Hagstad Stig, Backman Helena, Bjerg Anders, Ekerljung Linda, Ye Xiong, Hedman Linnea, Lindberg Anne, Torén Kjell, Lötvall Jan, Rönmark Eva, Lundbäck Bo
Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden; Obstructive Lung Disease In Northern Sweden (OLIN) Studies, Norrbotten County Council, Luleå, Sweden.
Obstructive Lung Disease In Northern Sweden (OLIN) Studies, Norrbotten County Council, Luleå, Sweden; Division of Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Sweden.
Respir Med. 2015 Nov;109(11):1439-45. doi: 10.1016/j.rmed.2015.09.012. Epub 2015 Sep 26.
Although active tobacco smoking is the main risk factor for COPD, COPD is not uncommon also among never-smokers. Different study locations along with different spirometric definitions of COPD have historically yielded different prevalence estimates of the disease.
To study current prevalence and risk factors of COPD among never-smokers in two areas of Sweden.
Data collected in 2008-2012 within the West Sweden Asthma Study and Obstructive Lung Disease in Northern Sweden Studies was pooled. The study population consisted of 1839 subjects who participated in spirometry and interviews. COPD was defined as post-bronchodilator a) FEV(1)/(F)VC < 0.7, b) FEV(1)/FVC < 0.7 and c) FEV(1)/FVC < lower limit of normal.
Of the 1839 subjects, 967 (52.6%) were never-smokers. Among the never-smoking subjects, the prevalence of COPD according to definitions a-c was 7.7%, 4.9% and 3.0%, respectively. The corresponding prevalence of GOLD grade ≥2 was 2.0%, 1.4% and 1.3%. No significant difference in prevalence between the two study areas was observed. In never-smokers, occupational exposure to gas, dust or fumes (GDF) was significantly associated with both COPD (OR 1.85, 95% CI 1.03-3.33), and GOLD ≥2 (OR 4.51, 1.72-11.9) according to definition a), after adjusting for age, educational level and exposure to passive smoking at work.
Depending on definition, prevalence of COPD among never-smokers was 3.0-7.7%, whereas GOLD ≥2 was present in 1.3-2.0%. Occupational exposure to GDF remained independently and significantly associated with COPD regardless of spirometric definition of the disease.
尽管主动吸烟是慢性阻塞性肺疾病（COPD）的主要危险因素，但在从不吸烟者中COPD也并不罕见。不同的研究地点以及对COPD不同的肺功能测定定义，历来会得出该疾病不同的患病率估计值。
研究瑞典两个地区从不吸烟者中COPD的当前患病率及危险因素。
汇总2008 - 2012年在瑞典西部哮喘研究和瑞典北部阻塞性肺病研究中收集的数据。研究人群包括1839名参加肺功能测定和访谈的受试者。COPD的定义为支气管扩张剂使用后：a）第1秒用力呼气容积（FEV₁）/用力肺活量（FVC）<0.7，b）FEV₁/FVC<0.7，c）FEV₁/FVC<正常下限。
在1839名受试者中，967名（52.6%）为从不吸烟者。在从不吸烟的受试者中，根据定义a - c，COPD的患病率分别为7.7%、4.9%和3.0%。慢性阻塞性肺疾病全球倡议（GOLD）≥2级的相应患病率分别为2.0%、1.4%和1.3%。未观察到两个研究地区患病率的显著差异。在从不吸烟者中，根据定义a），在调整年龄、教育水平和工作时被动吸烟暴露后，职业性接触气体、粉尘或烟雾（GDF）与COPD（比值比[OR]1.85，95%置信区间[CI]1.03 - 3.33）和GOLD≥2（OR 4.51，1.72 - 11.9）均显著相关。
根据定义，从不吸烟者中COPD的患病率为3.0% - 7.7%，而GOLD≥2级为1.3% - 2.0%。无论对该疾病的肺功能测定定义如何，职业性接触GDF仍然与COPD独立且显著相关。
