Prevalence and Population-Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study

BOLD Collaborative Research Group

doi:10.1164/rccm.202005-1990OC

Prevalence and Population-Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study

BOLD Collaborative Research Group

Medicine, General Medicine Division

Research output: Contribution to journal › Article › peer-review

65 Scopus citations

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.

Original language	English (US)
Pages (from-to)	1353-1365
Number of pages	13
Journal	American journal of respiratory and critical care medicine
Volume	203
Issue number	11
DOIs	https://doi.org/10.1164/rccm.202005-1990OC
State	Published - Jun 1 2021

Funding

Supported by Wellcome Trust grant 085790/Z/08/Z for the BOLD (Burden of Obstructive Lung Disease) study. The initial BOLD program was funded in part by unrestricted educational grants to the Operations Center in Portland, Oregon, from Altana, Aventis, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Merck, Novartis, Pfizer, Schering-Plough, Sepracor, and the University of Kentucky (Lexington, Kentucky). A full list of local funders can be found at https://www.boldstudy.org. GlaxoSmithKline, Merck Sharpe & Dohme, Novartis, Salzburger Gebietskrankenkasse and Salzburg Local Government (Salzburg, Austria); Research for International Tobacco Control, the International Development Research Centre, the South African Medical Research Council, the South African Thoracic Society GlaxoSmithKline Pulmonary Research Fellowship, and the University of Cape Town Lung Institute (Cape Town, South Africa); and Landspítali-University Hospital-Scientific Fund, GlaxoSmithKline Iceland, and AstraZeneca Iceland (Reykjavik, Iceland); GlaxoSmithKline Pharmaceuticals, Polpharma, Ivax Pharma Poland, AstraZeneca Pharma Poland, ZF Altana Pharma, Pliva Kraków, Adamed, Novartis Poland, Linde Gaz Polska, Lek Polska, Tarchomińskie Zakłady Farmaceutyczne Polfa, Starostwo Proszowice, Skanska, Zasada, Agencja Mienia Wojskowego w Krakowie, Telekomunikacja Polska, Biernacki, Biogran, Amplus Bucki, Skrzydlewski, Sotwin, and Agroplon (Cracow, Poland); Boehringer-Ingelheim, and Pfizer Germany (Hannover, Germany); the Norwegian Ministry of Health’s Foundation for Clinical Research, and Haukeland University Hospital’s Medical Research Foundation for Thoracic Medicine (Bergen, Norway); AstraZeneca, Boehringer-Ingelheim, Pfizer, and GlaxoSmithKline (Vancouver, Canada); Marty Driesler Cancer Project (Lexington, Kentucky); Altana, Boehringer Ingelheim (Phil), GlaxoSmithKline, Pfizer, Philippine College of Chest Physicians, Philippine College of Physicians, and United Laboratories (Phil) (Manila, Philippines); Air Liquide Healthcare P/L, AstraZeneca P/L, Boehringer Ingelheim P/L, GlaxoSmithKline Australia P/L, Pfizer Australia P/L (Sydney, Australia), Department of Health Policy Research Programme, Clement Clarke International (London, UK); Boehringer Ingelheim and Pfizer (Lisbon, Portugal), Swedish Heart and Lung Foundation, The Swedish Association against Heart and Lung Diseases, Glaxo Smith Kline (Uppsala, Sweden), Seed Money Grant (PF20/0512), Aga Khan University, and Chiesi Pakistan (Pvt.) Limited (Karachi, Pakistan).

Keywords

Burden of Obstructive Lung Disease (BOLD) study
Chronic airflow obstruction
Multinational study
Population-attributable risk

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1164/rccm.202005-1990OC

Cite this

@article{84b43592ec494ca584cbb8f8cc0760c4,

title = "Prevalence and Population-Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study",

