Publications
574 results found
Ahmed R, Robinson R, Elsony A, et al., 2018, A comparison of smartphone and paper data collection tools in the Burden of Obstructive Lung Disease (BOLD) study in Gezira state, Sudan, PLoS ONE, Vol: 13, ISSN: 1932-6203
Introduction:Data collection using paper-based questionnaires can be time consuming and return errors affect data accuracy, completeness, and information quality in health surveys. We compared smartphone and paper-based data collection systems in the Burden of Obstructive Lung Disease (BOLD) study in rural Sudan.Methods:This exploratory pilot study was designed to run in parallel with the cross-sectional household survey. The Open Data Kit was used to programme questionnaires in Arabic into smartphones. We included 100 study participants (83% women; median age = 41.5 ± 16.4 years) from the BOLD study from 3 rural villages in East-Gezira and Kamleen localities of Gezira state, Sudan. Questionnaire data were collected using smartphone and paper-based technologies simultaneously. We used Kappa statistics and inter-rater class coefficient to test agreement between the two methods.Results:Symptoms reported included cough (24%), phlegm (15%), wheezing (17%), and shortness of breath (18%). One in five were or had been cigarette smokers. The two data collection methods varied between perfect to slight agreement across the 204 variables evaluated (Kappa varied between 1.00 and 0.02 and inter-rater coefficient between 1.00 and -0.12). Errors were most commonly seen with paper questionnaires (83% of errors seen) vs smartphones (17% of errors seen) administered questionnaires with questions with complex skip-patterns being a major source of errors in paper questionnaires. Automated checks and validations in smartphone-administered questionnaires avoided skip-pattern related errors. Incomplete and inconsistent records were more likely seen on paper questionnaires.Conclusion:Compared to paper-based data collection, smartphone technology worked well for data collection in the study, which was conducted in a challenging rural environment in Sudan. This approach provided timely, quality data with fewer errors and inconsistencies compared to paper-based data collection. We rec
McKee M, Burney P, 2018, Walter Werner Holland: pioneer of European public health, BMJ-BRITISH MEDICAL JOURNAL, Vol: 360, ISSN: 1756-1833
Burney P, 2018, BOLD in Africa: What has it taught us?, AFRICAN JOURNAL OF RESPIRATORY MEDICINE, Vol: 13, ISSN: 1747-5597
Amaral AFS, Patel J, Kato BS, et al., 2018, Airflow obstruction and use of solid fuels for cooking or heating: BOLD results, American Journal of Respiratory and Critical Care Medicine, Vol: 197, Pages: 595-610, ISSN: 1073-449X
Rationale: Evidence supporting the association of COPD or airflow obstruction with use of solid fuels is conflicting and inconsistent. Objective: To assess the association of airflow obstruction with self-reported use of solid fuels for cooking or heating. Methods: We analysed 18,554 adults from the BOLD study, who had provided acceptable post-bronchodilator spirometry measurements and information on use of solid fuels. The association of airflow obstruction with use of solid fuels for cooking or heating was assessed by sex, within each site, using regression analysis. Estimates were stratified by national income and meta-analysed. We carried out similar analyses for spirometric restriction, chronic cough and chronic phlegm. Measurements and main results: We found no association between airflow obstruction and use of solid fuels for cooking or heating (ORmen=1.20, 95%CI 0.94-1.53; ORwomen=0.88, 95%CI 0.67-1.15). This was true for low/middle and high income sites. Among never smokers there was also no evidence of an association of airflow obstruction with use of solid fuels (ORmen=1.00, 95%CI 0.57-1.76; ORwomen=1.00, 95%CI 0.76-1.32). Overall, we found no association of spirometric restriction, chronic cough or chronic phlegm with the use of solid fuels. However, we found that chronic phlegm was more likely to be reported among female never smokers and those who had been exposed for ≥20 years. Conclusion: Airflow obstruction assessed from post-bronchodilator spirometry was not associated with use of solid fuels for cooking or heating.
