Amin Wagdy, Ashmawy Rasha, Sharaf Sandy, Zeina Sally, Hammouda Esraa Abdellatif, Mohamed Nancy, Gamal Rewan, Hamr Dina Abu, Gebril Heba, Alaa Ola, Taha Ussama, El-Feel Hazem
Director of the General Administration of Chest Diseases, MoHP, Giza, Egypt.
Department of Clinical Research, Maamora Chest Hospital, MoHP, Alexandria, Egypt.
BMC Health Serv Res. 2024 Jul 31;24(1):872. doi: 10.1186/s12913-024-11107-8.
Climate change poses a significant threat to respiratory health, exacerbating conditions like asthma, Chronic Obstructive Pulmonary Disease (COPD), and respiratory infections increasing morbidity and mortality indirectly through exposure to greenhouse gases. During the 27th Climate Change Conference (COP27), the Healthy Lung Initiative (HLI) for the early detection of COPD among smokers was launched in Egypt.
We aimed to detect the prevalence and predictors of confirmed COPD among smokers and assess physicians' adherence to prescribing pulmonary function tests (PFTs) among the COP27 conference attendees.
This study utilized smokers' data from the HLI, employing a cross-sectional design with an interview-based questionnaire, supplemented by spirometry for lung function evaluation. Participants, comprising Egyptian and non-Egyptian residents in Sharm El-Sheikh city, were provided with educational materials and encouraged to seek further evaluation from a pulmonologist.
The HLI study, conducted from November 6th to 20th, 2022, involved 1133 participants, 90% (1047) of whom were smokers. Most smokers were males (96.3%) and Egyptians (98.6%), with half aged 30-39 and the majority starting smoking within the last 20 years. Despite common respiratory symptoms, 47% suffered from dyspnea on exertion, and only 4.3% have undergone lung function tests, suggesting a potential underdiagnosis of COPD. Most participants (82.6%) had an FEV1/FVC ratio > 70%, indicating no spirometry-confirmed COPD diagnosis, while 147 participants (17% of them) exhibited all three cardinal COPD symptoms simultaneously. Male gender and daily cigarette consumption were significant predictors for confirmed COPD, while age showed no significance in regression analyses.
The ongoing HLI focuses on early detection and education to combat smoking-related risks, particularly among middle-aged males, while also highlighting the need for comprehensive strategies to address the intersection of smoking and climate change.
气候变化对呼吸健康构成重大威胁，加剧了哮喘、慢性阻塞性肺疾病（COPD）和呼吸道感染等病症，通过接触温室气体间接增加发病率和死亡率。在第27届气候变化大会（COP27）期间，埃及发起了旨在早期发现吸烟者中慢性阻塞性肺疾病的健康肺倡议（HLI）。
我们旨在检测吸烟者中确诊慢性阻塞性肺疾病的患病率和预测因素，并评估第27届气候变化大会与会者中医生开具肺功能测试（PFT）的依从性。
本研究利用了健康肺倡议中吸烟者的数据，采用横断面设计，通过基于访谈的问卷进行调查，并辅以肺功能测定来评估肺功能。参与者包括沙姆沙伊赫市的埃及居民和非埃及居民，为他们提供了教育材料，并鼓励他们寻求肺科医生的进一步评估。
2022年11月6日至20日进行的健康肺倡议研究涉及1133名参与者，其中90%（1047名）为吸烟者。大多数吸烟者为男性（96.3%）和埃及人（98.6%），一半年龄在30 - 39岁之间，大多数人在过去20年内开始吸烟。尽管有常见的呼吸道症状，47%的人在运动时出现呼吸困难，只有4.3%的人进行过肺功能测试，这表明慢性阻塞性肺疾病可能存在诊断不足的情况。大多数参与者（82.6%）的第一秒用力呼气容积/用力肺活量（FEV1/FVC）比值>70%，表明没有肺功能测定确诊的慢性阻塞性肺疾病诊断，而147名参与者（占17%）同时出现了慢性阻塞性肺疾病的所有三个主要症状。男性性别和每日吸烟量是确诊慢性阻塞性肺疾病的重要预测因素，而年龄在回归分析中无显著意义。
正在进行的健康肺倡议侧重于早期发现和教育，以应对与吸烟相关的风险，特别是在中年男性中，同时也强调需要采取综合策略来应对吸烟与气候变化的交叉问题。
