Abstract
The prevalence of chronic obstructive pulmonary disease (COPD) among urban populations is generally lower than rural residents, but the disease burden is still high. We conducted a cross-sectional prevalence survey of COPD among residents aged ≥40 years in an emerging city Shenzhen, China from September 2018 to June 2019. Through multi-stage stratified random sampling, a total of 4157 eligible participants were invited to complete a questionnaire and to take the spirometry test; 3591 with available data were enrolled in the final analysis. Individuals were diagnosed with COPD if the post-bronchodilator FEV1/FVC ratio was less than 0.7. The estimated standardized prevalence of COPD among residents over 40 years old in Shenzhen was 5.92% (95% confidential intervals [CI] 4.05–8.34). Risk factors for COPD included elder age (adjusted odds ratio 1.206, 95% CI 1.120–1.299 per 10-year increase), smoking over 20 pack-years (1.968, 1.367–2.832), history of chronic bronchitis (1.733, 1.036–2.900) or asthma (4.920, 2.425–9.982), and exposure to higher annual minimum concentrations of ambient SO2 (1.156, 1.053–1.270 per 1-μg/m3 increase). Among 280 spirometry-diagnosed patients, most (221, 78.93%) patients were classified as mild COPD (GOLD stage I). This survey found that the prevalence of COPD in Shenzhen is low and most patients had mild symptoms, thus recommended screening using spirometry in primary health care to detect early-stage COPD. Increased risk from the exposure to air pollutants also indicated the urgent need for environmental improvement in city settings.
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Data availability
The dataset analyzed during this study are included in this published article. The raw data of individuals used of this study are available from the corresponding author on reasonable request.
References
Adeloye D, Chua S, Lee C, Rudan I (2015) Global and regional estimates of COPD prevalence: systematic review and metaanalysis. J Glob Health 5(2):20415
Bednarek M, Maciejewski J, Wozniak M, Kuca P, Zielinski J (2008) Prevalence, severity and under diagnosis of COPD in the primary care setting. Thorax 63(5):402–407
Biener AI, Decker SL, Rohde F (2019) Prevalence and treatment of chronic obstructive pulmonary disease (COPD) in the United States. JAMA 322(7):602
Chen X-C, Cao J-J, Ward TJ, Ho K-F (2020) Characteristics and toxicological effects of commuter exposure to black carbon and metal components of fine particles (PM ) in Hong Kong. Sci Total Environ 2.5(742):140501
Chen X, Cheng J, Cao Y, Peng J (2017) Analysis of the impairment of pulmonary ventilation function and influencing factors in residents (>40 year old) of Shenzhen city. Chinese Journal of Prevention and Control of Chronic Diseases 25(01):21–25
Doiron D, de Hoogh K, Probst-Hensch N, Hansell AL (2019) Air pollution, lung function and COPD: results from the population based UK biobank study. Eur Respir J 54(1):1802140
Faizan MA, Thakur R (2019) Measuring the impact of household energy consumption on respiratory diseases in India. Global Health Research and Policy 4:10
Fang L, Gao P, Bao H, Wang L (2018) Chronic obstructive pulmonary disease in China: a nationwide prevalence study. Lancet Respir Med 6(6):421–430
Guan W-J, Zheng X-Y, Chung KF, Zhong N-S (2016) Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action. Lancet (London, England) 388(10054):1939–1951
Guirguis-Blake JM, Senger CA, Webber EM, Mularski RA, Whitlock EP (2016) Screening for chronic obstructive pulmonary disease: evidence report and systematic review for the US preventive services task force. JAMA 315(13):1378–1393
Guo B, Chen F, Deng Y, Zhao X (2018) Using rush hour and daytime exposure indicators to estimate the short-term mortality effects of air pollution: a case study in the Sichuan Basin, China. Environ Pollut 242(Pt B):1291–1298
Halpin DMG, Criner GJ, Papi A, Vogelmeier CF (2021) Global initiative for the diagnosis, management, and prevention of chronic obstructive lung disease. The 2020 GOLD science committee report on COVID-19 and chronic obstructive pulmonary disease. Am J Respir Crit Care Med 203(1):24–36
Han R, Zou J, Shen X, Yang Y (2015) The risk factors of chronic obstructive pulmonary disease in Heilongjiang province. Chinese Journal of Tuberculosis and Respiratory Diseases 38(2):93–98
