Estimating the prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry testing: data from The National Health and Nutrition Examination Survey, 2007-2010

Details

• Personal Author:
  Dillon C ; Doney B ; Hnizdo, Eva ; Paulose-Ram R ; Tilert T
• Description:
  Rationale: During 2007-2010, the National Health and Nutrition Examination Survey (NHANES), a nationally representative survey of the non-institutionalized US population, conducted a spirometry component which obtained pre-bronchodilator pulmonary lung function data on survey participants 6-79 years of age and post-bronchodilator pulmonary lung function data for the subset of this group with airflow limitation. Data on respiratory symptoms and other respiratory related data were also collected. These data offered a unique opportunity to examine multiple approaches to estimating the prevalence of COPD in a nationally representative US sample. Methods: NHANES 2007-2010 spirometry data were analyzed. Among those aged 40-79 years, 5,823 received the pre-bronchodilator spirometry. Those with likely airflow limitation were selected for the post-bronchodilator test (n=1,110). Airflow limitation was defined based on two criteria: 1) forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < 70%1,2; and 2) FEV1/FVC < lower limit of normal (LLN) according to age, sex, height, and race/ethnicity1,3,4. Persons were classified as having chronic obstructive pulmonary disease (COPD) based on 1) having airflow limitation as defined above using pre- or post-bronchodilator values, or 2) reporting the use of daytime supplemental oxygen therapy plus a physician diagnosis of COPD (ever had emphysema or current chronic bronchitis). The final analytic samples for the pre-bronchodilator and post-bronchodilator analyses were 77.1% (n=5,477) and 50.8% (n=564) of those eligible, respectively. To account for this non-response in the estimation of COPD, we used a method where NHANES examination weights were adjusted to the eligible pre-bronchodilator and post-bronchodilator subpopulations. Results: In 2007-2010, using the FEV1/FVC ratio <0.7 diagnostic criterion and pre-bronchodilator test results, the estimated prevalence of COPD was 20.9% (SE 1.1) among US adults aged 40-79 years. Applying the same criterion to post-bronchodilator test results, the prevalence was 14.0% (SE 1.0). Using the FEV1/FVC ratio
• Subjects:
  Age Factors Diagnosis Lung Lung Diseases Men Occupational Health Race Factors Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety Sex Characteristics Surveys And Questionnaires Women

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• Keywords:
  Age-factors Airway-obstruction Clinical-diagnosis Health-surveys Height-factors Humans Information-retrieval-systems Lung-disorders Lung-function Oxygen-therapy Pulmonary-function-tests Pulmonary-system-disorders Racial-factors Respiratory-system-disorders Sex-factors Spirometry Statistical-analysis

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• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Abstract or Summary
• 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:
  187
• NIOSHTIC Number:
  nn:20044386
• Citation:
  Am J Respir Crit Care Med 2013 May; 187(Meeting Abstracts):A3641
• Contact Point Address:
  T. Tilert, CDC/National Center for Health Statistics, Hyattsville, MD
• Federal Fiscal Year:
  2013
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Meeting Abstracts
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:897bbe23fce6e5aeb3d18beb460df2c3789e966c499a819148e4de65c1f2c6f5293dacde9a774e85b5c4f1c079ad2cc1a86e145c0236817fd2a07868637bbb4f
• Download URL:
  https://stacks.cdc.gov/view/cdc/200097/cdc_200097_DS1.pdf
• File Type:
  [PDF - 20.12 KB ]