Garcia-Larsen V, Thawer N, Charles D, et al., 2018, Dietary Intake of Flavonoids and Ventilatory Function in European Adults: A GA2LEN Study, Nutrients, Vol: 10, ISSN: 2072-6643
Background: Flavonoids exert anti-inflammatory properties and modulate oxidative stress in vitro, suggesting a protective effect on lung function, but epidemiological studies examining this association are scarce. Methods: A stratified random sample was drawn from the GA2LEN screening survey, in which 55,000 adults aged 15 to 75 answered a questionnaire on respiratory symptoms. Post-bronchodilator spirometry was obtained from 2850 subjects. Forced vital capacity (FVC), the ratio between the forced exhaled volume in 1 second (FEV1) and FVC (FEV1/FVC), FVC below lower limit of normal (FVC < LLN), and FEV1/FVC < LLN were calculated. Intake of the six main subclasses of flavonoids was estimated using the GA2LEN Food Frequency Questionnaire. Adjusted associations between outcomes and each subclass of flavonoids were examined with multivariate regressions. Simes’ procedure was used to test for multiple comparisons. Results: A total of 2599 subjects had valid lung function and dietary data. A lower prevalence of FVC < LLN (airway restriction) was observed in those with higher total flavonoid (adjusted odds ratio (aOR), higher vs. lowest quintile intake 0.58; 95% Confidence Interval (CI) 0.36, 0.94), and pro-anthocyanidin intakes (aOR 0.47; 95% CI 0.27, 0.81). A higher FEV1/FVC was associated with higher intakes of total flavonoids and pro-anthocyanidins (adjusted correlation coefficient (a β-coeff 0.33; 0.10, 0.57 and a β-coeff 0.44; 95% CI 0.19, 0.69, respectively). After Simes’ procedure, the statistical significance of each of these associations was attenuated but remained below 0.05, with the exception of total flavonoids and airway restriction. Conclusions: This population-based study in European adults provides cross-sectional evidence of a positive association of total flavonoid intake and pro-anthocyanidins and ventilatory function, and a negative association with spirometric restriction in European adults.
Larsen VG, Villegas R, Omenaas ER, et al., 2018, Dietary Intake of Anthocyanin Flavonoids and Ten Year Lung Function Decline in Adults from the European Community Respiratory Health Survey (ECRHS), International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Garcia Larsen V, Potts J, Omenaas E, et al., 2017, Dietary antioxidants and ten year lung function decline in adults from the ECRHS survey, European Respiratory Journal, Vol: 50, Pages: 1-9, ISSN: 0903-1936
The relationship between lung function decline and dietary antioxidants over 10 years in adults from three European countries was investigated.In 2002, adults from three participating countries of the European Community Respiratory Health Survey (ECRHS) answered a questionnaire and underwent spirometry (forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)), which were repeated 10 years later. Dietary intake was estimated at baseline with food frequency questionnaires (FFQ). Associations between annual lung function decline (mL) and diet (tertiles) were examined with multivariable analyses. Simes’ procedure was applied to control for multiple testing.A total of 680 individuals (baseline mean age 43.8±6.6 years) were included. A per-tertile increase in apple and banana intake was associated with a 3.59 mL·year−1 (95% CI 0.40, 7.68) and 3.69 mL·year−1 (95% CI 0.25, 7.14) slower decline in FEV1 and FVC, respectively. Tomato intake was also associated with a slower decline in FVC (4.5 mL·year−1; 95% CI 1.28, 8.02). Only the association with tomato intake remained statistically significant after the Simes’ procedure was performed. Subgroup analyses showed that apple, banana and tomato intake were all associated with a slower decline in FVC in ex-smokers.Intake of fruits and tomatoes might delay lung function decline in adults, particularly in ex-smokers.
Burney P, Patel J, Minelli C, et al., 2017, The population impact of smoking on chronic airflow obstruction in different global regions: a BOLD Study analysis, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Introduction: The proportion of chronic airflow obstruction (CAO) due to smoking (Population Attributable Fraction, PAF) is often estimated at around 50% and thought to be lower in poorer countries.Aims: To estimate the impact of smoking on CAO in rich and poor countries.Methods: A cross-sectional survey of adults >40 years old estimated the prevalence of CAO (FEV1/FVC < lower limit of normal, LLN) and the prevalence of smoking in 33 sites. Local estimates of relative risk adjusted for confounders, whose accuracy was improved using hierarchical Bayesian models, were combined with smoking rates to derive local estimates of PAF. Prevalence of CAO caused by smoking (Population excess risks, PER) were also estimated.Results: Prevalence of ever-smokers ranged from 2% (Cotonou, Benin) to 68% (Cape Town, S. Africa). In a third of sites prevalence of CAO among non-smokers was <5% (the expected value defined for a healthy non-smoking population by the LLN). The relative risk from smoking was similar across sites (2.15; 95%CI: 1.9 to 2.4; I2=0%), and so PAF was strongly related to smoking prevalence, and ranged from <10% (Pune, India; Ile-Ife, Nigeria; Blantyre, Malawi) to >50% (Cape Town; London, UK). PER values ranged from <1% (Benin; Ile-Ife; Pune; Blantyre; Penang, Malaysia; Riyadh, Saudi Arabia) to over 10% (Lexington, USA; Maastricht, Netherlands; London).Conclusions: Smoking is the most important cause of CAO in both rich and poor regions of the world. PAF values are mostly <50%, but this is not easy to interpret in areas with low CAO prevalence and where 5% of “normal” people are defined as “diseased” by the LLN. PER values are less dependent on reference criteria.
