Prevalence and Risk Factors for COPD in an Urbanizing Rural Area in Western China: A Cross-Sectional Study

Xiaolong Zhang,1,&ast; Zhiyin Lei,2,&ast; Ying Wu,3 Yuanyuan Song,4 Xiaoling Wu,3,5 Bo Yang,2 Jianmei Fan,2 Shixu Feng,2 Liping Wu,2 Lingyan Li,2 Qin Dai,2 Zhen Zeng,2 Mei Feng,3 Tingting Zhang3 1Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 4Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 5Department of Nursing, Sanya People’s Hospital/West China (Sanya) Hospital, Sichuan University, Sanya, Hainan Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ying Wu, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No. 37 Guoxue Alley, Chengdu, Sichuan Province, 610041, People’s Republic of China, Tel +86-18980606932, Email 358383278@qq.comPurpose: To investigate the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) in a rural area in western China with severe air pollution.Patients and Methods: 10% of local residents aged 40 years and above were included using a convenience sampling method. This was a cross-sectional study. A self-designed questionnaire was used to collect participants’ demographic data. The screening program was comprised of two steps: First, a portable electronic spirometer was used for COPD screening. Those participants with FEV1/FVC ratio < 0.7 were then referred to a confirmatory pulmonary function (PF) test. COPD was confirmed according to the 2020 Global Initiative for Chronic Obstructive Lung Disease criteria.Results: A total of 4577 participants aged 40 years old or above were included in the final analysis. Examination with a mobile spirometer identified 1159 individuals for confirmatory testing; after that, of the 1159 individuals, 889 were diagnosed with COPD by the confirmatory PF test. The prevalence of COPD among the target group was 19.4%. Older age, male sex (odds ratio [OR] = 1.537, 95% confidence interval [CI] 1.246– 1.894), smoking history (OR = 1.338, 95% CI 1.069– 1.675), family history of respiratory disease (OR = 1.625, 95% CI 1.350– 1.957), education level (OR = 0.735, 95% CI 0.617– 0.876), overweight (OR = 0.614, 95% CI 0.517– 0.730) and obesity (OR = 0.572, 95% CI 0.449– 0.721) were identified as independent factors associated with COPD. The screening program helped earlier detection of COPD in 719 participants.Conclusion: COPD was highly prevalent in the rural area studied. Rural residents who were older, current or ever-smokers, male and those who had a lower education level were more vulnerable to developing COPD. The COPD screening program may be helpful for earlier disease detection in rural health-care settings.Keywords: chronic obstructive pulmonary disease, prevalence, primary care, pulmonary function test, risk factors