Prevalence of chronic airflow limitation in Kashmir, North India: results from the BOLD study

Journal article

Background: Data on spirometrically defined chronic airflow limitation (CAL) are scarce in developing countries. Objective: To estimate the prevalence of spirometrically defined CAL in Kashmir, North India. Methods: Using Burden of Obstructive Lung Disease survey methods, we administered questionnaires to randomly selected adults aged 40 years. Post-bronchodilator spirometry was performed to estimate the prevalence of CAL and its relation to potential risk factors. Results: Of 1100 participants initially recruited, 953 (86.9%) responded and 757 completed acceptable spirometry and questionnaires. The prevalence of a forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio less than the lower limit of normal was 17.3% (4.5) in males and 14.8% (2.1) in females. Risk factors for CAL included higher age, cooking with wood and lower educational status. The prevalence of current smoking was 61% in males and 22% in females; most smoked hookahs. CAL was found equally in non-smoking males and females, and was independently associated with the use of the hookah, family history of respiratory disease and poor education. A self-reported doctor's diagnosis of chronic obstructive pulmonary disease was reported in 8.4/1000 (0.9% of females and 0.8% of males). Conclusion: Spirometrically confirmed CAL is highly prevalent in Indian Kashmir, and seems to be related to the high prevalence of smoking, predominantly in the form of hookah smoking.

Authors: Koul, P; Hakim, N; Malik, S; Khan, U; Patel, J

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: International Union Against Tuberculosis and Lung Disease
• Journal: International Journal of Tuberculosis and Lung Disease
• Volume: 20
• Issue: 10
• Pages: 1399-1404
• Publication date: 2016-10-20
• Acceptance date: 2016-09-01
• DOI: 10.5588/ijtld.15.0968
• EISSN: 1815-7920
• ISSN: 1027-3719
• Keywords: smoking; chronic airflow limitation; spirometry; COPD; prevalence