Risk of acute exacerbations in chronic obstructive pulmonary disease associated with biomass smoke compared with tobacco smoke

Jaeyoung Cho, Chang Hoon Lee, Seung Sik Hwang, Ki Uk Kim, Sang Haak Lee, Hye Yun Park, Seoung Ju Park, Kyung-Hoon Min, Yeon Mok Oh, Kwang Ha Yoo, Ki Suck Jung

Research output: Contribution to journalArticle

Abstract

Background: Risk of exacerbations in chronic obstructive pulmonary disease (COPD) associated with biomass smoke has not been well addressed, although biomass smoke is similar in composition to tobacco smoke. Methods: To investigate whether the risk of exacerbations in COPD associated with biomass smoke differs from that in COPD associated with tobacco smoke, we recruited patients with COPD from two Korean multicenter prospective cohorts. In a multiple linear regression model, the standardized regression coefficient (β) of biomass smoke exposure ≥25 years was most similar to that (β ) of tobacco smoke exposure ≥10 pack-years (β = - 0.13 and β = - 0.14). We grouped patients with COPD into four categories based on the above cut-offs: Less Tobacco-Less Biomass, Less Tobacco-More Biomass, More Tobacco-Less Biomass, and More Tobacco-More Biomass. The main outcome was the incidence of moderate or severe exacerbations. Results: Among 1033 patients with COPD, 107 were included in Less Tobacco-Less Biomass (mean age: 67 years, men: 67%), 40 in Less Tobacco-More Biomass (mean age: 70 years, men: 35%), 631 in More Tobacco-Less Biomass (mean age: 68 years, men: 98%), and 255 in More Tobacco-More Biomass (mean age: 69 years, men: 97%). The incidence rates of exacerbations were not significantly different between Less Tobacco-More Biomass and More Tobacco-Less Biomass (adjusted incidence rate ratio, 1.03; 95% confidence interval, 0.56-1.89; P = 0.921). No interaction between sex and tobacco and biomass smoke was observed. When propensity score matching with available covariates including age and sex was applied, a similar result was observed. Conclusions: Patients with COPD associated with biomass smoke and those with COPD associated with tobacco smoke had a similar risk of exacerbations. This suggests that patients with COPD associated with biomass smoke should be treated actively.

Original languageEnglish
Article number68
JournalBMC Pulmonary Medicine
Volume19
Issue number1
DOIs
Publication statusPublished - 2019 Mar 22

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Smoke
Biomass
Chronic Obstructive Pulmonary Disease
Tobacco
Linear Models
Incidence
Propensity Score

Keywords

  • Biomass smoke
  • Chronic obstructive pulmonary disease
  • Exacerbation
  • Tobacco smoke

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Risk of acute exacerbations in chronic obstructive pulmonary disease associated with biomass smoke compared with tobacco smoke. / Cho, Jaeyoung; Lee, Chang Hoon; Hwang, Seung Sik; Kim, Ki Uk; Lee, Sang Haak; Park, Hye Yun; Park, Seoung Ju; Min, Kyung-Hoon; Oh, Yeon Mok; Yoo, Kwang Ha; Jung, Ki Suck.

In: BMC Pulmonary Medicine, Vol. 19, No. 1, 68, 22.03.2019.

Research output: Contribution to journalArticle

Cho, Jaeyoung ; Lee, Chang Hoon ; Hwang, Seung Sik ; Kim, Ki Uk ; Lee, Sang Haak ; Park, Hye Yun ; Park, Seoung Ju ; Min, Kyung-Hoon ; Oh, Yeon Mok ; Yoo, Kwang Ha ; Jung, Ki Suck. / Risk of acute exacerbations in chronic obstructive pulmonary disease associated with biomass smoke compared with tobacco smoke. In: BMC Pulmonary Medicine. 2019 ; Vol. 19, No. 1.
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abstract = "Background: Risk of exacerbations in chronic obstructive pulmonary disease (COPD) associated with biomass smoke has not been well addressed, although biomass smoke is similar in composition to tobacco smoke. Methods: To investigate whether the risk of exacerbations in COPD associated with biomass smoke differs from that in COPD associated with tobacco smoke, we recruited patients with COPD from two Korean multicenter prospective cohorts. In a multiple linear regression model, the standardized regression coefficient (β) of biomass smoke exposure ≥25 years was most similar to that (β ′ ) of tobacco smoke exposure ≥10 pack-years (β = - 0.13 and β ′ = - 0.14). We grouped patients with COPD into four categories based on the above cut-offs: Less Tobacco-Less Biomass, Less Tobacco-More Biomass, More Tobacco-Less Biomass, and More Tobacco-More Biomass. The main outcome was the incidence of moderate or severe exacerbations. Results: Among 1033 patients with COPD, 107 were included in Less Tobacco-Less Biomass (mean age: 67 years, men: 67{\%}), 40 in Less Tobacco-More Biomass (mean age: 70 years, men: 35{\%}), 631 in More Tobacco-Less Biomass (mean age: 68 years, men: 98{\%}), and 255 in More Tobacco-More Biomass (mean age: 69 years, men: 97{\%}). The incidence rates of exacerbations were not significantly different between Less Tobacco-More Biomass and More Tobacco-Less Biomass (adjusted incidence rate ratio, 1.03; 95{\%} confidence interval, 0.56-1.89; P = 0.921). No interaction between sex and tobacco and biomass smoke was observed. When propensity score matching with available covariates including age and sex was applied, a similar result was observed. Conclusions: Patients with COPD associated with biomass smoke and those with COPD associated with tobacco smoke had a similar risk of exacerbations. This suggests that patients with COPD associated with biomass smoke should be treated actively.",
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AU - Cho, Jaeyoung

