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. 2004 Feb;59(2):120–125. doi: 10.1136/thorax.2003.011163

An international survey of chronic obstructive pulmonary disease in young adults according to GOLD stages

R de Marco 1, S Accordini 1, I Cerveri 1, A Corsico 1, J Sunyer 1, F Neukirch 1, N Kunzli 1, B Leynaert 1, C Janson 1, T Gislason 1, P Vermeire 1, C Svanes 1, J Anto 1, P Burney 1
PMCID: PMC1746950  PMID: 14760151

Abstract

Background: The recently published GOLD guidelines provide a new system for staging chronic obstructive pulmonary disease (COPD) from mild (stage I) to very severe (stage IV) and introduce a stage 0 (chronic cough and phlegm without airflow obstruction) that includes subjects "at risk" of developing the disease.

Methods: In order to assess the prevalence of GOLD stages of COPD in high income countries and to evaluate their association with the known risk factors for airflow obstruction, data from the European Community Respiratory Health Survey on more than 18 000 young adults (20–44 years) were analysed.

Results: The overall prevalence was 11.8% (95% CI 11.3 to 12.3) for stage 0, 2.5% (95% CI 2.2 to 2.7) for stage I, and 1.1% (95% CI 1.0 to 1.3) for stages II–III. Moderate to heavy smoking (⩾15 pack years) was significantly associated with both stage 0 (relative risk ratio (RRR) = 4.15; 95% CI 3.55 to 4.84) and stages I+ (RRR = 4.09; 95% CI 3.17 to 5.26), while subjects with stages I+ COPD had a higher likelihood of giving up smoking (RRR = 1.39; 95% CI 1.04 to 1.86) than those with GOLD stage 0 (RRR = 1.05; 95% CI 0.86 to 1.27). Environmental tobacco smoke had the same degree of positive association in both groups. Respiratory infections in childhood and low socioeconomic class were significantly and homogeneously associated with both groups, whereas occupational exposure was significantly associated only with stage 0. All the GOLD stages showed a significantly higher percentage of healthcare resource users than healthy subjects (p<0.001), with no difference between stage 0 and COPD.

Conclusions: A considerable percentage of young adults already suffered from COPD. GOLD stage 0 was characterised by the presence of the same risk factors as COPD and by the same high demand for medical assistance.