Brian M, Jarvis D, Burney P, et al., 2017, IDENTIFICATION OF ALLERGENS PRESENT IN DROSOPHILA MELANOGASTER USING A SERUM IMMUNOBLOTTING METHOD, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A62-A62, ISSN: 0040-6376
- Author Web Link
- Cite
- Citations: 1
Guevara-Rattray EM, Garden FL, James AL, et al., 2017, Atopy in people aged 40 years and over: Relation to airflow limitation, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 47, Pages: 1625-1630, ISSN: 0954-7894
- Author Web Link
- Open Access Link
- Cite
- Citations: 2
Mejza F, Gnatiuc L, Buist AS, et al., 2017, Prevalence and burden of chronic bronchitis symptoms: results from the BOLD study, European Respiratory Journal, Vol: 50, ISSN: 0903-1936
We studied the prevalence, burden and potential risk factors for chronic bronchitis symptoms in the Burden of Obstructive Lung Disease study.Representative population-based samples of adults aged ≥40 years were selected in participating sites. Participants completed questionnaires and spirometry. Chronic bronchitis symptoms were defined as chronic cough and phlegm on most days for ≥3 months each year for ≥2 years.Data from 24 855 subjects from 33 sites in 29 countries were analysed. There were significant differences in the prevalence of self-reported symptoms meeting our definition of chronic bronchitis across sites, from 10.8% in Lexington (KY, USA), to 0% in Ile-Ife (Nigeria) and Blantyre (Malawi). Older age, less education, current smoking, occupational exposure to fumes, self-reported diagnosis of asthma or lung cancer and family history of chronic lung disease were all associated with increased risk of chronic bronchitis. Chronic bronchitis symptoms were associated with worse lung function, more dyspnoea, increased risk of respiratory exacerbations and reduced quality of life, independent of the presence of other lung diseases.The prevalence of chronic bronchitis symptoms varied widely across the studied sites. Chronic bronchitis symptoms were associated with significant burden both in individuals with chronic airflow obstruction and those with normal lung function.
Burney PGJ, Minelli C, 2017, Using reference values to define disease based on the lower limit of normal biases the population attributable fraction, but not the population excess risk: the example of chronic airflow obstruction, Journal of Clinical Epidemiology, Vol: 93, Pages: 76-78, ISSN: 0895-4356
Background: The impact of disease on population health is most commonly estimated by the population attributable fraction (PAF), or less commonly by the excess risk, an alternative measure that estimates the absolute risk of disease in the population that can be ascribed to the exposure. Using chronic airflow obstruction as an example, we examined the impact on these estimates of defining disease based on different “normal” values.Method: We estimated PAF and the excess risk in scenarios in which the true rate of disease was 10% in the exposed and 5% in the unexposed, and where either 50% or 20% of the population was exposed. Disease definition was based on a “lower limit of normal”, using the 5th, 1st and 0.2nd centile of values in a “normal” population as thresholds to define normality. Results: Where normality is defined by centiles of values in a “normal” population, PAF is strongly influenced by which centile is selected to define normality. This is not true for the population excess risk. Conclusion: Care should be taken when interpreting estimates of PAF when disease is defined from a centile of a normal population.
