Central Data Catalog

Abstract
COPD is a growing cause of morbidity and mortality across the world. However, there is little data on the burden of COPD in India, especially in the rural population.

Aim: We aimed to study the prevalence and risk factors for COPD in a rural population in India using the Burden of Obstructive Lung Disease (BOLD) study protocol.

Methods: 3600 male and female subjects above the age of 25 yrs residing in 22 rural villages near Pune were randomly selected to participate in the study. 10 trained field workers visited their homes, and after obtaining written informed consent, administered the BOLD questionnaire and performed pre and post-bronchodilator spirometry using ndd sprirometer. COPD was defined as post-bronchodilator FEV1/FVC <70%.

Results: 2699 subjects (M: 49.9%; F: 50.1%) with a mean age 43.8±14.5 yrs consented. Acceptable spirometry was obtained from 1745 subjects. The overall prevalence of COPD was found to be 5.1% (M-6.5%; F-3.4%) and 85% of these never smoked. Male gender [Adj OR: 1.93 (CI 1.2-3.3); p=0.01] and increasing age [OR: 2.01 (CI 1.7-2.4); p<0.0001) were strongly associated with COPD. 70% of the COPDs lived in homes that used biomass fuel for cooking compared to 30% who used liquefied petroleum gas (LPG). Tobacco smoking on its own was significantly associated with COPD [OR: 2.34 (CI: 1.2-4.3); p=0.006], however, after adjustment, the risk reduced [Adj OR: 1.88 (CI: 0.96-3.7); p=0.06]. Smokers who used biomass fuel had a 3.2-fold higher prevalence of COPD than non-smokers using LPG (p=0.01).

Conclusion: COPD is more common amongst non-smokers in the rural population in India although smoking is a risk factor for COPD. Smokers who use biomass fuel for cooking have a significant additive risk of COPD.