RISK-FACTORS FOR CHRONIC OBSTRUCTIVE PULMONARY-DISEASE IN A NORTH ITALIAN RURAL AREA

To assess the role of risk factors for chronic obstructive lung diseas e (COPD) by multiple logistic models, the data of the first cross-sect ional epidemiological survey in the unpolluted rural area of the Po Ri ver Delta were analyzed (n = 2382; 20-64 years). Each subject filled o ut a standardized questionnaire; 94% of the subjects were also able to perform forced expirograms. Dependent variables were chronic respirat ory symptoms, asthma, abnormal parameters of flow-volume curve (ABNFVC ), and a complex characterized by chronic phlegm and/or any wheeze and /or dyspnea grade 2+ and/or diagnosis of asthma and/or an FEV1/FVC rat io less than 60% (ANYABN). Independent variables were: age, ever cigar ette smoking (SMK) and lifetime cigarette consumption expressed as pac k-years, childhood respiratory infections (CRI), adolescence-adulthood respiratory infections (ARI), familial history for COPD (FCOPD) or fo r asthma/allergies (FASTHMA), work exposure to dusts/chemicals (EXPO), low socio-economic conditions (SES). A significant relationship with almost all dependent variables was shown by pack-years, ARI and age in both sexes. In males, FCOPD was related to chronic mucus hypersecreti on and to ABNFVC, FASTHMA was associated with wheeze and ANYABN. EXPO was related to dyspnea and asthmatic symptoms in both sexes and also t o bronchitic symptoms in males. CRI was a significant contributor for asthma symptoms in males, for ANYABN in females. SES had no significan t association. In conclusion, our findings show that, beside lifetime cigarette smoking, other host - or environment - related conditions ar e important risk factors for COPD, suggesting the need for a more thor ough strategy for prevention.