Abstract
Introduction: Although chronic airflow obstruction (CAO) occurs mostly in smokers, little is known about CAO among nonsmoking adults, particularly in developing countries.
Objective: To assess the prevalence of CAO in never smokers in Annaba, Algeria, and to describe its main characteristics. Method: A cross-sectional study was conducted using the Burden of Obstructive Lung Didease (BOLD) protocol in a representative sample of Annaba residents aged 40 years and above. Pre and post-bronchodilator spirometry was performed and quality controlled. Demographic data, on exposure to risk factors, previous diagnosis of respiratory disease were collected by standardized interviews. CAO was defined as postbronchodilator one second expiratory volume to forced vital capacity ratio (FEV1/FVC) of <0.7. The severity of airway obstruction was further defined by post-bronchodilator FEV1<80% predicted for stage2 or higher. Population-weighted prevalence of never smoking CAO was estimated using survey weights.
Results: From 890 individuals who took part in the study, 549 (61.7%) had never smoked and had complete data. The estimated population prevalence of CAO for all stages was 5.9% (1.2), with a prevalence of 6.4% (2.4) among men and 5.7% (1.4) among women. The prevalence of GOLD stage2 or higher CAO was 3.5% (0.9), 4.1% (1.4) and 2.9% (1.2) in men and women respectively. Almost half of never smokers with CAO reported a diagnosis of asthma (13/30) while none had a medical diagnosis of COPD.
Conclusion: The prevalence of CAO in never smokers in Annaba is low. CAO is not specific to COPD. Underdiagnosis was as common in CAO patients who never smoked as in ever smokers.
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