Pereira M, Thompson JR, Burney PG, et al., 2017, Influence of Lung Development Genes on Lung Function in Adults: Application of a Bayesian Model to UK Biobank Data, Annual Meeting of the International-Genetic-Epidemiology-Society (IGES), Publisher: WILEY, Pages: 655-655, ISSN: 0741-0395
Jarvis D, Newson R, Janson C, et al., 2017, Prevalence of asthma-like symptoms with ageing., Thorax, Vol: 73, Pages: 37-48, ISSN: 1468-3296
BACKGROUND: Change in the prevalence of asthma-like symptoms in populations of ageing adults is likely to be influenced by smoking, asthma treatment and atopy. METHODS: The European Community Respiratory Health Survey collected information on prevalent asthma-like symptoms from representative samples of adults aged 20-44 years (29 centres in 13 European countries and Australia) at baseline and 10 and 20 years later (n=7844). Net changes in symptom prevalence were determined using generalised estimating equations (accounting for non-response through inverse probability weighting), followed by meta-analysis of centre level estimates. FINDINGS: Over 20 years the prevalence of 'wheeze' and 'wheeze in the absence of a cold' decreased (-2.4%, 95% CI -3.5 to -1.3%; -1.5%, 95% CI -2.4 to -0.6%, respectively) but the prevalence of asthma attacks, use of asthma medication and hay fever/nasal allergies increased (0.6%, 95% CI 0.1 to 1.11; 3.6%, 95% CI 3.0 to 4.2; 2.7%, 95% CI 1.7 to 3.7). Changes were similar in the first 10 years compared with the second 10 years, except for hay fever/nasal allergies (increase seen in the first 10 years only). Decreases in these wheeze-related symptoms were largely seen in the group who gave up smoking, and were seen in those who reported hay fever/nasal allergies at baseline. INTERPRETATION: European adults born between 1946 and 1970 have, over the last 20 years, experienced less wheeze, although they were more likely to report asthma attacks, use of asthma medication and hay fever. Decrease in wheeze is largely attributable to smoking cessation, rather than improved treatment of asthma. It may also be influenced by reductions in atopy with ageing.
Grønseth R, Erdal M, Tan WC, et al., 2017, Unemployment in chronic airflow obstruction around the world: Results from the BOLD study, European Respiratory Journal, Vol: 50, ISSN: 1399-3003
Objectives: We aimed to examine associations between chronic airflow obstruction (CAO) and unemployment across the world.Methods: Cross-sectional data from 26 sites in the Burden of Obstructive Lung Disease (BOLD) Study were used to analyze effects of CAO on unemployment. Odds ratios (OR) for unemployment in subjects 40-65 years old were estimated with multilevel mixed-effects generalized linear model with study site as random effect. Site-by-site heterogeneity was assessed using individual participant data meta-analyses.Results: Of 18710 participants, 11.3% had CAO. Ratio of unemployed subjects with CAO divided by subjects without CAO showed large site discrepancies, though these were no longer significant after adjusting for age, sex, smoking and education. Site-adjusted OR for unemployment (95%CI) was 1.79 (1.41, 2.27) for CAO cases, decreasing to 1.43 (1.14, 1.79) after adjusting for sociodemographic factors, comorbidities and forced vital capacity. Of other covariates that were associated with unemployment, age and education were important risk factors in high-income sites (OR (95%CI) 4.02 (3.53, 4.57) and 3.86 (2.80, 5.30) respectively), while female gender was important in low-to-middle-income sites (OR 3.23 (2.66, 3.91)). Conclusions: In the global BOLD study, CAO was associated with increased levels of unemployment, even after adjusting for sociodemographic factors, comorbidities and lung function.
Chamitava L, Bakolis I, Burney PGJ, et al., 2017, Respiratory health and dietary patterns in adults from ECRHS III, European-Respiratory-Society (ERS) International Congress, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Gronseth R, Erdal M, Tan WC, et al., 2017, Unemployment in chronic airflow obstruction (CAO) around the world: results from the Burden of Obstructive Lung Disease (BOLD) study, European Respiratory Society (ERS) International Congress, Publisher: European Respiratory Society, ISSN: 0903-1936
Objectives: We aimed to examine associations between CAO and unemployment across the world.Methods: Cross-sectional data from 26 sites in the Burden of Obstructive Lung Disease (BOLD) Study were used to analyze effects of CAO on unemployment. Odds ratios (OR) for unemployment in subjects 40-65 years old were estimated with multilevel mixed-effects generalized linear model with study site as random effect. Site-by-site heterogeneity was assessed using individual participant data meta-analyses.Results: Of 18710 participants, 11.3% had CAO. Ratio of unemployed subjects with CAO divided by unemployed subjects without CAO showed large discrepancies between sites, particularly in low-to-middle income countries with ratio from 0.5 (lower unemployment among CAO cases) in the Philippines to 5.8 (higher unemployment among CAO cases) in India. Site-adjusted OR for unemployment (95% confidence interval) was 1.79 (1.41, 2.27) for participants with CAO, decreasing to 1.43 (1.14, 1.79) after adjusting for gender, age, smoking, comorbidities, education and forced vital capacity (FVC). Risk factors for unemployment in high-income sites were age (OR (95%CI) 4.02 (3.53, 4.57), and primary education vs university education 3.86 (2.80, 5.30). Female gender was the most important factor for unemployment in low-to-middle-income sites (OR 3.23 (2.66, 3.91).Conclusions: CAO was associated with unemployment even after adjusting for sociodemographic factors, comorbidities and FVC. We observed that the association was particularly strong in high-income sites.
