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1 Division of Respiratory Diseases, IRCCS Policlinico S. Matteo and 4 Dept of Applied Health Sciences, University of Pavia, Pavia, 2 Unit of Epidemiology and Medical Statistics, University of Verona, Verona, 3 Cardio-Thoracic Dept, University and Hospital of Pisa, and 5 CNR Institute of Clinical Physiology, Pisa, Italy
CORRESPONDENCE: I. Cerveri, Division of Respiratory Diseases, IRCCS Policlinico S. Matteo, University of Pavia, via Taramelli 5, 27100, Pavia, Italy. Fax: 39 0382 423150. E-mail: i.cerveri@libero.it
Keywords: chronic obstructive pulmonary disease, cross-sectional studies, health surveys, risk factors, smoking
Received: December 27, 2002
Accepted May 15, 2003
This work was partially supported by grants from: Italian Ministry of University Scientific and Technological Research (MURST); GlaxoSmithKline Italia; National Health Service, AUSL Ferrara; National Health Service, AUSL Pavia; National Health Service, ASL 4 Turin; IRCCS Policlinico S. Matteo; Municipality of Udine; Councillorship for Health, Modena Province; Pavia Province; Siracusa Province; Veneto Region.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underline that the presence of chronic cough and sputum production before airflow obstruction offers a unique opportunity to identify subjects at risk of chronic obstructive pulmonary disease for an early intervention. Current epidemiological data on these subjects are scant.
Between 19982000, the authors evaluated the prevalence and characteristics of these symptoms by a multicentre cross-sectional survey of Italian people aged between 2044 yrs from the general population (Italian Study on Asthma in Young Adults (ISAYA)). Besides the questions on asthma, more than 18,000 subjects answered the question: "Have you had cough and phlegm on most days for as much as 3 months per year and for at least two successive years?"
The adjusted prevalence of subjects with chronic cough and phlegm was 11.9%, being 11.8% in males and 12.0% in females. From these subjects
The prevalence of subjects with chronic cough and phlegm is startlingly high among young adults. Further follow-up studies are needed to establish how many of them will go on to develop chronic obstructive pulmonary disease.
20% reported coexisting asthma and
30%, predominately females, were nonsmokers. The survey showed thatsex (female), smoking and low socioeconomic status were significantly and independently associated with chronic cough and phlegm, current smoking playing the major role.
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