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Research ArticleOriginal Research

Smoke, Biomass Exposure, and COPD Risk in the Primary Care Setting: The PUMA Study

Maria Montes de Oca, Gustavo Zabert, Dolores Moreno, Maria E Laucho-Contreras, Maria Victorina Lopez Varela and Filip Surmont
Respiratory Care May 2017, respcare.05440; DOI: https://doi.org/10.4187/respcare.05440
Maria Montes de Oca
Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.
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  • For correspondence: [email protected]
Gustavo Zabert
Facultad de Ciencias Médicas Universidad del Comahue, Rio Negro, Argentina.
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Dolores Moreno
Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.
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Maria E Laucho-Contreras
Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.
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Maria Victorina Lopez Varela
Universidad de la República, Facultad de Medicina, Hospital Maciel, Montevideo, Uruguay.
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Filip Surmont
Medical Affairs, AstraZeneca Latin America, Miami, FL, USA.
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Abstract

BACKGROUND: The evidence indicates that risk factors other than smoking are important in the development of COPD. It has been postulated that less traditional risk factors (eg, exposure to coal and/or biomass smoke) may interact with smoking to further increase COPD risk. This analysis evaluated the effect of exposure to biomass and smoking on COPD risk in a primary care setting in Latin America.

METHODS: Subjects attending routine primary care visits, ≥40 y old, who were current or former smokers or were exposed to biomass smoke, completed a questionnaire and performed spirometry. COPD was defined as post-bronchodilator FEV1/FVC < 0.70 and the lower limit of normal. Smoking was defined by pack-years (≤ 20, 20−30, or > 30), and biomass exposure was defined as an exposure to coal or wood (for heating, cooking, or both) for ≥ 10 y.

RESULTS: One thousand seven hundred forty-three individuals completed the questionnaire, and 1,540 performed spirometry. Irrespective of COPD definition, approximately 40% of COPD subjects reported exposure to biomass versus 30% of those without COPD. A higher proportion of COPD subjects (post-bronchodilator FEV1/FVC < 0.70) than those without COPD smoked > 30 pack-years (66% vs 39%); similar results were found with the lower limit of normal definition. Analysis of exposure to biomass > 10 y plus smoking > 20 pack-years (reference was no exposure) found that tobacco smoking (crude odds ratio [OR] 4.50, 95% CI 2.73−7.41; adjusted OR 3.30, 95% CI 1.93−5.63) and biomass exposure (crude OR 3.66, 95% CI 2.00−6.73; adjusted OR 2.28, 95% CI 1.18−4.41) were risk factors for COPD, with smoking a possible confounder for the association between biomass and COPD (post-bronchodilator FEV1/FVC < 0.70); similar results were found with the lower limit of normal definition.

CONCLUSIONS: Subjects with COPD from primary care had a higher exposure to biomass and smoking compared with non-COPD subjects. Smoking and biomass are both risk factors for COPD, but they do not appear to have an additive effect.

  • COPD
  • smoke
  • biomass exposure
  • primary care

Footnotes

  • Correspondence: María Montes de Oca MD, Hospital Universitario de Caracas, Facultad de Medicina, Los Chaguaramos, 1030, Universidad Central de Venezuela, Caracas, Venezuela. E-mail: montesdeoca.maria{at}gmail.com
  • Copyright © 2017 by Daedalus Enterprises
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Respiratory Care: 66 (2)
Respiratory Care
Vol. 66, Issue 2
1 Feb 2021
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Smoke, Biomass Exposure, and COPD Risk in the Primary Care Setting: The PUMA Study
Maria Montes de Oca, Gustavo Zabert, Dolores Moreno, Maria E Laucho-Contreras, Maria Victorina Lopez Varela, Filip Surmont
Respiratory Care May 2017, respcare.05440; DOI: 10.4187/respcare.05440

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Smoke, Biomass Exposure, and COPD Risk in the Primary Care Setting: The PUMA Study
Maria Montes de Oca, Gustavo Zabert, Dolores Moreno, Maria E Laucho-Contreras, Maria Victorina Lopez Varela, Filip Surmont
Respiratory Care May 2017, respcare.05440; DOI: 10.4187/respcare.05440
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