Horner A, Soriano JB, Puhan MA, et al., 2017, Altitude and COPD prevalence: analysis of the PREPOCOL-PLATINO-BOLD-EPI-SCAN study., Respiratory Research, Vol: 18, ISSN: 1465-9921
BACKGROUND: COPD prevalence is highly variable and geographical altitude has been linked to it, yet with conflicting results. We aimed to investigate this association, considering well known risk factors. METHODS: A pooled analysis of individual data from the PREPOCOL-PLATINO-BOLD-EPI-SCAN studies was used to disentangle the population effect of geographical altitude on COPD prevalence. Post-bronchodilator FEV1/FVC below the lower limit of normal defined airflow limitation consistent with COPD. High altitude was defined as >1500 m above sea level. Undiagnosed COPD was considered when participants had airflow limitation but did not report a prior diagnosis of COPD. RESULTS: Among 30,874 participants aged 56.1 ± 11.3 years from 44 sites worldwide, 55.8% were women, 49.6% never-smokers, and 12.9% (3978 subjects) were residing above 1500 m. COPD prevalence was significantly lower in participants living at high altitude with a prevalence of 8.5% compared to 9.9%, respectively (p < 0.005). However, known risk factors were significantly less frequent at high altitude. Hence, in the adjusted multivariate analysis, altitude itself had no significant influence on COPD prevalence. Living at high altitude, however, was associated with a significantly increased risk of undiagnosed COPD. Furthermore, subjects with airflow limitation living at high altitude reported significantly less respiratory symptoms compared to subjects residing at lower altitude. CONCLUSION: Living at high altitude is not associated with a difference in COPD prevalence after accounting for individual risk factors. However, high altitude itself was associated with an increased risk of undiagnosed COPD.
Coton S, Vollmer WM, Bateman E, et al., 2017, Severity of airflow obstruction in Chronic Obstructive Pulmonary Disease (COPD): proposal for a new classification, Journal of Chronic Obstructive Lung Disease, Vol: 14, Pages: 469-475, ISSN: 1541-2555
Current classifications of Chronic Obstructive Pulmonary Disease (COPD) severity are complex and do not grade levels of obstruction. Obstruction is a simpler construct and independent of ethnicity.Using data from the Burden of Obstructive Lung Disease (BOLD) study we constructed an index of severity based on the FEV1/FVC ratio with cut-points dividing the population into four similar sized strata to those created by the GOLD criteria using FEV1. We measured agreement between classifications and validity of the FEV1-based classification in identifying the level of obstruction as defined by the new groupings. We compared the strengths of association of each classification with quality of life, MRC dyspnoea score and the self-reported exacerbation rate.Agreement between classifications was only fair. FEV1-based criteria for moderate COPD identified only 79% of those with moderate obstruction and misclassified half of the participants with mild obstruction as having more severe COPD. Both scales were equally strongly associated with quality of life, exertional dyspnoea and respiratory exacerbations.Severity assessed using the FEV1/FVC ratio is only in moderate agreement with the severity assessed using FEV1 but is equally strongly associated with other outcomes. Severity assessed using the FEV1/FVC ratio is likely to be independent of ethnicity.
Saad N, Patel JH, Minelli C, et al., 2017, Explaining ethnic disparities in lung function among young adults: a pilot investigation, PLOS One, Vol: 12, ISSN: 1932-6203
BackgroundEthnic disparities in lung function have been linked mainly to anthropometric factors but have not been fully explained. We conducted a cross-sectional pilot study to investigate how best to study ethnic differences in lung function in young adults and evaluate whether these could be explained by birth weight and socio-economic factors.MethodsWe recruited 112 university students of White and South Asian British ethnicity, measured post-bronchodilator lung function, obtained information on respiratory symptoms and socio-economic factors through questionnaires, and acquired birth weight through data linkage. We regressed lung function against ethnicity and candidate predictors defined a priori using linear regression, and used penalised regression to examine a wider range of factors. We reviewed the implications of our findings for the feasibility of a larger study.ResultsThere was a similar parental socio-economic environment and no difference in birth weight between the two ethnic groups, but the ethnic difference in FVC adjusted for sex, age, height, demi-span, father’s occupation, birth weight, maternal educational attainment and maternal upbringing was 0.81L (95%CI: -1.01 to -0.54L). Difference in body proportions did not explain the ethnic differences although parental immigration was an important predictor of FVC independent of ethnic group. Participants were comfortable with study procedures and we were able to link birth weight data to clinical measurements.ConclusionStudies of ethnic disparities in lung function among young adults are feasible. Future studies should recruit a socially more diverse sample and investigate the role of markers of acculturation in explaining such differences.