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.",

keywords = "Burden of Obstructive Lung Disease (BOLD) study, Chronic airflow obstruction, Multinational study, Population-attributable risk",

author = "{BOLD Collaborative Research Group} and Peter Burney and Jaymini Patel and Cosetta Minelli and Louisa Gnatiuc and Amaral, {Andr{\'e} F.S.} and Ali Kocaba{\c s} and Cherkaski, {Hamid Hacene} and Amund Gulsvik and Rune Nielsen and Eric Bateman and Anamika Jithoo and Kevin Mortimer and Sooronbaev, {Talant M.} and Herv{\'e} Lawin and Chakib Nejjari and Mohammed Elbiaze and {El Rhazi}, Karima and Zheng, {Jin Ping} and Pixin Ran and Tobias Welte and Daniel Obaseki and Gregory Erhabor and Asma Elsony and Osman, {Nada Bakri} and Rana Ahmed and Ewa Nizankowska-Mogilnicka and Filip Mejza and Mannino, {David M.} and Cristina B{\'a}rbara and Wouters, {Emiel F.M.} and Idolor, {Luisito F.} and Loh, {Li Cher} and Abdul Rashid and Sanjay Juvekar and Thorarinn Gislason and {Al Ghobain}, Mohamed and Michael Studnicka and Imed Harrabi and Meriam Denguezli and Koul, {Parvaiz A.} and Christine Jenkins and Guy Marks and Rain J{\~o}gi and Hasan Hafizi and Christer Janson and Tan, {Wan C.} and Althea Aquart-Stewart and Bertrand Mbatchou and Nafees, {Asaad Ahmed} and Weiss, {Kevin B.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2021 by the American Thoracic Society",

year = "2021",

month = jun,

day = "1",

doi = "10.1164/rccm.202005-1990OC",

language = "English (US)",

volume = "203",

pages = "1353--1365",

journal = "American journal of respiratory and critical care medicine",

issn = "1073-449X",

publisher = "American Thoracic Society",

number = "11",

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TY - JOUR

T1 - Prevalence and Population-Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study

AU - BOLD Collaborative Research Group

AU - Burney, Peter

AU - Patel, Jaymini

AU - Minelli, Cosetta

AU - Gnatiuc, Louisa

AU - Amaral, André F.S.

AU - Kocabaş, Ali

AU - Cherkaski, Hamid Hacene

AU - Gulsvik, Amund

AU - Nielsen, Rune

AU - Bateman, Eric

AU - Jithoo, Anamika

AU - Mortimer, Kevin

AU - Sooronbaev, Talant M.

AU - Lawin, Hervé

AU - Nejjari, Chakib

AU - Elbiaze, Mohammed

AU - El Rhazi, Karima

AU - Zheng, Jin Ping

AU - Ran, Pixin

AU - Welte, Tobias

AU - Obaseki, Daniel

AU - Erhabor, Gregory

AU - Elsony, Asma

AU - Osman, Nada Bakri

AU - Ahmed, Rana

AU - Nizankowska-Mogilnicka, Ewa

AU - Mejza, Filip

AU - Mannino, David M.

AU - Bárbara, Cristina

AU - Wouters, Emiel F.M.

AU - Idolor, Luisito F.

AU - Loh, Li Cher

AU - Rashid, Abdul

AU - Juvekar, Sanjay

AU - Gislason, Thorarinn

AU - Al Ghobain, Mohamed

AU - Studnicka, Michael

AU - Harrabi, Imed

AU - Denguezli, Meriam

AU - Koul, Parvaiz A.

AU - Jenkins, Christine

AU - Marks, Guy

AU - Jõgi, Rain

AU - Hafizi, Hasan

AU - Janson, Christer

AU - Tan, Wan C.

AU - Aquart-Stewart, Althea

AU - Mbatchou, Bertrand

AU - Nafees, Asaad Ahmed

AU - Weiss, Kevin B.

PY - 2021/6/1

Y1 - 2021/6/1

N2 - 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.

AB - 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.

KW - Burden of Obstructive Lung Disease (BOLD) study

KW - Chronic airflow obstruction

KW - Multinational study

KW - Population-attributable risk

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U2 - 10.1164/rccm.202005-1990OC

DO - 10.1164/rccm.202005-1990OC

M3 - Article

C2 - 33171069

AN - SCOPUS:85107550887

SN - 1073-449X

VL - 203

SP - 1353

EP - 1365

JO - American journal of respiratory and critical care medicine

JF - American journal of respiratory and critical care medicine

IS - 11

ER -

Prevalence and Population-Attributable Risk for Chronic Airflow Obstruction in a Large Multinational Study

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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