Wednesday, 13 July 2016

20 year study on lung health finds risk factors for COPD

Deputy Head of SPHPM, Professor Michael Abramson and Senior Research Fellow Dr Geza Benke, both from Monash Centre for Occupational and Environmental Health (MonCOEH), recently published findings from a 20-year study on lung health in adults in the International Journal of Chronic Obstructive Pulmonary Disease.

Chronic Obstructive Pulmonary Disease (COPD) is a collective term for a number of lung diseases that affect breathing such as emphysema, chronic bronchitis and chronic asthma. The study followed up Melbourne participants in the European Community Respiratory Health Survey (ECRHS) to investigate changes in symptoms between sexes and the roles of asthma, smoking, age, sex, height, and change in body mass index (BMI), a measure of overweight/obesity.

The ECRHS is a major international study designed to assess lung health in adults. The ECRHS was carried out in response to the world-wide increase in asthma prevalence in the 1980s, which pointed to environmental factors being important in the development of the disease. It was the first study of its kind to assess the prevalence of asthma in young adults in many countries using a standardised protocol, and indicated that asthma and allergies were more prevalent in Australia and New Zealand than most European countries.

The 20-year follow-up, which involved spirometry tests, showed that most respiratory symptoms had either remained relatively stable over the years or decreased, but that a decline in forced vital capacity (FVC) was greater in obese females than obese males. Spirometry tests measure lung function. Forced vital capacity is the maximum amount that a person can breath out.

Among both men and women factors such as age, baseline lung function, and changes in BMI were all associated with the rate of decline in lung function, but obesity and personal smoking appeared to put females at higher risk of lung function decline (LFD) than males.

However encouragingly the study did find that the number of participants still smoking 20 years on from the first study had markedly declined, from 20.2 per cent to 7.3 per cent. Researchers have said that health promotion campaigns should particularly target females to prevent COPD.

“Obesity and smoking puts females at higher risk of lung function decline than males. In Australia, there are already health promotion campaigns around healthy eating, physical activity, and smoking cessation. Our findings suggest that these could, in part, be retargeted toward females to reduce the future risk of chronic lung diseases,” said Professor Michael Abramson.

“We would also encourage clinicians to ask their middle-aged patients presenting with respiratory symptoms about early life factors, as well as taking a full smoking history and measuring their height, weight and lung function,” he said.

Colleagues who collaborated on the study included: Professor Shyamali Dharmage, Professor Bruce Thompson, Brigitte Borg, Catherine Smith and Dr Sonia Kaushik.

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