Townend J, Minelli C, Mortimer K, et al., 2017, The association between chronic airflow obstruction and poverty in 12 sites from the multinational BOLD study, European Respiratory Journal, Vol: 49, ISSN: 1399-3003
Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0–10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV1/FVC<lower limit of normal were tested for association with poverty for each site, and the results were combined by meta-analysis.Mean wealth scores ranged from 4 in Blantyre (Malawi) and Kashmir (India) to 10 in Riyadh (Saudi Arabia), and the prevalence of obstruction, from 16% in Kashmir to 3% in Riyadh and Penang (Malaysia). Following adjustments for age and sex, FEV1/FVC increased by 0.36% (absolute change) (95%CI: 0.22, 0.49; p<0.001) per unit increase in wealth score. Adjustments for other confounders reduced this effect to 0.23% (0.11, 0.34), but even this value remained highly significant (p<0.001). Results were consistent across sites (I2=1%; phet=0.44). Mean wealth scores explained 38% of the variation in mean FEV1/FVC between sites (r2=0.385, p=0.031).Airflow obstruction is consistently associated with poverty at individual and community levels across several countries.
Saad NJ, Patel J, Burney P, et al., 2017, Birth Weight and Lung Function in Adulthood: A Systematic Review and Meta-analysis., Annals of the American Thoracic Society, Vol: 14, Pages: 994-1004, ISSN: 2329-6933
RATIONALE: There is evidence suggesting that birth weight may influence lung function in adulthood, but it is unclear whether it might differentially affect restrictive (FVC) and obstructive (FEV1/FVC) patterns. OBJECTIVES: To summarize evidence available on the association of birth weight, weight at 1 year, and weight gain in the first year of life with FVC and FEV1/FVC in adulthood. METHODS: We performed a systematic review of the literature by searching MEDLINE, EMBASE, and Web of Science through January 2015. Data were combined using inverse-variance weighted meta-analysis with random effects models and between-study heterogeneity evaluated. We conducted a priori subgroup or sensitivity analyses by age, country wealth, ethnicity, sex, and smoking. We evaluated risk of bias using the Newcastle Ottawa Scale and reporting bias using funnel plots. RESULTS: Eighteen articles were included in the review and 13 in the meta-analyses. Most studies were from high-income countries, and all had a low risk of bias. We found strong evidence of an association of birth weight with adult FVC, a 59.4 ml higher FVC in adulthood per kilogram increase in birth weight (95% confidence interval, 43.3-75.5), with no evidence of heterogeneity. Evidence of an association of birth weight with FEV1/FVC was weaker and showed some inconsistency across studies. Only one study investigated weight at 1 year, and another one reported weight gain in the first year. CONCLUSIONS: Our meta-analyses show strong and consistent evidence of an association of birth weight with adult FVC, a measure of restrictive impairment, with much weaker evidence for airflow obstruction.
Obaseki DO, Erhabor GE, Awopeju OF, et al., 2017, Reduced forced vital capacity in an African population: prevalence and risk factors, Annals of the American Thoracic Society, Vol: 14, Pages: 714-721, ISSN: 2329-6933
Rationale:Black Africans have reduced FVC compared with whitepersons, but the prevalence and determinants of reduced values arenot well understood.Objectives:To evaluate the prevalence and factors leading toreduced FVC in a Nigerian population and to examine currenttheories regarding the determinants of this difference.Methods:We studied the ventilatory function of 883 adults aged40 years or older participating in the Burden of Obstructive LungDiseaseStudyinIle-Ife,Nigeria.Respondentscompletedpre-andpost-bronchodilator spirometry test and provided information on theirsmoking history, respiratory symptoms, risk factors, and diagnoses,including anthropometric details. We used standard categories todefine body mass index as either underweight, normal, overweight, orobese. We defined reduced FVC as a post-bronchodilator FVC belowthe lower limit of normal using National Health and NutritionExamination Survey (NHANES) equations, Global Lung FunctionInitiative 2012 equations, and local reference equations based onnonsmoking study participants without a respiratory diagnosis. Wefitmultivariate linear regression models to FVC as a continuous measure,adjusting for age, sex, height, and other confounders.Results:The prevalence of reduced FVC was 70.4% for menand 72.8% for women when using NHANES values for whiteAmericans, 17.8% for men and 14.4% for women usingNHANES equations for African Americans, and 15.5% for menand 20.5% for women using the Global Lung Function Initiative2012 equations. Using the equations derived from nonsmokingrespondents in the survey without a respiratory diagnosis, theprevalence of reduced FVC was less than 4% for both menand women. FVC was lower in participants who had lessthan 7 years of education (FVC,296 ml; 95% confidenceinterval [CI],2172 to219), were underweight (FVC,2269 ml;95% CI,2464 to273), were overweight (FVC,2132 ml;95% CI,2219 to246), and were obese (FVC,2222 ml; 95%CI,2332 to2112).Conclusions:There is a wide variation in the prevalenc
