232938 Health outcomes associated with excessive lung function decline and respiratory symptoms in a community cohort

Monday, November 8, 2010 : 8:50 AM - 9:10 AM

Penelope J. Baughman, MPA, MPH , Department of Community Medicine, West Virginia University, Morgantown, WV
Jacob L. Marott, MSc , Bispebjerg University Hospital, Copenhagen, Denmark
Peter Lange, MD , Hvidovre Hospital, Copenhagen, Denmark
Eva Hnizdo, PhD , Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV
Background: In creating workplace respiratory disease prevention strategies, a thorough understanding is needed of the relative contributions of lung function loss and respiratory symptoms and disease to predict health outcomes. Methods: Copenhagen City Heart Study data collected at four examinations during 19762003 were used to assess risk associated with excessive lung function decline and respiratory symptoms and disease. Risks of chronic obstructive pulmonary disease (COPD) morbidity, COPD or coronary heart disease (CHD) mortality, and all-cause mortality were estimated in relation to asthma, chronic bronchitis, shortness of breath, and cross-sectional lung function or with one of four criteria for longitudinal lung function decline over five years of follow-up. Hazard ratios (HR) and 95% confidence intervals (CI) estimated the relationships between lung function parameters and event rates by gender and for never smokers. Age, height-adjusted baseline lung function (FEV1/Height2), and height were adjusted for in the models. Results: For COPD morbidity, the increasing trend in the HR (95% CI) by quartiles of the slope was 1.61 (1.182.19), 2.54 (1.873.45), and 3.77 (2.765.15) for males; 2.48 (1.893.27), 3.37 (2.554.44), and 6.12 (4.638.10) for females; and 1.89 (0.764.69), 2.25 (0.885.78), and 4.14 (1.5710.90) for never smokers. The risk of COPD or CHD mortality and of all-cause mortality also showed a significant increasing trend. Discussion: The risk of respiratory morbidity and mortality showed an increasing trend with lung function decline after adjustment for baseline lung function and respiratory symptoms and disease.

Learning Objectives:
1. Identify the most useful measures of lung function decline for the prediction of morbidity and mortality. 2. Identify the critical level of lung function decline that becomes a significant predictor of morbidity and mortality. 3. Assess the usefulness of respiratory symptoms and disease in predicting morbidity and mortality relative to lung function level and decline.

Keywords: Chronic Diseases, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I performed the analysis outlined in the abstract and am conducting my dissertation research on respiratory disease.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.