Chronic Obstructive Pulmonary Disease (COPD) seems to be increasing in low-income and middle-income countries. The aim of the present study was to determine the prevalence of chronic airway obstruction in Mexico in a population with risk factors for COPD.
Individuals 40 years or older with known risk factors for COPD (smoking, indoor pollution from biomass cooking and occupational dusts and chemicals) whether symptomatic or not, were referred by first-contact physicians in 27 Mexican cities. After obtaining written informed consent they were invited to answer a questionnaire and undergo pre and postbronchodilator spirometry. We defined COPD as a postbronchodilator FEV1/FVC < 0.7.
A total of 2,617 subjects were referred for evaluation; 2,293 (87.6%) had an acceptable spirometry (at least 3 FVC and FEV-1 maneuvers reproducible within 150 mL). 472 of them (20.6%) had a FEV1/FVC < 70%. COPD rate in males (24.1%) was significantly higher than in females (18.3%; p = 0.001). According to the GOLD classification, 20.3% had stage I COPD, 46.0% stage II, 26.1% stage III and 7.6% stage IV. COPD patients had smoked for a significantly higher number of years (31.8+16.6) than non COPD patients (22.7+12.1, p < 0.001) and also smoked a significantly higher number of cigarettes per day (18.5+10.3 vs. 12.9+13.6, p < 0.001). COPD patients had also a significantly more frequent history of exposure to biomass smoke (23.3%) than non-COPD subjects (18.3%, p = 0.002); females have been exposed to biomass smoke more frequently (56.3% vs. 30.1%, p < 0.001) and for more years (24+23.1 vs. 18.6+15.7; p < 0.001) than males. Despite being symptomatic and/or having risk factors for COPD only 256 (11.3%) had a spirometry in the past. Only 9.3% of current smokers had received advice to quit smoking from their physician.
About a fifth of primary health care patients with exposure risks for COPD with or without symptoms have irreversible airflow obstruction. Main exposures observed were smoking and cooking with wood stoves.
COPD in Mexico is underdiagnosed and as a consequence it goes untreated, including smoking cessation interventions.
Rafael Laniado-Laborin, Consultant fee, speaker bureau, advisory committee, etc. During the last 12 months I have received fees from Glaxo-Smith-Kline (250 pounds) to participate on an advisory committee for COPD related products. Our current presentation includes only epidemiological information on the prevalence of disease in Mexico. We will NOT be discussing information about any diagnostic or therapeutic product/procedure/technique either already approved for its use or that is considered research and is NOT yet approved for any purpose.; No Product/Research Disclosure Information