Amaral AF, Strachan DP, Burney PG, et al., 2017, Female smokers are at greater risk of airflow obstruction than male smokers: UK Biobank, American Journal of Respiratory and Critical Care Medicine, Vol: 195, Pages: 1226-1235, ISSN: 1535-4970
RATIONALE: The prevalence of chronic obstructive pulmonary disease (COPD) is increasing faster among women than among men. <br><br> Objectives: To examine sex differences in the risk of airflow obstruction (COPD hallmark) in relation to smoking history. <br><br> Methods: We analysed 149,075 women and 100,252 men taking part in the UK Biobank, who had provided spirometry measurements and information on smoking. The association of airflow obstruction with smoking characteristics was assessed, by sex, using regression analysis. The shape of this relationship was examined using restricted cubic splines. <br><br> Measurements and main results: The association of airflow obstruction with smoking status was stronger in women (ORex=1.44; ORcurrent=3.45) than in men (ORex=1.25; ORcurrent=3.06) (P-interaction=5.6x10(-4)). In both sexes, the association of airflow obstruction with cigarettes/day, duration and pack-years did not follow a linear pattern, with the increase in risk at lower doses being steeper among women. For equal doses of exposure, sex differences were present in both ex- and current smokers for cigarettes/day (P-interactionex=6.0x10(-8); P-interactioncurrent=1.1x10(-5)), duration (P-interactionex=7.9x10(-4); P-interactioncurrent=0.004) and pack-years (P-interactionex=6.6x10(-18); P-interactioncurrent=1.3x10(-6)). Overall those who started smoking before 18 were more likely to have airflow obstruction, but a sex difference in this association was not clear. For equal time since quitting, the reduction in risk among women seemed less marked than among men. <br><br> Conclusion: Exposed to the same dose of smoking, women show higher risk of airflow obstruction than men. This could partly explain the increasingly smaller sex difference in the prevalence of COPD, especially in countries where smoking patterns have become similar between women and men.
Bousquet J, Farrell J, Crooks G, et al., 2017, Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5), CLINICAL AND TRANSLATIONAL ALLERGY, Vol: 7, ISSN: 2045-7022
Burney PGJ, 2017, Chronic respiratory disease - the acceptable epidemic?, Clinical Medicine, Vol: 17, Pages: 29-32, ISSN: 1473-4893
Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death in the UK but is an even greater problem in low income countries. It is assumed by many to be almost entirely attributed to smoking. However, smoking alone cannot account for the distribution of the disease in the world and there is accumulating evidence that the disease is overwhelmingly a disease of poverty. The size of the problem and the failure of current hypotheses to explain the distribution of chronic lung disease make the lack of funding in this area surprising. The failure of science funders to respond to the analysis of the Cooksey report, which pointed out the extreme discrepancy between the size of the problem and the paucity of research funding, represents a serious failure in science policy. The lack of urgency in the face of such a large burden of illness suggests a degree of complacency in the face of a disease that is overwhelmingly a disease of the poor.
Garcia-Larsen V, Arthur R, Potts JF, et al., 2017, Is fruit and vegetable intake associated with asthma or chronic rhino-sinusitis in European adults? Results from the Global Allergy and Asthma Network of Excellence (GA(2)LEN) Survey, Clinical and Translational Allergy, Vol: 7, ISSN: 2045-7022
Background:Fruits and vegetables are rich in compounds with proposed antioxidant, anti-allergic and anti-inflammatory properties, which could contribute to reduce the prevalence of asthma and allergic diseases.Objective:We investigated the association between asthma, and chronic rhino-sinusitis (CRS) with intake of fruits and vegetables in European adults.Methods:A stratified random sample was drawn from the Global Allergy and Asthma Network of Excellence (GA2LEN) screening survey, in which 55,000 adults aged 15–75 answered a questionnaire on respiratory symptoms. Asthma score (derived from self-reported asthma symptoms) and CRS were the outcomes of interest. Dietary intake of 22 subgroups of fruits and vegetables was ascertained using the internationally validated GA2LEN Food Frequency Questionnaire. Adjusted associations were examined with negative binomial and multiple regressions. Simes procedure was used to control for multiple testing.Results:A total of 3206 individuals had valid data on asthma and dietary exposures of interest. 22.8% reported having at least 1 asthma symptom (asthma score ≥1), whilst 19.5% had CRS. After adjustment for potential confounders, asthma score was negatively associated with intake of dried fruits (β-coefficient −2.34; 95% confidence interval [CI] −4.09, −0.59), whilst CRS was statistically negatively associated with total intake of fruits (OR 0.73; 95% CI 0.55, 0.97). Conversely, a positive association was observed between asthma score and alliums vegetables (adjusted β-coefficient 0.23; 95% CI 0.06, 0.40). None of these associations remained statistically significant after controlling for multiple testing.Conclusion and clinical relevance:There was no consistent evidence for an association of asthma or CRS with fruit and vegetable intake in this representative sample of European adults.
