Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007-2010

Details

• Personal Author:
  Dillon C ; Doney B ; Hnizdo, Eva ; Paulose-Ram R ; Tilert T
• Description:
  Background: During 2007-2010, the National Health and Nutrition Examination Survey (NHANES) conducted a spirometry component which obtained pre-bronchodilator pulmonary lung function data on a nationally representative sample of US adults aged 6-79 years and post-bronchodilator pulmonary lung function data for the subset of adults with airflow limitation. The goals of this study were to 1) compute prevalence estimates of chronic obstructive pulmonary disease (COPD) using pre-bronchodilator and post-bronchodilator spirometry measurements and fixed ratio and lower limit of normal (LLN) diagnostic criteria and 2) examine the potential impact of nonresponse on the estimates. Methods: This analysis was limited to those aged 40-79 years who were eligible for NHANES pre-bronchodilator spirometry (n=7,104). Examinees with likely airflow limitation were further eligible for post-bronchodilator testing (n=1,110). Persons were classified as having COPD based on FEV1/FVC < 70% (fixed ratio) or FEV1/FVC < lower limit of normal (LLN) based on person's age, sex, height, and race/ethnicity. Those without spirometry but self-reporting both daytime supplemental oxygen therapy plus emphysema and/or current chronic bronchitis were also classified as having COPD. The final analytic samples for pre-bronchodilator and post-bronchodilator analyses were 77.1% (n=5,477) and 50.8% (n=564) of those eligible, respectively. To account for non-response, NHANES examination weights were adjusted to the eligible pre-bronchodilator and post-bronchodilator subpopulations. Results: In 2007-2010, using the fixed ratio criterion and pre-bronchodilator test results, COPD prevalence was 20.9% (SE 1.1) among US adults aged 40-79 years. Applying the same criterion to post-bronchodilator test results, prevalence was 14.0% (SE 1.0). Using the LLN criterion and pre-bronchodilator test results, the COPD prevalence was 15.4% (SE 0.8), while applying the same criterion to post-bronchodilator test results, prevalence was 10.2% (SE 0.8). Conclusions: The overall COPD prevalence among US adults aged 40-79 years varied from 10.2% to 20.9% based on whether pre- or post-bronchodilator values were used and which diagnostic criterion (fixed ratio or LLN) was applied. The overall prevalence decreased by approximately 33% when airflow limitation was based on post-bronchodilator as compared to pre-bronchodilator spirometry, regardless of which diagnostic criterion was used. [Description provided by NIOSH]
• Subjects:
  Aging Chronic Disease Demography Epidemiology Lung Lung Diseases Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety

  More +
• Keywords:
  Age-groups Author Keywords: Spirometry Bronchodilator Chronic-degenerative-diseases COPD Demographic-characteristics Humans Lung-disease Lung-disorders Lung-function NHANES Occupational-respiratory-disease Prevalence Pulmonary-system Pulmonary-system-disorders Respiratory-system-disorders Spirometry Statistical-analysis Surveillance

  More +
• ISSN:
  1465-9921
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  14
• NIOSHTIC Number:
  nn:20043422
• Citation:
  Respir Res 2013 Oct; 14:103
• Contact Point Address:
  Timothy Tilert, Division of National Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, USA
• Email:
  ttilert@cdc.gov
• Federal Fiscal Year:
  2014
• NORA Priority Area:
  Mining
• Peer Reviewed:
  True
• Source Full Name:
  Respiratory Research
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a50a5b971cf2cb5e488b0d277ac3550cb6602c00e7bc7a55a74025bcb870bbcd7dcd76f0be5fa2d3514f630f5a33ee0c51f1687a025d7c1a4abf042df6cdeba5
• Download URL:
  https://stacks.cdc.gov/view/cdc/195317/cdc_195317_DS1.pdf
• File Type:
  [PDF - 280.36 KB ]