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Allergy and Airway |

Clinical Characteristics of Chronic Obstructive Pulmonary Disease in Nonsmoking Subjects

Prem Parkash Gupta, MD; Rohtas Yadav, MD; Sumit Mittal, MBBS; Dipti Agarwal, MD
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Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India


Chest. 2014;146(4_MeetingAbstracts):20A. doi:10.1378/chest.1976421
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Abstract

SESSION TITLE: COPD Diagnosis and Evaluation Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: To assess proportion of non-smokers among COPD patients attending a COPD Clinic at a tertiary level medical college hospital and to evaluate associated risk factors, clinical characteristics and spirometric indices in these non-smoking COPD subjects.

METHODS: We assessed 507 COPD patients (men, 404 and women, 103) attending a COPD Clinic and diagnosed as per GOLD guidelines. 63 out of 507 patients (men, 16 and women, 47) had no smoking history. Risk factors associated with COPD in these non-smoking patients were assessed. Patients` clinical data was collected and spirometric indices were studied.

RESULTS: Out of all 507 COPD patients, 12.4% were non-smokers; 45.6% of women and 3.9% of men were non-smokers. The mean age of non-smoking COPD patients was 58.43 ± 11.75 years. The duration of illness was 7.81 ± 7.06 years. 45/63 patients had a semi-urban background. The risk factors associated with non-smoking COPD were: cooking using solid fuel (85.7%), occupational exposure (84.1%), passive smoking (ETS) (76.2%), heating using solid fuel (74.6%), and air pollution only in (23.8%) of patients. In women, most frequent risk factor was cooking smoke followed by occupational exposure, whereas in men, most frequent risk factor was occupational exposure followed by passive smoking. Organic dust related occupations were most commonly related to COPD. 7.9% of non-smoking COPD patients had a past history of respiratory problems prior to age 10. Dyspnoea was most frequent (95.2%) symptom, followed by cough (93.75%). Wheezing was observed in 25.4% of non-smoking COPD patients. FEV1 in non-smoking COPD patients had inverse correlations with passive smoking, occupational exposure, exposure to cooking smoke, exposure to heating smoke and prior history of asthma; however, there was no correlation with BMI or socioeconomic status. Regression analysis showed that model of all risk factors taken strongly predicted FEV1 in these patients.

CONCLUSIONS: We observed that 12.4% of COPD patients had no smoking history. Non-smoking COPD was more frequent in women. We were able to assess various risk factors related to COPD in non-smoker patients and predicting its severity.

CLINICAL IMPLICATIONS: The identification of risk factors and clinical characteristics in non-smoking COPD patients is important for prevention, early diagnosis and better management of COPD including avoidance of causative agents wherever feasible.

DISCLOSURE: The following authors have nothing to disclose: Prem Parkash Gupta, Rohtas Yadav, Sumit Mittal, Dipti Agarwal

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