Abstract
Aim: To assess the effect of lifelong occupational history and smoking on chronic obstructive pulmonary disease (COPD) in general population in Almaty. Materials and Methods: 1500 adults (median age 49, interquartile range (IQR) 28 years), 50% females, were randomly selected in a primary care facility in Almaty, Kazakhstan and provided data on demographics, respiratory symptoms (CAT and mMRC), smoking status and detailed lifetime occupational history. COPD was defined as postbronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) below lower limit of normal (LLN). Results: 230 (15%) subjects had CAT>=10; 136 (9%) participants had mMRC score >=2. Greater CAT score was associated with age, smaller income and less exercise. 26% population were ever exposed to vapors, gases, dusts and fumes (VGDF). In age group 40 years and above (N=1024), COPD was found in 57 participants (prevalence 5.6%), more in men (8.7% vs. 3.4%). In the multivariate model adjusted for age, sex, ever-smoking, income and exercise, any exposure to VGDF increased the odds of COPD (odds ratio (OR) 1.71; 95% confidence interval (CI) 1.03;2.84), more in the highest exposure category (OR 2.36 (95% CI 1.20;4.66)). Conclusions: Lifetime exposure to VGDF, found in ¼ of general population, increased the odds of COPD independent of smoking by 71%.