AUTHOR=Long HuanYu , Xing ZhenZhen , Chai Di , Liu WeiMing , Tong YaQi , Wang YuXia , Ma YaLi , Pan MingMing , Cui Jia , Guo YanFei 

TITLE=Solid Fuel Exposure and Chronic Obstructive Pulmonary Disease in Never-Smokers

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.757333

DOI=10.3389/fmed.2021.757333

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> Chronic obstructive pulmonary disease (COPD) is a public health challenge globally. The burden of COPD is high in never-smokers but little is known about its causes. We aimed to find the prevalence and correlates of COPD in never-smokers, with a special focus on solid fuel exposure.</p><p><bold>Methods:</bold> We conducted a cross-sectional study in Western China. COPD was defined by FEV1/FVC &lt; lower limits of normal (LLN). Descriptive statistics and multivariable logistic regression were used for analyses.</p><p><bold>Results:</bold> Six thousand two hundred and seventy one patients were enrolled between June 2015 and August 2016. The prevalence of COPD in never-smokers was 15.0% (95% confidence interval 14.1–15.9). The common independent predictors of COPD in never-smokers included age ≥60 years, exposure to solid fuel, living in a rural area and a history of tuberculosis. Participants with solid fuel exposure were 69% more likely to have COPD (adjusted odds ratio 1.69, 95% CI 1.41–2.04) than those without such exposure. In addition, we found a positive association between small airway dysfunction and solid fuel exposure (OR 1.35, 95% CI 1.18–1.53).</p><p><bold>Conclusions:</bold> This study confirmed the substantial burden of COPD among never-smokers and also defined the risk factors for COPD in never-smokers. Furthermore, we found a positive association between solid fuel exposure and COPD or small airway dysfunction.</p>