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The interaction between family history of COPD, personal smoking and post-bronchodilator airflow obstruction: A cohort study

Jennifer Perret, Melanie Matheson, David Johns, Adrian Lowe, Caroline Lodge, John Burgess, Bruce Thompson, Christine McDonald, Stephen Morrison, Paul Thomas, Michael Abramson, E. Hadyn Walters, Shyamali Dharmage
European Respiratory Journal 2015 46: PA1111; DOI: 10.1183/13993003.congress-2015.PA1111
Jennifer Perret
1Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC Australia
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Melanie Matheson
1Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC Australia
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David Johns
2School of Medicine, University of Tasmania, Hobart, TAS Australia
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Adrian Lowe
1Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC Australia
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Caroline Lodge
1Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC Australia
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John Burgess
1Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC Australia
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Bruce Thompson
3Allergy Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, VIC Australia
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Christine McDonald
4Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, VIC Australia
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Stephen Morrison
5Department of Medicine, University of Queensland, Brisbane, QLD Australia
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Paul Thomas
6Department of Medicine, University of New South Wales, Sydney, NSW Australia
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Michael Abramson
7School of Public Health & Preventive Medicine, The Alfred Hospital, Melbourne, VIC Australia
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E. Hadyn Walters
2School of Medicine, University of Tasmania, Hobart, TAS Australia
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Shyamali Dharmage
1Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, VIC Australia
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Abstract

Rationale: The aetiology of COPD is multifactorial, but the independent and combined associations of a personal smoking and family history (FH) of COPD are rarely reported

Aim: To examine the role of FH of COPD in predicting post-bronchodilator (BD) airflow obstruction in middle-age

Methods: Post-BD spirometry (n=1,389) was used from the 37 year follow-up of the Tasmanian Longitudinal Health Study (TAHS) cohort, when participants were middle-aged. FH of COPD was defined by an affirmative response to questions encompassing 'Has any close biological relative ever had self-reported, doctor-diagnosed or died from COPD, COAD, chronic bronchitis or emphysema?' Multivariable regression models were used and interactions examined.

Results: One third of participants reported a FH of COPD (n=462, 34%). The effect of personal smoking was modified by FH of COPD when assessed by post-BD FEV1/FVC (p-value for interaction 0.015): Smokers of at least 10 pack-years with a FH of COPD had a lower post-BD FEV1/FVC by more than half a standard deviation, which approximated an absolute reduction in FEV1/FVC of 5%. This was significantly greater than the estimate for those without a FH of COPD.

Post-BD FEV1/FVC (z-scores [95%CI])
FH of COPD, emphysema ± chronic bronchitis
Personal smokingNoYes
Never-smokerReference+0.14 [-0.04 to +0.3]
Ever-smoker
< 10 pack-years−0.09 [−0.3 to +0.1]+0.04 [−0.2 to +0.3]
≥ 10 pack-years−0.36 [−0.5 to −0.2]***−0.59 [−0.8 to −0.4]******p<0.001

Conclusion: A FH of COPD augments the adverse effect of personal smoking on lung function. Public health messages should highlight this extra risk.

  • COPD - mechanism
  • Epidemiology
  • Copyright ©ERS 2015
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The interaction between family history of COPD, personal smoking and post-bronchodilator airflow obstruction: A cohort study
Jennifer Perret, Melanie Matheson, David Johns, Adrian Lowe, Caroline Lodge, John Burgess, Bruce Thompson, Christine McDonald, Stephen Morrison, Paul Thomas, Michael Abramson, E. Hadyn Walters, Shyamali Dharmage
European Respiratory Journal Sep 2015, 46 (suppl 59) PA1111; DOI: 10.1183/13993003.congress-2015.PA1111

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The interaction between family history of COPD, personal smoking and post-bronchodilator airflow obstruction: A cohort study
Jennifer Perret, Melanie Matheson, David Johns, Adrian Lowe, Caroline Lodge, John Burgess, Bruce Thompson, Christine McDonald, Stephen Morrison, Paul Thomas, Michael Abramson, E. Hadyn Walters, Shyamali Dharmage
European Respiratory Journal Sep 2015, 46 (suppl 59) PA1111; DOI: 10.1183/13993003.congress-2015.PA1111
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