Chronic Obstructive Pulmonary Disease Prevalence and Associated Risk Factors in Adults Aged 40 Years and Older in Southeast China: A Cross-Sectional Study During 2019–2020

Abstract

Purpose

Chronic obstructive pulmonary disease (COPD) is one of many major public health problems in China, and its prevalence and associated risk factors in the southeast of China need to be determined to facilitate disease control and prevention.

Methods

A multistage stratified cluster sampling method was used to select 5486 participants aged ≥ 40 years from nine COPD monitoring districts in Fujian Province during 2019–2020. Participants were interviewed using a laptop-based questionnaire and underwent pulmonary function tests. COPD was diagnosed according to the 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.

Results

Final analysis was conducted using data from 4999 participants with qualified post-bronchodilator results. The prevalence of COPD was 11.6% (95% confidence interval [CI]: 10.5–12.7). Risk factors for COPD in the logistic regression model were being male (odds ratio [OR] = 2.83, 95% CI: 2.01–3.98), > 70 years old (OR = 16.16, 95% CI: 8.14–32.08), having a low body mass index (BMI) (OR = 1.81, 95% CI: 1.13–2.89), parental history of respiratory disease (OR = 1.78, 95% CI: 1.50–2.10), being a current (OR = 2.82, 95% CI: 1.83–4.36) or former (OR = 2.47, 95% CI: 1.45–4.19) smoker, and indoor exposure to biomass (OR = 1.28, 95% CI: 1.05–1.58).

Conclusion

The estimated prevalence of COPD in southeast China is high. COPD was strongly associated with sex, aging, a low BMI, parental history of respiratory diseases, smoking, and indoor exposure to biomass in adults aged ≥ 40 years. The government should urgently implement comprehensive measures to reduce the risk factors for COPD.

Keywords:

• COPD
• logistic models
• biomass
• public health
• smoking
• surveys and questionnaires

Abbreviations

BMI, Body Mass Index; CDC, Center for Disease Control and Prevention; CI, confidence interval; COPD, Chronic Obstructive Pulmonary Disease; FEV1, Forced Expiratory Volume in 1s; FVC, Forced Vital Capacity; GOLD, Global Initiative for Chronic Obstructive Lung Disease; OR, Odds Ratio; PPS, Probability Proportional Sampling; WHO, World Health Organization.

Data Sharing Statement

The datasets used during the current study are available from the corresponding author on reasonable request.

Acknowledgments

The authors would like to thank all the health staff members in CDC and health institutions joined in this survey in nine COPD monitoring districts in Fujian Province. Special thanks to all the study individuals who agreed to participate in this study. We also thank Chronic Disease Center of China CDC for supporting this research.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

This work was supported by grants from Fujian Province Pilot Project (2020Y0060), Scientific and Technology Innovation Platform Construction of Fujian Province (2019Y2001), Fujian Provincial Health Youth Project (2017-2-13), Fujian Provincial Center for Disease Control and Prevention Science and Technology Project. The funder of this survey had no role in study design, data collection, data analysis, data interpretation or writing this manuscript.

Disclosure

The authors report no conflicts of interest in this work.