Prevalence and Risk Factors for COPD in an Urbanizing Rural Area in Western China: A Cross-Sectional Study

Abstract

Purpose

To investigate the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) in a rural area in western China with severe air pollution.

Patients and Methods

10% of local residents aged 40 years and above were included using a convenience sampling method. This was a cross-sectional study. A self-designed questionnaire was used to collect participants’ demographic data. The screening program was comprised of two steps: First, a portable electronic spirometer was used for COPD screening. Those participants with FEV₁/FVC ratio <0.7 were then referred to a confirmatory pulmonary function (PF) test. COPD was confirmed according to the 2020 Global Initiative for Chronic Obstructive Lung Disease criteria.

Results

A total of 4577 participants aged 40 years old or above were included in the final analysis. Examination with a mobile spirometer identified 1159 individuals for confirmatory testing; after that, of the 1159 individuals, 889 were diagnosed with COPD by the confirmatory PF test. The prevalence of COPD among the target group was 19.4%. Older age, male sex (odds ratio [OR] = 1.537, 95% confidence interval [CI] 1.246–1.894), smoking history (OR = 1.338, 95% CI 1.069–1.675), family history of respiratory disease (OR = 1.625, 95% CI 1.350–1.957), education level (OR = 0.735, 95% CI 0.617–0.876), overweight (OR = 0.614, 95% CI 0.517–0.730) and obesity (OR = 0.572, 95% CI 0.449–0.721) were identified as independent factors associated with COPD. The screening program helped earlier detection of COPD in 719 participants.

Conclusion

COPD was highly prevalent in the rural area studied. Rural residents who were older, current or ever-smokers, male and those who had a lower education level were more vulnerable to developing COPD. The COPD screening program may be helpful for earlier disease detection in rural health-care settings.

Keywords:

• chronic obstructive pulmonary disease
• prevalence
• primary care
• pulmonary function test
• risk factors

Ethical Approval

This project was approved by the Ethics Committee on Biomedical Research West China Hospital of Sichuan University (Ethical No. 2019-065). The study was conducted in accordance with the Declaration of Helsinki.

Acknowledgments

For continuous support, assistance, cooperation, and participation, we thank the local committees in the villages and districts in Jianyang, Sichuan Province, China. We thank Benjamin Knight, MSc., from Liwen Bianji (Edanz) (www.liwenbianji.cn) for editing the English text of a draft of this manuscript.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by West China Nursing Discipline Development Special Fund Project, Sichuan University (Grant NO. HXHL19034); 1-3-5 Project for Disciplines of Excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (Grant NO. 2018HXFH031); Chengdu Municipal Health Commission (Grant NO.2020116); Science and Technology of Sichuan Province (Grant NO. 2021YFS0130). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.