PT  - JOURNAL ARTICLE
AU  - Townend, John
AU  - Minelli, Cosetta
AU  - Mortimer, Kevin
AU  - Obaseki, Daniel O.
AU  - Al Ghobain, Mohammed
AU  - Cherkaski, Hamid
AU  - Denguezli, Myriam
AU  - Gunesekera, Kirthi
AU  - Hafizi, Hasan
AU  - Koul, Parvaiz A.
AU  - Loh, Li C.
AU  - Nejjari, Chakib
AU  - Patel, Jaymini
AU  - Sooronbayev, Talant
AU  - Buist, Sonia A.
AU  - Burney, Peter G.J.
TI  - The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study
AID  - 10.1183/13993003.01880-2016
DP  - 2017 Jun 01
TA  - European Respiratory Journal
PG  - 1601880
VI  - 49
IP  - 6
4099  - http://erj.ersjournals.com/content/49/6/1601880.short
4100  - http://erj.ersjournals.com/content/49/6/1601880.full
SO  - Eur Respir J2017 Jun 01; 49
AB  - Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0–10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV1/FVC<lower limit of normal were tested for association with poverty for each site, and the results were combined by meta-analysis.Mean wealth scores ranged from 4 in Blantyre (Malawi) and Kashmir (India) to 10 in Riyadh (Saudi Arabia), and the prevalence of obstruction, from 16% in Kashmir to 3% in Riyadh and Penang (Malaysia). Following adjustments for age and sex, FEV1/FVC increased by 0.36% (absolute change) (95%CI: 0.22, 0.49; p<0.001) per unit increase in wealth score. Adjustments for other confounders reduced this effect to 0.23% (0.11, 0.34), but even this value remained highly significant (p<0.001). Results were consistent across sites (I2=1%; phet=0.44). Mean wealth scores explained 38% of the variation in mean FEV1/FVC between sites (r2=0.385, p=0.031).Airflow obstruction is consistently associated with poverty at individual and community levels across several countries.Poverty is a strong predictor of chronic airflow obstruction independent of age, sex, smoking and tuberculosis http://ow.ly/T2Sz30bdUNC