AS, Gnatiuc L, Mannino DM, Janson C, Bateman ED, Burney P, BOLD Collaborative Research Groupet al., 2019, Overdiagnosis of COPD in subjects with unobstructed spirometry: a BOLD analysis, Chest, Vol: 156, Pages: 277-288, ISSN: 0012-3692

BACKGROUND: There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries participating in the BOLD Study between 2003 and 2012. METHODS: A false positive diagnosis of COPD was considered when participants reported a doctor's diagnosis of COPD, but postbronchodilator spirometry was unobstructed (FEV1/FVC > LLN). Additional analyses were performed using the fixed ratio criterion (FEV1/FVC < 0.7). RESULTS: Among 16,177 participants, 919 (5.7%) reported a previous medical diagnosis of COPD. Postbronchodilator spirometry was unobstructed in 569 subjects (61.9%): false positive COPD. A similar rate of overdiagnosis was seen when using the fixed ratio criterion (55.3%). In a subgroup analysis excluding participants who reported a diagnosis of "chronic bronchitis" or "emphysema" (n = 220), 37.7% had no airflow limitation. The site-specific prevalence of false positive COPD varied greatly, from 1.9% in low- to middle-income countries to 4.9% in high-income countries. In multivariate analysis, overdiagnosis was more common among women, and was associated with higher education; former and current smoking; the presence of wheeze, cough, and phlegm; and concomitant medical diagnosis of asthma or heart disease. Among the subjects with false positive COPD, 45.7% reported current use of respiratory medication. Excluding patients with reported asthma, 34.4% of those with normal spirometry still used a respiratory medication. CONCLUSIONS: False positive COPD is frequent. This might expose nonobstructed subjects to possible adverse effects of respiratory medication.

Journal article

Lyons SA, Burney PGJ, Ballmer-Weber BK, Fernandez-Rivas M, Barreales L, Clausen M, Dubakiene R, Fernandez-Perez C, Fritsche P, Jedrzejczak-Czechowicz M, Kowalski ML, Kralimarkova T, Kummeling I, Mustakov TB, Lebens AFM, van Os-Medendorp H, Papadopoulos NG, Popov TA, Sakellariou A, Welsing PMJ, Potts J, Mills ENC, van Ree R, Knulst AC, Le T-Met al., 2019, Food allergy in adults: substantial variation in prevalence and causative foods across Europe, Journal of Allergy and Clinical Immunology: In Practice, Vol: 7, Pages: 1920-1928.e11, ISSN: 2213-2198

BACKGROUND: The EuroPrevall study showed that prevalence of self-reported food allergy (FA) in adults across Europe ranged from 2-37% for any food and 1-19% for 24 selected foods. OBJECTIVE: To determine prevalence of probable FA (symptoms plus sIgE-sensitisation) and challenge-confirmed FA in European adults, along with symptoms and causative foods. METHODS: In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in eight European centres. Phase II consisted of an extensive questionnaire on reactions to 24 pre-selected commonly implicated foods, and measurement of sIgE. Multiple imputation was performed performed to estimate missing symptom and serology information for non-responders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge. RESULTS: Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3% and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhino-conjunctivitis (29.5%). Hazelnut, peach and apple were the most common causative foods in Lodz, Utrecht and Zurich. Peach was also among the top three causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% was classified as positive. CONCLUSION: Food allergy shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches 6% in parts of Europe.

Journal article

Triest FJJ, Studnicka M, Franssen FME, Vollmer WM, Lamprecht B, Wouters EFM, Burney P, Vanfleteren LEGWet al., 2019, Airflow obstruction and cardio-metabolic comorbidities, COPD: Journal of Chronic Obstructive Pulmonary Disease, Vol: 16, Pages: 109-117, ISSN: 1541-2555

Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction and often co-exists with cardiovascular disease (CVD), hypertension and diabetes. This international study assessed the association between airflow obstruction and these comorbidities. 23,623 participants (47.5% males, 19.0% current smokers, age: 55.1 ± 10.8 years) in 33 centers in the Burden of Obstructive Lung Disease (BOLD) initiative were included. 10.4% of subjects had airflow obstruction. Self-reports of physician-diagnosed CVD (heart disease or stroke), hypertension and diabetes were regressed against airflow obstruction (post-bronchodilator FEV1/FVC < 5th percentile of reference values), adjusting for age, sex, smoking (including pack-years), body mass index and education. Analyses were undertaken within center and meta-analyzed across centers checking heterogeneity using the I2-statistic. Crude odds ratios for the association with airflow obstruction were 1.42 (95% CI: 1.20–1.69) for CVD, 1.24 (1.02–1.51) for hypertension, and 0.93 (0.76–1.15) for diabetes. After adjustment these were 1.00 (0.86–1.16) (I2:6%) for CVD, 1.14 (0.99–1.31) (I2:53%) for hypertension, and 0.76 (0.64–0.89) (I2:1%) for diabetes with similar results for men and women, smokers and nonsmokers, in richer and poorer centers. Alternatively defining airflow obstruction by FEV1/FVC < 2.5th percentile or 0.70, did not yield significant other results. In conclusion, the associations of CVD and hypertension with airflow obstruction in the general population are largely explained by age and smoking habits. The adjusted risk for diabetes is lower in subjects with airflow obstruction. These findings emphasize the role of common risk factors in explaining the coexistence of cardio-metabolic comorbidities and COPD.

Journal article

Sakhamuri S, Lutchmansingh F, Simeon D, Conyette L, Burney P, Seemungal Tet al., 2019, Reduced forced vital capacity is independently associated with ethnicity, metabolic factors and respiratory symptoms in a Caribbean population: A cross-sectional study, BMC Pulmonary Medicine, Vol: 19, ISSN: 1471-2466

BackgroundRelationships between low forced vital capacity (FVC), and morbidity have previously been studied but there are no data available for the Caribbean population. This study assessed the association of low FVC with risk factors, health variables and socioeconomic status in a community-based study of the Trinidad and Tobago population.MethodsA cross-sectional survey was conducted using the Burden of Obstructive Lung Disease (BOLD) study protocol. Participants aged 40 years and above were selected using a two-stage stratified cluster sampling. Generalized linear models were used to examine associations between FVC and risk factors.ResultsAmong the 1104 participants studied a lower post-bronchodilator FVC was independently associated with a large waist circumference (− 172 ml; 95% CI, − 66 to − 278), Indo-Caribbean ethnicity (− 180 ml; 95% CI, − 90 to − 269) and being underweight (− 185 ml; 95% CI, − 40 to − 330). A higher FVC was associated with smoking cannabis (+ 155 ml; 95% CI, + 27 to + 282). Separate analyses to examine associations with health variables indicated that participants with diabetes (p = 0∙041), history of breathlessness (p = 0∙007), and wheeze in the past 12 months (p = 0∙040) also exhibited lower post-bronchodilator FVC.ConclusionThese findings suggest that low FVC in this Caribbean population is associated with ethnicity, low body mass index (BMI), large waist circumference, chronic respiratory symptoms, and diabetes.

Journal article

Nightingale R, Lesosky M, Flitz G, Rylance SJ, Meghji J, Burney P, Balmes J, Mortimer Ket al., 2019, Non-communicable respiratory disease and air pollution exposure in Malawi (CAPS). A cross-sectional study, American Journal of Respiratory and Critical Care Medicine, Vol: 199, Pages: 613-621, ISSN: 1073-449X

Background Non-communicable respiratory diseases and exposure to air pollution are thought to be important contributors to morbidity and mortality in sub-Saharan African adults. Methods We did a cross-sectional study among adults in communities participating in a randomised controlled trial of a cleaner-burning biomass-fuelled cookstove intervention (CAPS) in rural Malawi. We assessed chronic respiratory symptoms, spirometric abnormalities, personal exposure to air pollution (fine particulate matter (PM2.5) and carbon monoxide (CO)). Weighted prevalence estimates were calculated; multivariable and intention-to-treat analyses were done. Results 1481 participants (mean (SD)) age 43·8 (17·8)) 57% female) were recruited. The prevalence of chronic respiratory symptoms, spirometric obstruction and restriction were 13·6% (95% CI:11.9-15.4), 8·7% (95% CI:7·0-10·7) and 34·8% (95% CI:31·7-38·0), respectively. Median 48-hour personal PM2.5 and CO exposures were 71·0 μg/m3 (IQR:44·6-119·2) and 1·23 ppm (IQR:0·79-1·93), respectively. Chronic respiratory symptoms were associated with current/ex-smoking (OR=1·59 (95% CI:1·05-2·39)), previous TB (OR=2·50 (95% CI:1·04-15·58)) and CO exposure (OR=1·46 (95% CI:1·04-2·05)). Exposure to PM2.5 was not associated with any demographic, clinical or spirometric characteristics. There was no effect of the CAPS intervention on any of the secondary trial outcomes. Conclusion The burden of chronic respiratory symptoms, abnormal spirometry and air pollution exposures in adults in rural Malawi is of considerable potential public health importance. We found little evidence that air pollution exposures were associated with chronic respiratory symptoms or spirometric abnormalities and no evidence that the CAPS intervention had effects on the secondary trial outcomes. More effective