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Selected References

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  1. Burney P. G., Luczynska C., Chinn S., Jarvis D. The European Community Respiratory Health Survey. Eur Respir J. 1994 May;7(5):954–960. doi: 10.1183/09031936.94.07050954. [DOI] [PubMed] [Google Scholar]
  2. Burney P., Malmberg E., Chinn S., Jarvis D., Luczynska C., Lai E. The distribution of total and specific serum IgE in the European Community Respiratory Health Survey. J Allergy Clin Immunol. 1997 Mar;99(3):314–322. doi: 10.1016/s0091-6749(97)70048-4. [DOI] [PubMed] [Google Scholar]
  3. Cerveri I., Accordini S., Corsico A., Zoia M. C., Carrozzi L., Cazzoletti L., Beccaria M., Marinoni A., Viegi G., de Marco R. Chronic cough and phlegm in young adults. Eur Respir J. 2003 Sep;22(3):413–417. doi: 10.1183/09031936.03.00121103. [DOI] [PubMed] [Google Scholar]
  4. Cerveri I., Accordini S., Verlato G., Corsico A., Zoia M. C., Casali L., Burney P., de Marco R., European Community Respiratory Health Survey (ECRHS) Study Group Variations in the prevalence across countries of chronic bronchitis and smoking habits in young adults. Eur Respir J. 2001 Jul;18(1):85–92. doi: 10.1183/09031936.01.00087101. [DOI] [PubMed] [Google Scholar]
  5. Cerveri Isa, Corsico Angelo, Zoia Maria C. GOLD stage 0. Am J Respir Crit Care Med. 2003 Mar 15;167(6):936–936. doi: 10.1164/ajrccm.167.6.957. [DOI] [PubMed] [Google Scholar]
  6. Coultas D. B., Mapel D., Gagnon R., Lydick E. The health impact of undiagnosed airflow obstruction in a national sample of United States adults. Am J Respir Crit Care Med. 2001 Aug 1;164(3):372–377. doi: 10.1164/ajrccm.164.3.2004029. [DOI] [PubMed] [Google Scholar]
  7. De Vita F., Orditura M., Galizia G., Romano C., Roscigno A., Lieto E., Catalano G. Serum interleukin-10 levels as a prognostic factor in advanced non-small cell lung cancer patients. Chest. 2000 Feb;117(2):365–373. doi: 10.1378/chest.117.2.365. [DOI] [PubMed] [Google Scholar]
  8. Dekhuijzen P. N. R. The Confronting COPD International Survey: patients hardly know they have COPD. Eur Respir J. 2002 Oct;20(4):793–794. doi: 10.1183/09031936.02.00404402. [DOI] [PubMed] [Google Scholar]
  9. Fabbri Leonardo M., Romagnoli Micaela, Corbetta Lorenzo, Casoni Gianluca, Busljetic Kamelija, Turato Graziella, Ligabue Guido, Ciaccia Adalberto, Saetta Marina, Papi Alberto. Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2002 Nov 8;167(3):418–424. doi: 10.1164/rccm.200203-183OC. [DOI] [PubMed] [Google Scholar]
  10. Feinleib M., Rosenberg H. M., Collins J. G., Delozier J. E., Pokras R., Chevarley F. M. Trends in COPD morbidity and mortality in the United States. Am Rev Respir Dis. 1989 Sep;140(3 Pt 2):S9–18. doi: 10.1164/ajrccm/140.3_Pt_2.S9. [DOI] [PubMed] [Google Scholar]
  11. Janson C., Chinn S., Jarvis D., Burney P. Physician-diagnosed asthma and drug utilization in the European Community Respiratory Health Survey. Eur Respir J. 1997 Aug;10(8):1795–1802. doi: 10.1183/09031936.97.10081795. [DOI] [PubMed] [Google Scholar]
  12. Peña V. S., Miravitlles M., Gabriel R., Jiménez-Ruiz C. A., Villasante C., Masa J. F., Viejo J. L., Fernández-Fau L. Geographic variations in prevalence and underdiagnosis of COPD: results of the IBERPOC multicentre epidemiological study. Chest. 2000 Oct;118(4):981–989. doi: 10.1378/chest.118.4.981. [DOI] [PubMed] [Google Scholar]
  13. Quanjer P. H., Tammeling G. J., Cotes J. E., Pedersen O. F., Peslin R., Yernault J. C. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993 Mar;16:5–40. [PubMed] [Google Scholar]
  14. Snider Gordon L. Nosology for our day: its application to chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2003 Mar 1;167(5):678–683. doi: 10.1164/rccm.200203-204PP. [DOI] [PubMed] [Google Scholar]
  15. Thom T. J. International comparisons in COPD mortality. Am Rev Respir Dis. 1989 Sep;140(3 Pt 2):S27–S34. doi: 10.1164/ajrccm/140.3_Pt_2.S27. [DOI] [PubMed] [Google Scholar]
  16. Vestbo Jørgen, Lange Peter. Can GOLD Stage 0 provide information of prognostic value in chronic obstructive pulmonary disease? Am J Respir Crit Care Med. 2002 Aug 1;166(3):329–332. doi: 10.1164/rccm.2112048. [DOI] [PubMed] [Google Scholar]
  17. Xu X., Weiss S. T., Rijcken B., Schouten J. P. Smoking, changes in smoking habits, and rate of decline in FEV1: new insight into gender differences. Eur Respir J. 1994 Jun;7(6):1056–1061. [PubMed] [Google Scholar]
  18. de Marco R., Verlato G., Zanolin E., Bugiani M., Drane J. W. Nonresponse bias in EC Respiratory Health Survey in Italy. Eur Respir J. 1994 Dec;7(12):2139–2145. doi: 10.1183/09031936.94.07122139. [DOI] [PubMed] [Google Scholar]

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