Abstract

Investigating COPD trends may help healthcare providers to forecast future disease burden. We estimated sex- and smoking-specific incidence trends of pre-bronchodilator airflow obstruction (AO) among adults without asthma from 11 European countries within a 20-year follow-up (ECRHS and SAPALDIA cohorts). We also quantified the extent of misclassification in the definition based on pre-bronchodilator spirometry (using post-bronchodilator measurements from a subsample of subjects) and we used this information to estimate the incidence of post-bronchodilator AO (AOpost-BD), which is the primary characteristic of COPD. AO incidence was 4.4 (95% CI: 3.5–5.3) male and 3.8 (3.1–4.6) female cases/1,000/year. Among ever smokers (median pack-years: 20, males; 12, females), AO incidence significantly increased with ageing in men only [incidence rate ratio (IRR), 1-year increase: 1.05 (1.03–1.07)]. A strong exposure-response relationship with smoking was found both in males [IRR, 1-pack-year increase: 1.03 (1.02–1.04)] and females [1.03 (1.02–1.05)]. The positive predictive value of AO for AOpost-BD was 59.1% (52.0–66.2%) in men and 42.6% (35.1–50.1%) in women. AOpost-BD incidence was 2.6 (1.7–3.4) male and 1.6 (1.0–2.2) female cases/1,000/year. AO incidence was considerable in Europe and the sex-specific ageing-related increase among ever smokers was strongly related to cumulative tobacco exposure. AOpost-BD incidence is expected to be half of AO incidence.

Details

Title
Incidence trends of airflow obstruction among European adults without asthma: a 20-year cohort study
Author
Accordini Simone 1   VIAFID ORCID Logo  ; Calciano Lucia 1 ; Marcon Alessandro 1 ; Pesce Giancarlo 2   VIAFID ORCID Logo  ; Antó, Josep M 3 ; Beckmeyer-Borowko, Anna B 4 ; Anne-Elie, Carsin 5 ; Corsico, Angelo G 6 ; Imboden Medea 4 ; Janson Christer 7 ; Keidel, Dirk 4 ; Locatelli, Francesca 1 ; Svanes Cecilie 8 ; Burney Peter G J 9 ; Jarvis, Deborah 9 ; Probst-Hensch, Nicole M 4 ; Minelli Cosetta 10 

1  University of Verona, Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, Verona, Italy (GRID:grid.5611.3) (ISNI:0000 0004 1763 1124) 
2  University of Verona, Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, Verona, Italy (GRID:grid.5611.3) (ISNI:0000 0004 1763 1124); Sorbonne Universités, INSERM UMR-S 1136, IPLESP, Team EPAR, Paris, France (GRID:grid.503257.6) (ISNI:0000 0000 9776 8518) 
3  ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (GRID:grid.503257.6); Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (GRID:grid.20522.37) (ISNI:0000 0004 1767 9005); CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); Universitat Pompeu Fabra (UPF), Barcelona, Spain (GRID:grid.5612.0) (ISNI:0000 0001 2172 2676) 
4  Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Basel, Switzerland (GRID:grid.416786.a) (ISNI:0000 0004 0587 0574); University of Basel, Basel, Switzerland (GRID:grid.6612.3) (ISNI:0000 0004 1937 0642) 
5  ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (GRID:grid.6612.3); CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); Universitat Pompeu Fabra (UPF), Barcelona, Spain (GRID:grid.5612.0) (ISNI:0000 0001 2172 2676) 
6  IRCCS ‘San Matteo’ Hospital Foundation-University of Pavia, Division of Respiratory Diseases, Pavia, Italy (GRID:grid.419425.f) (ISNI:0000 0004 1760 3027) 
7  Uppsala University, Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala, Sweden (GRID:grid.8993.b) (ISNI:0000 0004 1936 9457) 
8  University of Bergen, Centre for International Health, Department of Global Public Health and Primary Care, Bergen, Norway (GRID:grid.7914.b) (ISNI:0000 0004 1936 7443); Haukeland University Hospital, Department of Occupational Medicine, Bergen, Norway (GRID:grid.412008.f) (ISNI:0000 0000 9753 1393) 
9  Imperial College London, Population Health and Occupational Disease, National Heart and Lung Institute, London, UK (GRID:grid.7445.2) (ISNI:0000 0001 2113 8111); Imperial College London, MRC-PHE Centre for Environment and Health, London, UK (GRID:grid.7445.2) (ISNI:0000 0001 2113 8111) 
10  Imperial College London, Population Health and Occupational Disease, National Heart and Lung Institute, London, UK (GRID:grid.7445.2) (ISNI:0000 0001 2113 8111) 
Publication year
2020
Publication date
2020
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-020-60478-5
ProQuest document ID
2365156161
Copyright
This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.