Journal article

Razzaq S, Nafees AA, Rabbani U, Irfan M, Naeem S, Khan MA, Fatmi Z, Burney Pet al., 2018, Epidemiology of asthma and associated factors in an urban Pakistani population: Adult Asthma Study-Karachi, BMC Pulmonary Medicine, Vol: 18, ISSN: 1471-2466

BackgroundThis study was conducted in order to determine the prevalence of asthma and associated risk factors in the adult population of Karachi, Pakistan.MethodsThis multi-stage, cross-sectional survey was conducted from May 2014–August 2015; comprising 1629 adults in 75 randomly selected clusters in Karachi, Pakistan. Definitions included: ‘self-reported asthma’, ‘reversibility in FEV1’ and ‘respiratory symptoms and reversibility in FEV1’.ResultsPrevalence of asthma was 1.8% (self-reported) (95% CI: 1.0–2.6), 11.3% (reversibility in FEV1) (95% CI: 9.4–13.3) and 6.6% (symptoms and reversibility in FEV1) (95% CI: 5.1–8.1). Asthmatics were more likely to belong to the age group ≥38 years according to ‘reversibility in FEV1’ and ‘respiratory symptoms and reversibility in FEV1’ (AOR: 1.9, 95% CI: 1.2–3.3) and (AOR: 2.1, 95% CI: 1.1–4.2), respectively. Asthmatics were more likely to report history of allergies (AOR: 1.9, 95% CI: 1.2–2.9) and (AOR: 2.8, 95% CI: 1.7–4.8); and were exposed to environmental tobacco smoke (AOR: 1.6, 95% CI: 1.1–2.5) and (AOR: 1.9, 95% CI: 1.1–3.3) according to ‘reversibility in FEV1’ and ‘respiratory symptoms and reversibility in FEV1’, respectively. Asthmatics were more likely to report pack years of smoking ≥5 (AOR: 2.3, 95% CI: 1.1–4.7) according to ‘respiratory symptoms and reversibility in FEV1’.ConclusionThis study reports a high prevalence of asthma among Pakistani adults and calls for developing appropriate public health policies for prevention and control of asthma in the country. Further studies should be conducted to determine the national prevalence as well as follow-up studies to identify preventable causes for adult asthma.

Journal article

Burney P, 2018, Walter Werner Holland, 1929-2018 OBITUARY, INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol: 22, Pages: 1531-1531, ISSN: 1027-3719

Journal article

Burney PGJ, Patel J, Minelli C, 2018, THE POPULATION ATTRIBUTABLE RISKS (PAR) FOR CHRONIC AIRFLOW OBSTRUCTION (CAO) IN 40 CENTRES WORLDWIDE, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A247-A248, ISSN: 0040-6376

Conference paper

Bakolis I, Hooper R, Bachert C, Lange B, Haahtela T, Keil T, Hofmaier S, Fokkens W, Rymarczyk B, Janson C, Burney PG, Garcia Larsen Vet al., 2018, Dietary patterns and respiratory health in adults from nine European countries – evidence from the GA2LEN study, Clinical and Experimental Allergy, Vol: 48, Pages: 1474-1482, ISSN: 0954-7894

