Proportion and clinical characteristics of non-asthmatic non-smokers among adults with airflow obstruction

Abstract

Background and objectivesChronic obstructive pulmonary disease (COPD) mainly develops after long-term exposure to cigarette or biomass fuel smoke, but also occurs in non-smokers with or without a history of asthma. We investigated the proportion and clinical characteristics of non-smokers among middle-aged to elderly subjects with airflow obstruction.MethodsWe retrospectively analyzed 1,892 subjects aged 40–89 years who underwent routine preoperative spirometry at a tertiary university hospital in Japan. Airflow obstruction was defined as a forced expiratory volume in 1 second (FEV1)/forced vital capacity < 0.7 or as the lower limit of the normal.ResultsAmong 323 patients presenting with FEV1/forced vital capacity < 0.7, 43 had asthma and 280 did not. Among the non-asthmatic patients with airflow obstruction, 94 (34%) were non-smokers. A larger number of women than men with airflow obstruction had asthma (26% vs. 7.6%, p < 0.001), or were non-smokers among non-asthmatics (72% vs. 20%, p < 0.001). Non-asthmatic non-smokers, rather than non-asthmatic smokers, asthmatic non-smokers, and asthmatic smokers, exhibited better pulmonary function (median FEV1: 79% of predicted FEV1 vs. 73%, 69%, and 66%, respectively, p = 0.005) and less dyspnea on exertion (1% vs. 12%, 12%, and 28%, respectively, p = 0.001). Pulmonary emphysema on thoracic computed tomography was less common in non-smokers (p < 0.001). Using the lower limit of the normal to define airflow obstruction yielded similar results.ConclusionsThere are a substantial number of non-smokers with airflow obstruction compatible with COPD in Japan. In this study, airflow obstruction in non-smokers was more common in women and likelier to result in mild functional and pathological abnormalities than in smokers. Further studies are warranted to investigate the long-term prognosis and appropriate management of this population in developed countries, especially in women.

The Proportion of Non-smokers in Cases of Chronic Obstructive pulmonary Disease in Padang City West Sumatra

“…In this study, the highest number of non-smokers COPD cases in men was 55.6%, this is the same as Denguezli's findings in Tunisia that cases of non-smokers COPD were male dominated by 78.3% (Denguezli et al, 2016). Different results were obtained by Hiroto Takiguchi in Japan who stated that cases of non-smokers COPD were found in women with a 72% percentage (Takiguchi et al, 2018) and Thomsen's study in Denmark with findings of non-smoking COPD cases in women by 52%. The difference in the results of this study compared to other studies may be due to different habits in the community In Indonesia, most women live at home and rarely smoke so that exposure to cigarette smoke or other pollutants is smaller than men who are often outside the home and in the work environment which causes them to be exposed to cigarette smoke both as active and passive smokers and also exposed to pollutants in travel or because of work (Brashier & Kodgule, 2012;Ngahane et al, 2015).…”

“…This data is not much different from the data from Lamprecht's study in 2011 which reported the number of non-smoking COPD cases as much as 20.5% of total COPD sufferers (Lamprecht et al, 2011) and according to Thomsen's study which reported 22%. Thomsen et al, 2013) But this data is different from the findings of Takiguchi which is 34% and the findings of denguezli are 45.1% (Denguezli et al, 2016;Takiguchi et al, 2018). The data of this study with 50 cases of COPD approached the results of a study conducted by Lamprecht with 4291 subjects conducted internationally because they were both crosssectionally conducted (Lamprecht et al, 2011).…”

“…The data of this study with 50 cases of COPD approached the results of a study conducted by Lamprecht with 4291 subjects conducted internationally because they were both crosssectionally conducted (Lamprecht et al, 2011). In contrast to Takiguchi and Denguezli's research conducted retrospectively so that the findings of the data were different (Denguezli et al, 2016;Takiguchi et al, 2018). In contrast to Thomsen's research in Denmark, despite having a prospective method, it has the same findings as this study (Thomsen et al, 2013).…”

“…(Naser , Medison, & Erly, 2016; RISKESDAS, 2013) Smoking is not the only cause of COPD, some previous studies have stated that exposure to smoke using kerosene at home, dust in the workplace, or at home can be a risk factor for occurrence COPD even though the patient has never smoked (Kurmi, Lam, & Ayres, 2012; Mahmood et al, 2017; Ngahane et al, 2015) even genetic is estimated to play a role in the occurrence of diseases today (Hasni, Siregar, & Lim, 2016;Lakhdar et al, 2010). The prevalence of COPD in the non-proxies group has been carried out several studies in various countries, in Japan by 34% (Takiguchi et al, 2018), Tunisia by 45.1% (Denguezli et al, 2016), Denmark by 22% (Thomsen, Nordestgaard, Vestbo, & Lange, 2013), Malaysia and Indonesia respectively at 21% and 27% (Salvi & Barnes, 2009). This study aims to determine the proportion of non-smokers in COPD cases in the City of Padang, Indonesia.…”

Correlation of Oral Health Status with Chronic Obstructive Pulmonary Disease in a Tertiary Care Hospital

“…It also states that impaired lung function growth in early life associated with a decline in lung function in adulthood induces COPD 5. COPD has been strongly associated with smoking and is clinically characterized by symptoms like cough, sputum production, and/or dyspnea. 6,7 The therapeutic line focuses on reducing the symptoms and preventing exacerbations of the disease. Bronchodilators are the mainstay which includes β 2 -agonists and anticholinergics, either used alone or in combination with corticosteroids.…”