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Communications to the Editor |

Detection of COPD in High-Risk Populations FREE TO VIEW

Konstantinos I. Gourgoulianis, MD; Konstantinos Hristou, MD; Paschalis A. Molyvdas, MD
Author and Funding Information

Affiliations: Medical School, University of Thessaly Larissa, Greece,  National Research Institute of Tuberculosis and Lung Disease Warsaw, Poland

Correspondence to: Konstantinos I. Gourgoulianis, MD, Pulmonologist, Associate Professor, Medical School, University of Thessaly, 22 Papakyriazi, 41222 Larissa, Greece; e-mail: Kgourg@med.uth.gr



Chest. 2002;121(5):1721. doi:10.1378/chest.121.5.1721
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Published online

To the Editor:

Recently, Zielinski and Bednarek1showed that mass spirometry in high-risk groups such as smokers is an effective and easy method for the early detection of COPD. Except smokers, high-risk groups are minorities such as Gypsies and industrial workers. We reported that approximately 50% of 121 Gypsies aged 14 to 70 years who lived in a campsite in central Greece had abnormal spirometry findings. Approximately 70% of these subjects were smokers, and their diet was rich in alcohol and poor in antioxidants such as oranges and vegetables.2Our group also examined approximately 1,000 subjects aged > 55 years who lived in rural or industrial areas. The first published data showed that chronic bronchitis in industrial workers (17.1%) was about twice as frequent than in farmers (9.6%). Smoking habits were the same in industrial workers and farmers.3 The main finding of our studies was that 50% of COPD patients who received the diagnosis for the first time from their history, clinical examination, and spirometry never had visited a physician. %In contrast to epidemiologic studies that estimate the frequency of COPD based on mortality, the direct studies using spirometric screening will show the true dimensions of the COPD problem. There are two additional points we would like to make with this letter. First, high-risk populations for COPD are also minorities and people with occupational exposure. Second, pulmonary outpatient clinics, in addition to spirometric screening, must organize educational programs and preventive strategies on smoking cessation, pollution control, and dietary habits.

Zielinski, J, Bednarek, M (2001) Know the age of your lung study group: early detection of COPD in a high-risk population using spirometric screening.Chest119,731-736. [PubMed] [CrossRef]
 
Gourgoulianis, KI, Tsoutsou, P, Fotiadou, N, et al Lung function in Gypsies in Greece.Arch Environ Health2000;55,453-454. [PubMed]
 
Gourgoulianis, KI, Katicos, P, Moraitis, M, et al Chronic bronchitis in rural and industrial areas.Ann Agric Environ Med2000;7,29-31. [PubMed]
 
To the Editor:

Thank you for your interest in our study and pointing out additional risk factors for the development of COPD. I agree with you that only epidemiologic studies including spirometry may show the true prevalence of COPD, which seems to be higher than previously estimated. Such studies were recently completed in the United States1and Europe.23

Projections of trends in mortality from the most important causes of death also clearly show that COPD is an enemy of public health and is gaining ground worldwide.4The recent initiative for global management of COPD recently published by the World Health Organization/National Heart, Lung, and Blood Institute5 also draws professional and public attention to that deadly disease.

I also agree with you that to control COPD in the future, development of effective smoking cessation and clean air programs are of utmost importance.

References
Mannino, DM, Gagnon, RC, Petty, TL Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey, 1988–1994.Arch Intern Med2000;160,1683-1689. [PubMed] [CrossRef]
 
Cerveri, I, Accordini, S, Verlato, G, et al Prevalence of obstructive lung disease in a general population: relation to occupational title and exposure to some airborne agents.Thorax1991;46,863-870. [PubMed]
 
Bakke, PS, Baste, V, Hanon, R, et al Variations in the prevalence across countries of chronic bronchitis and smoking habits in young adults.Eur Respir J2001;18,85-92. [PubMed]
 
Murray, CLJ, Lopez, AD Alternative projection of mortality and disability by cause, 1990–2020: global burden of disease study.Lancet1997;394,1498-1504
 
Pauwels, RA, Buist, AS, Calverely, PMA, et al Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: National Heart, Lung, and Blood Institute and World Health Organization global initiative for chronic obstructive lung disease (GOLD); executive summary.Am J Respir Crit Care Med2001;163,1256-1276. [PubMed]
 

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References

Zielinski, J, Bednarek, M (2001) Know the age of your lung study group: early detection of COPD in a high-risk population using spirometric screening.Chest119,731-736. [PubMed] [CrossRef]
 
Gourgoulianis, KI, Tsoutsou, P, Fotiadou, N, et al Lung function in Gypsies in Greece.Arch Environ Health2000;55,453-454. [PubMed]
 
Gourgoulianis, KI, Katicos, P, Moraitis, M, et al Chronic bronchitis in rural and industrial areas.Ann Agric Environ Med2000;7,29-31. [PubMed]
 
Mannino, DM, Gagnon, RC, Petty, TL Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey, 1988–1994.Arch Intern Med2000;160,1683-1689. [PubMed] [CrossRef]
 
Cerveri, I, Accordini, S, Verlato, G, et al Prevalence of obstructive lung disease in a general population: relation to occupational title and exposure to some airborne agents.Thorax1991;46,863-870. [PubMed]
 
Bakke, PS, Baste, V, Hanon, R, et al Variations in the prevalence across countries of chronic bronchitis and smoking habits in young adults.Eur Respir J2001;18,85-92. [PubMed]
 
Murray, CLJ, Lopez, AD Alternative projection of mortality and disability by cause, 1990–2020: global burden of disease study.Lancet1997;394,1498-1504
 
Pauwels, RA, Buist, AS, Calverely, PMA, et al Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: National Heart, Lung, and Blood Institute and World Health Organization global initiative for chronic obstructive lung disease (GOLD); executive summary.Am J Respir Crit Care Med2001;163,1256-1276. [PubMed]
 
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