New evidence of risk factors for community-acquired pneumonia: a population-based study

¹ Critical Care Unit, Hospital de Mataró, Universitat Autònoma de Barcelona, Ciber Enfermedades Respiratorias, Barcelona
² Dept of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona
³ Research Unit, Hospital de Mataró, Mataró, Barcelona
⁴ Hospital Nostra Senyora de Meritxell, Principat d'Andorra
⁵ Institut Català de la Salut (ICS)
⁶ IB-SALUT Balears
⁷ INSALUD, Valencia
⁸ Institut Clínic del Torax, Servei de Pneumologia, IDIBAPS, Hospital Clínic de Barcelona, Universitat de Barcelona, Ciber Enfermedades Respiratorias, Barcelona, Spain

^* To whom correspondence should be addressed. E-mail: jalmirall{at}csdm.cat.

	Abstract

To identify risk factors for community-acquired pneumonia (CAP) with special emphasis on modifiable risk factors and generalizable to the general population.

Population-based case-control study with a target population of 859, 033 inhabitants >14 years of age. A total of 1336 patients with confirmed CAP over 1-year were matched to control subjects by age sex, and primary center.

In the univariate analysis, outstanding risk factors were passive smoking in never smokers >65 years, heavy alcohol intake, contact with pets, household with >10 people, contact with children, interventions on the upper airways, and poor dental health. Risky treatments included amiodarone, N-acetyl-cysteine, and oral steroids. Influenza and pneumococcal vaccine, and visiting the dentist were protective factors. Multivariable analysis confirmed cigarette smoking, usual contact with children, sudden changes of temperature at work, inhalation therapy (particularly containing steroids and using plastic pear-spacers), oxygen therapy, asthma, and chronic bronchitis as independent risk factors.

Interventions for reducing CAP should integrate health habits and lifestyle factors related to household, work and community, together with individual clinical conditions, comorbidities, and oral or inhaled regular treatments. Prevention would include vaccination, dental hygiene, and avoidance of upper respiratory colonization.

This article has been cited by other articles:

				W S Lim, S V Baudouin, R C George, A T Hill, C Jamieson, I Le Jeune, J T Macfarlane, R C Read, H J Roberts, M L Levy, et al. BTS guidelines for the management of community acquired pneumonia in adults: update 2009 Thorax, October 1, 2009; 64(Suppl_3): iii1 - iii55. [Full Text] [PDF]

				M. P. Wise, D. W. Williams, M. A. Lewis, J. G. Thomas, and P. J. Frost Impact of poor dental health on pneumonia Eur. Respir. J., October 1, 2008; 32(4): 1123 - 1124. [Full Text] [PDF]