Cooksley, Nathania A J B

Atkinson, David

Marks, Guy B

Toelle, Brett G

Reeve, David

Johns, David P

Abramson, Michael J

Burton, Deborah L

James, Alan L

Wood-Baker, Richard

Walters, E Haydn

Buist, A Sonia

Maguire, Graeme P

2015-07

Mortality and hospital separation data suggest a higher burden of chronic obstructive pulmonary disease (COPD) in indigenous than non-indigenous subpopulations of high-income countries. This study sought to accurately measure the true prevalence of post-bronchodilator airflow obstruction and forced vital capacity reduction in representative samples of Indigenous and non-Indigenous Australians. This study applies cross-sectional population-based survey of Aboriginal and non-Indigenous residents of the Kimberley region of Western Australia aged 40 years or older, following the international Burden Of Lung Disease (BOLD) protocol. Quality-controlled spirometry was conducted before and after bronchodilator. COPD was defined as Global initiative for chronic Obstructive Lung Disease (GOLD) Stage 2 and above (post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1 /FVC) ratio <0.7 and FEV1  < 80% predicted). Complete data were available for 704 participants. The prevalence of COPD, adjusted for age, gender and body weight in Aboriginal participants (7.2%, 95% confidence interval (CI) 3.9 to 10.4) was similar to that seen in non-Indigenous Kimberley participants (8.2%, 95% CI 5.7 to 10.7) and non-Indigenous residents of the remainder of Australia (7.1%, 95% CI 6.1 to 8.0). The prevalence of low FVC (<80% predicted) was substantially higher in Aboriginal compared with non-Indigenous participants (74.0%, 95% CI 69.1 to 78.8, vs 9.7%, 95% CI 7.1 to 12.4). Low FVC, rather than airflow obstruction, characterizes the impact of chronic lung disease previously attributed to COPD in this population subject to significant social and economic disadvantage. Environmental risk factors other than smoking as well as developmental factors must be considered. These findings require further investigation and have implications for future prevention of chronic lung disease in similar populations.

Respirology (Carlton, Vic.) 2015-07; 20(5): 766-74

http://orcid.org/0000-0002-4123-8598

http://orcid.org/0000-0002-7375-0019

https://pubmed.ncbi.nlm.nih.gov/25704620/?otool=iaurydwlib

https://hdl.handle.net/10137/5509

chronic obstructive pulmonary disease

indigenous population

race

respiratory function test

vital capacity

Aged

Bronchodilator Agents

Cross-Sectional Studies

Female

Humans

Male

Middle Aged

Population Groups

Prevalence

Respiratory Function Tests

Risk Factors

Smoking

Western Australia

Pulmonary Disease, Chronic Obstructive

Vital Capacity

Prevalence of airflow obstruction and reduced forced vital capacity in an Aboriginal Australian population: The cross-sectional BOLD study.

Journal Article

Publication