Hendryx M, Luo J, Chojenta C, Byles JE (2019) Air pollution exposures from multiple point sources and risk of incident chronic obstructive pulmonary disease (COPD) and asthma. Environ Res 179(Pt A):108783
Houben-Wilke S, Janssen DJA, Franssen FME, Vanfleteren LEGW, Wouters EFM, Spruit MA (2018) Contribution of individual COPD assessment test (CAT) items to CAT total score and effects of pulmonary rehabilitation on CAT scores. Health Qual Life Outcomes 16(1):205
Huang Y-K, Luvsan M-E, Gombojav E, Ochir C, Bulgan J, Chan C-C (2013) Land use patterns and SO and NO pollution in Ulaanbaatar, Mongolia. Environ Res 124:1–6
Jones PW, Harding G, Berry P, Wiklund I, Chen W-H, Kline Leidy N (2009) Development and first validation of the COPD assessment test. Eur Respir J 34(3):648–654
Jones PW, Tabberer M, Chen W-H (2011) Creating scenarios of the impact of COPD and their relationship to COPD Assessment Test (CAT ) scores. BMC Pulmonary Medicine 11(1):42
Kon SSC, Canavan JL, Jones SE, Man WD-C (2014) Minimum clinically important difference for the COPD assessment test: a prospective analysis. Lancet Respir Med 2(3):195–203
Shenzhen Meteorological Bureau (2020) Shenzhen Climate Bulletin. Retrieved from http://sztqb.sznews.com/attachment/pdf/202002/27/d545ba11-0af1-4730-a795-62951a4aeee0.pdf
Shenzhen Municipal Ecological Environment Bureau (2020) 2019 Shenzhen Municipal Environmental Status Bulletin. Retrieved from http://www.sz.gov.cn/zfgb/2020/gb1151/content/post_7574296.html
Shenzhen Statistics Bureau, NBS Survey Office in Shenzhen (2019) Shenzhen statistical yearbook 2019. China Statistics Press, Beijing
Shenzhen Statistics Bureau, NBS Survey Office in Shenzhen (2017) Shenzhen statistical yearbook 2017. China Statistics Press, Beijing
Singh D, Agusti A, Anzueto A, Vogelmeier C (2019) Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: the GOLD science committee report 2019. Eur Respir J 53(5):1900164. https://doi.org/10.1183/13993003.00164-2019
Standing Committee of Shenzhen Municipal People’s Congress (2020) Health regulations in Shenzhen special economic zone
Sun S, Jin J, Xia M, Wang P (2020) Vehicle emissions in a middle-sized city of China: current status and future trends. Environ Int 137:105514
Vestbo J, Hurd SS, Agustí AG, Rodriguez-Roisin R (2013) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 187(4):347–365
Vogelmeier CF, Criner GJ, Martinez FJ, Agustí A (2017) Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med 195(5):557–582
Wang C, Xu J, Yang L, He J (2018) Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet 391(10131):1706–1717
Zhong N, Wang C, Yao W, Ran P (2007) Prevalence of chronic obstructive pulmonary disease in China: a large, population-based survey. Am J Respir Crit Care Med 176(8):753–760
Zhou Y, Zhong N, Li X, Ran P (2017) Tiotropium in early-stage chronic obstructive pulmonary disease. N Engl J Med 377(10):923–935
Acknowledgements
We thank the physicians of municipal- and district-level Centers for Chronic Disease Control in Shenzhen and public health teams of investigated communities for their work in this prevalence survey.
Funding
This study was funded by the Sanming project of Medicine in Shenzhen (SZSM201611030 to WT); and the Fundamental Research Funds for the Central Universities (2042021kf0041 to QJ). The funders had no role in the study design, data collection and analysis, or preparation of the manuscript.
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LJ, HG, and WT designed and managed the study. LJ and CL collected, processed, and cleaned the raw data; JY and QJ did the data analysis and interpretation. JY drafted the manuscript; LJ, LW, and QJ prepared the final article; all authors contributed to and reviewed the final version.
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The epidemiological investigation and related tests and evaluations were conducted after receiving the signed informed consent from all the participants. This survey was reviewed and approved by the Ethics Committee of Shenzhen Center for Chronic Disease Control (No. SZCCC-2020-018-05-PJ).
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Ji, C., Yin, JF., Lu, CR. et al. Control of chronic obstructive pulmonary disease in urban populations: findings from a cross-sectional prevalence survey in Shenzhen, China . Environ Sci Pollut Res 29, 11843–11853 (2022). https://doi.org/10.1007/s11356-021-16553-z
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DOI: https://doi.org/10.1007/s11356-021-16553-z