非吸烟者的慢性阻塞性肺病
Sundeep S Salvi1, Peter J Barnes
1Chest Research Foundation, Pune, India. ssalvi@crfindia.com
Lancet (London, England)
|September 1, 2009
概括
生物质烟雾暴露可能是导致慢性阻塞性肺病 (COPD) 的全球主要原因,影响数十亿人. 本综述审查了除了烟草吸烟之外的各种COPD风险因素,包括生物质燃料,职业暴露和感染.
科学领域:
- 肺部医学 肺部医学
- 环境健康 环境健康
- 流行病学 流行病学
背景情况:
- 慢性阻塞性肺病 (COPD) 是全球重要的健康负担,导致广泛的发病率和死亡率.
- 虽然烟草吸烟是主要的危险因素,但COPD病例的很大一部分,特别是在发展中国家,发生在从未吸烟的人身上.
- 这凸显了识别和理解非传统COPD风险因素的重要性.
研究的目的:
- 审查和综合各种环境和职业暴露与COPD发展之间的关联的证据.
- 强调生物质燃料烟雾作为COPD潜在的全球主要风险因素的重要作用.
- 探索其他促成因素,如职业灰尘,感染和空气污染.
主要方法:
- 对现有的流行病学研究和科学文献进行系统审查.
- 分析全球人口的生物质燃料烟雾暴露与烟草吸烟数据.
- 综合证据证明COPD与包括生物质烟雾,职业暴露,儿童感染,喘和空气污染在内的因素之间的关联.
主要成果:
- 据估计,25-45%的COPD患者从未吸烟,这表明非吸烟者COPD的负担很高.
- 大约有30亿人接触到生物质燃料烟雾,这可能使其成为全球最重要的COPD风险因素.
- 对生物质燃料,职业暴露,结核病史,喘,儿童呼吸道感染,室外空气污染和社会经济地位的关联进行了审查.
结论:
- 在全球范围内,生物质燃料的烟雾暴露是COPD的关键,未被认可的危险因素.
- 与非吸烟相关的COPD非常普遍,需要对风险因素有更广泛的了解.
- 公共卫生战略应应对生物质烟雾暴露,特别是在发展中国家,以减轻全球COPD负担.
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