Prevalence of COPD: first epidemiological study of a large region in Turkey.

Background: Although chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity worldwide, epidemiological data on COPD is very limited. This study was designed to obtain some baseline data on COPD in the Malatya region of Turkey.

Methods: Sixty clusters from urban and rural regions were randomly selected. Ten and seven consecutive households were included in the study from each urban and rural cluster, respectively. A validated questionnaire on the epidemiology of COPD was completed for each participant over 18 by a pulmonary physician. Each subject underwent standard spirometric measurement and early bronchodilation testing.

Results: A total of 1160 participants completed the study (93%). Some 6.9% of the participants were found to have COPD (F/M=1/4). While the prevalence of COPD was 18.1% in current smokers over 40 years of age, the prevalence was 4.5% among younger smokers. Some 25.5% of the women and 57.2% of the men were current smokers. Biomass exposure, as a sole reason for COPD, was significantly common among female patients living in rural areas (54.5%). In the development of COPD, the relative risk ratio of cigarette smoke was found to be 3.4 and 3.3 times higher than biomass exposure and occupational exposure, respectively.

Conclusions: Smoking rate and COPD prevalence were found to be unexpectedly high in the region, and biomass exposure is still an important cause of COPD, particularly among females living in rural areas. We think that national policies against smoking and biomass exposure should be implemented immediately.