Key indicators for considering a diagnosis of chronic obstructive pulmonary disease (COPD)

Consider COPD, and perform spirometry, if any of these indicators are present in an individual over age 40. These indicators are not diagnostic themselves, but the presence of multiple key indicators increases the probability of a diagnosis of COPD. Spirometry is required to establish a diagnosis of COPD.
Dyspnoea that isProgressive over time
Characteristically worse with exercise
Chronic coughMay be intermittent and may be unproductive
Recurrent wheeze
Chronic sputum productionWith any pattern
Recurrent lower respiratory tract infections
History of risk factorsHost factors (such as genetic factors, congenital/developmental abnormalities etc.)
Tobacco smoke
Smoke from home cooking and heating fuels
Occupational dusts, vapours, fumes, gases and other chemicals
Family history of COPD and/or childhood factorsFor example low birthweight, childhood respiratory infections