The Risk Factors and Characteristics of COPD Among Nonsmokers in Korea: An Analysis of KNHANES IV and V

Lung. 2016 Jun;194(3):353-61. doi: 10.1007/s00408-016-9871-6. Epub 2016 Apr 1.

Abstract

Purpose: Chronic obstructive pulmonary disease (COPD) is increasing in prevalence and mortality. This study evaluated the prevalence, risk factors, characteristics, and health-related quality of life (HRQoL) of COPD among nonsmokers in Korea.

Methods: This was a population-based cross-sectional study using data obtained from the Fourth and Fifth Korean National Health and Nutrition Examination Survey, which was conducted from 2007 to 2011.

Results: A total of 15,063 participants completely answered the questionnaire and performed the spirometry. Among them, 59.6 % were nonsmokers and 40.4 % were smokers. The prevalence of nonsmoker COPD was 7.1 %. On multivariate analysis, age ≥65 years (OR, 2.93; 95 % CI, 2.44-3.51), male sex (OR, 2.98; 95 % CI, 2.40-3.71), living in rural area (OR, 1.26; 95 % CI, 1.05-1.51), lower body mass index (BMI) (<18.5 kg/m(2)) (OR, 3.00; 95 % CI, 1.78-5.01), self-reported asthma (OR, 2.72; 95 % CI, 2.05-3.60), and self-reported tuberculosis (OR, 4.73; 95 % CI, 3.63-6.17) showed a significantly higher risk of nonsmoker COPD. Analysis of nonsmoker and smoker COPD revealed that there are more females in nonsmoker COPD patients (73.9 vs. 6.9 %, P < 0.001). Nonsmoker COPD patients presented with impaired mobility, pain/discomfort, and anxiety/depression functions as well as a lower mean EuroQol Five-Dimension Questionnaire utility score, which showed HRQoL.

Conclusions: The burden of nonsmoker COPD was considerable. Older age, male sex, lower BMI, self-reported asthma, and self-reported tuberculosis were risk factors for nonsmoker COPD and there were differences between nonsmoker and smoker COPD in terms of sex, comorbidities, and HRQoL.

Keywords: Chronic obstructive pulmonary disease; Never-smoker; Nonsmoker; Population study; Quality of life.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anxiety / epidemiology
  • Asthma / epidemiology
  • Body Mass Index
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mobility Limitation
  • Nutrition Surveys
  • Pain / epidemiology
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Quality of Life
  • Republic of Korea / epidemiology
  • Risk Factors
  • Rural Population / statistics & numerical data
  • Sex Factors
  • Smoking / epidemiology*
  • Spirometry
  • Tuberculosis, Pulmonary / epidemiology
  • Urban Population / statistics & numerical data