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Original Research: COPD |

Prior TB, Smoking, and Airflow Obstruction: A Cross-Sectional Analysis of the Guangzhou Biobank Cohort Study

Kin-bong Hubert Lam, PhD; Chao Qiang Jiang, MD; Rachel E. Jordan, PhD; Martin R. Miller, MD; Wei Sen Zhang, MD, PhD; Kar Keung Cheng, MBBS, PhD; Tai Hing Lam, MD; Peymané Adab, MD; Latin American Project for the Investigation of Obstructive Lung Disease (PLATINO) Team
Author and Funding Information

From the Institute of Occupational and Environmental Medicine (Dr K.-b. H. Lam), University of Birmingham, UK; Guangzhou Number 12 People’s Hospital (Drs Jiang and Zhang), Guangzhou, People’s Republic of China; Unit of Public Health, Epidemiology, and Biostatistics (Drs Jordan, Cheng, and Adab), University of Birmingham, UK; Department of Medicine (Dr Miller), University Hospital Birmingham NHS Trust, Birmingham, UK; and School of Public Health (Dr T. H. Lam), The University of Hong Kong, Pokfulam, Hong Kong.

Correspondence to: Tai Hing Lam, MD, Department of Community Medicine and School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong; e-mail: hrmrlth@hkucc.hku.hk


Funding/Support: The Guangzhou Biobank Cohort Study was funded by The University of Hong Kong Foundation for Educational Development and Research, the Guangzhou Public Health Bureau, the Guangzhou Science and Technology Bureau, and The University of Birmingham.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(3):593-600. doi:10.1378/chest.09-1435
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Background:  Prior pulmonary TB has been shown to be associated with a higher risk of airflow obstruction, which is the hallmark of COPD, but whether smoking modifies this relationship is unclear. We investigated the relationships between prior TB, smoking, and airflow obstruction in a Chinese population sample.

Methods:  Participants in the Guangzhou Biobank Cohort Study underwent spirometry, chest radiography, and a structured interview on lifestyle and exposures. Prior TB was defined as the presence of radiologic evidence suggestive of inactive TB. Airflow obstruction was based on spirometric criteria.

Results:  The prevalence of prior TB in this sample (N = 8,066, mean age: 61.9 years) was 24.2%. After controlling for sex, age, and smoking exposure, prior TB remained independently associated with an increased risk of airflow obstruction (odds ratio = 1.37; 95% CI, 1.13-1.67). Further adjustment for exposure to passive smoking, biomass fuel, and dust did not alter the relationship. Smoking did not modify the relationship between prior TB and airflow obstruction.

Conclusions:  Prior TB is an independent risk factor for airflow obstruction, which may partly explain the higher prevalence of COPD in China. Clinicians should be aware of this long-term risk in individuals with prior TB, irrespective of smoking status, particularly in patients from countries with a high TB burden.

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