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Urbanization and Daily Exposure to Biomass Fuel Smoke Both Contribute to Chronic Bronchitis Risk in a Population with Low Prevalence of Daily Tobacco Smoking

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dc.contributor.author Miele, Catherine H.
dc.contributor.author Jaganath, Devan
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Bernabe-Ortiz, Antonio
dc.contributor.author Gilman, Robert H.
dc.contributor.author Johnson, Caroline M.
dc.contributor.author Diette, Gregory B.
dc.contributor.author Wise, Robert A.
dc.contributor.author Checkley, William
dc.date.accessioned 2019-02-06T14:52:17Z
dc.date.available 2019-02-06T14:52:17Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5295
dc.description.abstract OBJECTIVE: Risk factors beyond tobacco smoking associated with chronic bronchitis are not well understood. We sought to describe the prevalence and risk factors of chronic bronchitis across four distinct settings in Peru with overall low prevalence of tobacco smoking yet varying degrees of urbanization, daily exposure to biomass fuel smoke and living at high altitude. METHODS: We analyzed data of 2,947 participants from rural and urban Puno, Lima and Tumbes including spirometry, blood samples, anthropometry and administered questionnaires about respiratory symptoms. We used multivariable Poisson regression to assess biologic, socioeconomic and environmental risk factors associated with chronic bronchitis. RESULTS: Overall prevalence of chronic bronchitis was 5.9% (95%CI 5.1%-6.9%) with variation by setting: prevalence was lower in semi-urban Tumbes (1.3%) vs. highly urbanized Lima (8.9%), urban Puno (7.0%) and rural Puno (7.8%; p < 0.001). Chronic bronchitis was more common among participants with vs. without COPD based on FEV1/FVC< LLN (12.1% vs 5.6%, p < 0.01) and it was associated with increased reporting of dyspnea on exertion (p < 0.001), hospitalization (p = 0.003) and workdays missed due to respiratory symptoms (p < 0.001). Older age (Prevalence ratio [PR] = 1.23 for each 10-years of age, 95%CI 1.09-1.40) past history of asthma (PR = 2.87, 95%CI 1.80-4.56), urbanization (PR = 3.34, 95%CI 2.18-5.11) and daily exposure to biomass fuel smoke (PR = 2.00, 95%CI 1.30-3.07) were all associated with chronic bronchitis. CONCLUSIONS: We found important variations in the prevalence of chronic bronchitis across settings. Prevalence increased with both urbanization and with daily exposure to biomass fuel smoke. Having chronic bronchitis was also associated with worse patient-centered outcomes including dyspnea, hospitalization and missed workdays. en_US
dc.language.iso eng
dc.publisher Taylor & Francis
dc.relation.ispartof urn:issn:1541-2563
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Middle Aged en_US
dc.subject Peru/epidemiology en_US
dc.subject Prevalence en_US
dc.subject Risk Factors en_US
dc.subject COPD en_US
dc.subject biomass fuel en_US
dc.subject urbanization en_US
dc.subject tobacco en_US
dc.subject pollution en_US
dc.subject Rural Population en_US
dc.subject Biomass en_US
dc.subject Spirometry en_US
dc.subject Air Pollutants/adverse effects en_US
dc.subject Bronchitis, Chronic/epidemiology/etiology en_US
dc.subject chronic bronchitis en_US
dc.subject respiratory disease en_US
dc.subject Smoking/adverse effects/epidemiology en_US
dc.subject Urbanization/trends en_US
dc.title Urbanization and Daily Exposure to Biomass Fuel Smoke Both Contribute to Chronic Bronchitis Risk in a Population with Low Prevalence of Daily Tobacco Smoking en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.3109/15412555.2015.1067765
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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