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Prevalence and Environmental Correlates of Small Airways Dysfunction in a Rural Swiss Cohort
Marco Fiori1,2, Dragana Radovanovic2, Alessio Casutt2,3,4
1Internal Medicine Division, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Respiration; International Review of Thoracic Diseases
|November 14, 2025
Summary
Small airways dysfunction (SAD) prevalence was low in rural Switzerland, especially compared to urban or polluted areas. Active smoking was linked to SAD, suggesting air pollution may impact small airways.
Area of Science:
- Pulmonary Medicine
- Environmental Health
- Epidemiology
Background:
- Small airways dysfunction (SAD) is an early indicator of respiratory disease.
- Variability in SAD prevalence across countries suggests air pollution may be a factor.
- Assessing SAD in diverse populations is crucial for understanding respiratory health.
Purpose of the Study:
- To determine SAD prevalence in a rural Swiss population.
- To compare Swiss rural SAD rates with international cohorts.
- To identify factors associated with SAD in this population.
Main Methods:
- Analysis of data from the Swiss Longitudinal Cohort Study (SWICOS).
- Spirometry used to define SAD (maximal mid expiratory flow below lower limit of normal).
- Air pollution data sourced from monitoring stations near the study sites.
Main Results:
- SAD prevalence was 2.60% in 423 participants (mean age 50.4 years).
- SAD was significantly associated with active smoking.
- Particulate matter exposure was lower than in other international cohorts.
Conclusions:
- Rural Swiss SAD prevalence was lower than urban and international cohorts.
- Findings support the hypothesis that air pollution contributes to small airways impairment.
- Active smoking is a key factor associated with SAD in this population.
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