Fedorova OS, Janse JJ, Ogorodova LM, et al., 2017, Opisthorchis felineus negatively associates with skin test reactivity in Russia-EuroPrevall-International Cooperation study, Allergy, Vol: 72, Pages: 1096-1104, ISSN: 0105-4538
BACKGROUND: Most studies on the relationship between helminth infections and atopic disorders have been conducted in (sub)tropical developing countries where exposure to multiple parasites and lifestyle can confound the relationship. We aimed to study the relationship between infection with the fish-borne helminth Opishorchis felineus and specific IgE, skin prick testing, and atopic symptoms in Western Siberia, with lifestyle and hygiene standards of a developed country. METHODS: Schoolchildren aged 7-11 years were sampled from one urban and two rural regions. Skin prick tests (SPT) and specific IgE (sIgE) against food and aeroallergens were measured, and data on allergic symptoms and on demographic and socioeconomic factors were collected by questionnaire. Diagnosis of opisthorchiasis was based on PCR performed on stool samples. RESULTS: Of the 732 children included, 34.9% had opisthorchiasis. The sensitization to any allergen when estimated by positive SPT was 12.8%, while much higher, 24.0%, when measured by sIgE. Atopic symptoms in the past year (flexural eczema and/or rhinoconjunctivitis) were reported in 12.4% of the children. SPT was positively related to flexural eczema and rhinoconjunctivitis, but not to wheezing. Opisthorchiasis showed association with lower SPT response, as well as borderline association with low IgE reactivity to any allergen. However, the effect of opisthorchiasis on SPT response was not mediated by IgE, suggesting that opisthorchiasis influences SPT response through another mechanism. Opisthorchiasis also showed borderline association with lower atopic symptoms. CONCLUSIONS: There is a negative association between a chronic helminth infection and skin prick test reactivity even in a developed country.
Koul PA, Hakim NA, Malik SA, et al., 2016, Prevalence of Chronic airflow limitation in Kashmir, North India: Results from the BOLD study., International Journal of Tuberculosis and Lung Disease, Vol: 20, Pages: 1399-1404, ISSN: 1815-7920
BACKGROUND: Data on spirometrically defined chronic airflow limitation (CAL) are scarce in developing countries.OBJECTIVE: To estimate the prevalence of spirometrically defined CAL in Kashmir, North India.METHODS: Using Burden of Obstructive Lung Disease survey methods, we administered questionnaires to randomly selected adults aged 40 years. Post-bronchodilator spirometry was performed to estimate the prevalence of CAL and its relation to potential risk factors.RESULTS: Of 1100 participants initially recruited, 953 (86.9%) responded and 757 completed acceptable spirometry and questionnaires. The prevalence of a forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio less than the lower limit of normal was 17.3% (4.5) in males and 14.8% (2.1) in females. Risk factors for CAL included higher age, cooking with wood and lower educational status. The prevalence of current smoking was 61% in males and 22% in females; most smoked hookahs. CAL was found equally in non-smoking males and females, and was independently associated with the use of the hookah, family history of respiratory disease and poor education. A self-reported doctor's diagnosis of chronic obstructive pulmonary disease was reported in 8.4/1000 (0.9% of females and 0.8% of males).CONCLUSION: Spirometrically confirmed CAL is highly prevalent in Indian Kashmir, and seems to be related to the high prevalence of smoking, predominantly in the form of hookah smoking.
Horner A, Soriano JB, Puhan MA, et al., 2016, Altitude and COPD prevalence and other determinants: analysis of the PREPOCOL-PLATINO-BOLD-EPISCAN study, WIENER KLINISCHE WOCHENSCHRIFT, Vol: 128, Pages: 776-777, ISSN: 0043-5325
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.