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Free Content Can age and sex explain the variation in COPD rates across large urban cities? A population study in Canada

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OBJECTIVE: To measure the prevalence of chronic obstructive pulmonary disease (COPD) and determine the effect of age and sex on the variation in prevalence across major cities within the same country and health care system.

METHOD: We used the Burden of Obstructive Lung Disease (BOLD) methodology to estimate the prevalence of COPD in adults aged ≥40 years in different Canadian cities. The study used interviewer-administered questionnaires on respiratory, smoking and occupational history, medication use and comorbidities. Post-bronchodilator spirometry was used to classify subjects. We determined the prevalence and severity of COPD with and without adjustments for age and sex distribution across different cities.

RESULTS: The study population was 3042. Overall, 16.7% (95%CI 14.8–18.7) of study subjects met the cri- teria for Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity Stage 1 or higher. The prevalence according to the criteria for the lower limits of normal of the ratio forced expiratory volume in 1 second/forced vital capacity was 11.6% (95%CI 9.9–13.3). COPD prevalence varied by severity across site (P = 0.0025). After age-sex adjustment, the variation disappeared (P> 0.16).

CONCLUSION: Age and sex differences account for most of the heterogeneity in COPD estimates across large cities within the same country. Adjustments for age and sex are essential in comparing COPD rates across the country.
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Document Type: Short Communication

Affiliations: 1: University of British Columbia James Hogg Research Laboratories, Providence Heart and Lung Institute, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada 2: Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada 3: Division of Respiratory Medicine, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada 4: Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada 5: Division of Respiratory Medicine, The Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada 6: Respiratory Division, Department of Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada 7: Oregon Health and Science University, Portland, Oregon, USA

Publication date: December 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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