TY - JOUR T1 - Impaired pulmonary function and the risk of tuberculosis – A population based cohort study JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2869 AU - Malin Inghammar AU - Claes-Göran Löfdahl AU - Niclas Winquist AU - Gunnar Engström AU - Arne Egesten Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2869.abstract N2 - Background: Even though COPD is a frequent co-morbid condition in elderly with active tuberculosis relatively little is known to what extent impaired lung function increases the incidence of active tuberculosis in excess of the direct effect of smoking.Methods: 28,907 participants of the Malmo Preventive Project performed a spirometry at base-line examination and were followed for a mean of 25 years. Pulmonary function was measured as FVC and FEV1 % of predicted (standardized for age, height and gender) and classified according to the GOLD criteria. Cases of incident tuberculosis, notified in the local tuberculosis register 1989-2008 were identified. Hazard ratios (HR) for subsequent tuberculosis according to FEV1 and GOLD-stage were estimated using Cox regression.Main results: A total of 26 cases of incident tuberculosis were identified corresponding to an overall incidence of 5.2 (95% confidence interval [95% CI] 3.5-7.6) per 100,000 person-years. The incidence rate was inversely correlated with FEV1 (% of predicted), HR per 10%-unit increase 0.71 (95% CI 0.59-0.86). The results persisted after adjustment for smoking and age at screening, HR per 10%-unit increase in FEV1 (% of predicted) 0.75 (95% CI 0.61-0.91).The incidence of TB increased with GOLD-stage, stage I, crude HR 1.9 (95% CI 0.5-6.7), stage II, HR 5.64 (95% CI 2.2-14.7), stage III+IV, HR 6.9 (95%CI 0.9-52.6), p<0.001 for linear trend, although only one case of TB occurred in GOLD-stage III+IV.Conclusions: Impaired pulmonary function or COPD is associated with an increased incidence of active tuberculosis. ER -