Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm

Roberto De Marco, Simone Accordini, Isa Cerveri, Angelo Corsico, Josep M. Antó, Nino Künzli, Christer Janson, Jordi Sunyer, Deborah Jarvis, Susan Chinn, Paul Vermeire, Cecilie Svanes, Ursula Ackermann-Liebrich, Thorarinn Gislason, Joachim Heinrich, Bénédicte Leynaert, Françoise Neukirch, Jan P. Schouten, Matthias Wjst, Peter Burney

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale: The few prospective studies aimed at assessing the incidence of chronic obstructive pulmonary disease (COPD) in relation to the presence of chronic cough/phlegm have produced contrasting results. Objectives: To assess the incidence of COPD in a cohort of young adults and to test whether chronic cough/phlegm and dyspnea are independent predictors of COPD. Methods: An international cohort of 5,002 subjects without asthma (ages 20-44 yr) with normal lung function (FEV1/FVC ratio ≥ 70%) from 12 countries was followed from 1991-2002 in the frame of the European Community Respiratory Health Survey II. Incident cases of COPD were those who had an FEV 1/FVC ratio less than 70% at the end of the follow-up, but did not report having had a doctor diagnose asthma during the follow-up. Main Results: The incidence rate of COPD was 2.8 cases/1,000/yr (95% confidence interval [CI], 2.3-3.3). Chronic cough/phlegm was an independent and statistically significant predictor of COPD (incidence rate ratio [IRR], 1.85; 95% CI, 1.17-2.93) after adjusting for smoking habits and other potential confounders, whereas dyspnea was not associated with the disease (IRR = 0.98; 95% CI, 0.64-1.50). Subjects who reported chronic cough/phlegm both at baseline and at the follow-up had a nearly threefold-increased risk of developing COPD with respect to asymptomatic subjects (IRR = 2.88; 95% CI, 1.44-5.79). Conclusions: The incidence of COPD is substantial even in young adults. The presence of chronic cough/phlegm identifies a subgroup of subjects with a high risk of developing COPD, independently of smoking habits.

Original languageEnglish
Pages (from-to)32-39
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume175
Issue number1
DOIs
Publication statusPublished - Jan 1 2007

Keywords

  • Chronic cough and phlegm
  • Chronic obstructive pulmonary disease
  • Epidemiology
  • Incidence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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