Background: Dietary patterns defined using Principal Component Analysis (PCA) offer an alternative to the analysis of individual foods and nutrients and have been linked with asthma and allergic disease. However, results have not been reproducible in different settings.Objective: To identify dietary patterns common to different European countries and examine their associations with asthma and allergic symptoms. Methods: In sixteen study centres in nine European countries, 3206 individuals aged 15-77 years completed a common, internationally validated, Food Frequency Questionnaire and a respiratory symptoms questionnaire. The outcomes of interest were current asthma, asthma symptoms score (derived based on responses to 5 asthma symptom-related questions), atopy (positive skin prick test). Spirometry was used to estimate forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), the FEV1/FVC, spirometric restriction (FVC below the lower limit of normal (<LLN)) and FEV1/FVC < LLN. A novel meta-analytic approach was used to identify dietary patterns using PCA and to examine associations with asthma and allergic symptoms.Results: Two dietary patterns emerged, generally correlating with the same foods in different countries: one associated with intake of animal proteins and carbohydrates; the other with fruit and vegetables. There was evidence that the former pattern was associated with a higher asthma score (RR 1.63, 95% CI: 1.33-2.01), current asthma (RR 2.03, 95% CI: 1.52-2.71), wheeze (RR 1.84, 95%CI: 1.30-2.60), atopic status (RR 1.68, 95%CI: 1.16-2.44) and with decreased lung function, including an FVC <LLN (RR 4.57, 95% CI: 2.27-9.21). Conclusions & Clinical Relevance: Our findings suggest an increase in sensitisation to common allergens, an increase in asthma symptoms and a reduction in lung function in those eating a diet rich in animal proteins and carbohydrates. We found little evidence of an association between these outcomes and

Journal article

Broström E, Jõgi R, Gislason T, Benediktsdottir B, Burney PGJ, Janson Cet al., 2018, The prevalence of chronic airflow obstruction in three cities in the Nordic-Baltic region, Respiratory Medicine, Vol: 143, Pages: 8-13, ISSN: 0954-6111

Background: Chronic airflow obstruction (CAO) is the primary characteristic of Chronic obstructive pulmonary disease (COPD) but is also seen in chronic asthma. Objective: To compare the prevalence of CAO and possible risk factors between Tartu in Estonia, Reykjavik in Iceland and Uppsala in Sweden. Methods: All participants underwent spirometry testing of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) before and after bronchodilation. CAO was defined as post-bronchodilator FEV1/FVC below lower limit of normal. Information on respiratory diseases and smoking status, was obtained through questionnaires administered by trained interviewers. Results: 1037 men and 956 women participated in the study. The prevalence of CAO was lower in women in Tartu compared to the other centres (4.9% vs. 13.4 and 8.7% in Reykjavik and Uppsala, respectively, p = 0.002) while no difference was found for men. A similar picture was seen for the proportion of participants that had smoked 10 pack years or more which was much lower in Tartu for women than in Reykjavik and Uppsala, respectively (13.2% vs. 33.7 and 29.2%, p < 0.001). (Fig. 1). Of the participants with CAO the majority (57–67%) did not have a previous diagnosis of asthma or COPD. Conclusion: The prevalence of CAO was lower in Estonian women than in women from Iceland and Sweden. The reason for this was probably that the Estonian women had smoked less than the female participants from Iceland and Sweden. The majority of those with CAO do not have a diagnosed lung disease.

Journal article

Pereira M, Thompson JR, Burney PG, Minelli Cet al., 2018, Bioshrink: a R shiny application for Bayesian analysis of genetic association studies that incorporates biological information, 27th Annual Meeting of the International-Genetic-Epidemiology-Society (IGES), Publisher: WILEY, Pages: 723-723, ISSN: 0741-0395

Conference paper

Burney P, Patel J, Minelli C, 2018, Late Breaking Abstract - The population attributable risks (PAR) for chronic airflow obstruction (CAO) in 40 BOLD study centres worldwide., 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Peralta GP, Fuertes E, Carsin A-E, Probst-Hensch N, Marcon A, Nowak D, Amaral AFS, Johannessen A, Janson C, Dharmage S, Gislason T, Garcia-Larsen V, Abramson MJ, Sigsgaard T, Anto JM, Weyler J, Bono R, Holm M, Burney P, Heinrich J, Forsberg B, Raherison-Semjen C, Siroux V, Leynaert B, Accordini S, Martinez-Moratalla J, Sanchez-Ramos J-L, Jarvis DL, Garcia-Aymerich Jet al., 2018, Body mass index trajectories during adult life and lung function decline, 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Brian M, Jarvis D, Burney P, Cullinan P, Jones M, Briza Pet al., 2018, Application of a mass-spectrometry based method to identify novel occupational allergens, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI), Publisher: WILEY, Pages: 95-95, ISSN: 0105-4538

Conference paper

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