AU - Lee, Chang Hoon

AU - Hwang, Seung Sik

AU - Kim, Ki Uk

AU - Lee, Sang Haak

AU - Park, Hye Yun

AU - Park, Seoung Ju

AU - Min, Kyung-Hoon

AU - Oh, Yeon Mok

AU - Yoo, Kwang Ha

AU - Jung, Ki Suck

PY - 2019/3/22

Y1 - 2019/3/22

N2 - Background: Risk of exacerbations in chronic obstructive pulmonary disease (COPD) associated with biomass smoke has not been well addressed, although biomass smoke is similar in composition to tobacco smoke. Methods: To investigate whether the risk of exacerbations in COPD associated with biomass smoke differs from that in COPD associated with tobacco smoke, we recruited patients with COPD from two Korean multicenter prospective cohorts. In a multiple linear regression model, the standardized regression coefficient (β) of biomass smoke exposure ≥25 years was most similar to that (β ′ ) of tobacco smoke exposure ≥10 pack-years (β = - 0.13 and β ′ = - 0.14). We grouped patients with COPD into four categories based on the above cut-offs: Less Tobacco-Less Biomass, Less Tobacco-More Biomass, More Tobacco-Less Biomass, and More Tobacco-More Biomass. The main outcome was the incidence of moderate or severe exacerbations. Results: Among 1033 patients with COPD, 107 were included in Less Tobacco-Less Biomass (mean age: 67 years, men: 67%), 40 in Less Tobacco-More Biomass (mean age: 70 years, men: 35%), 631 in More Tobacco-Less Biomass (mean age: 68 years, men: 98%), and 255 in More Tobacco-More Biomass (mean age: 69 years, men: 97%). The incidence rates of exacerbations were not significantly different between Less Tobacco-More Biomass and More Tobacco-Less Biomass (adjusted incidence rate ratio, 1.03; 95% confidence interval, 0.56-1.89; P = 0.921). No interaction between sex and tobacco and biomass smoke was observed. When propensity score matching with available covariates including age and sex was applied, a similar result was observed. Conclusions: Patients with COPD associated with biomass smoke and those with COPD associated with tobacco smoke had a similar risk of exacerbations. This suggests that patients with COPD associated with biomass smoke should be treated actively.

AB - Background: Risk of exacerbations in chronic obstructive pulmonary disease (COPD) associated with biomass smoke has not been well addressed, although biomass smoke is similar in composition to tobacco smoke. Methods: To investigate whether the risk of exacerbations in COPD associated with biomass smoke differs from that in COPD associated with tobacco smoke, we recruited patients with COPD from two Korean multicenter prospective cohorts. In a multiple linear regression model, the standardized regression coefficient (β) of biomass smoke exposure ≥25 years was most similar to that (β ′ ) of tobacco smoke exposure ≥10 pack-years (β = - 0.13 and β ′ = - 0.14). We grouped patients with COPD into four categories based on the above cut-offs: Less Tobacco-Less Biomass, Less Tobacco-More Biomass, More Tobacco-Less Biomass, and More Tobacco-More Biomass. The main outcome was the incidence of moderate or severe exacerbations. Results: Among 1033 patients with COPD, 107 were included in Less Tobacco-Less Biomass (mean age: 67 years, men: 67%), 40 in Less Tobacco-More Biomass (mean age: 70 years, men: 35%), 631 in More Tobacco-Less Biomass (mean age: 68 years, men: 98%), and 255 in More Tobacco-More Biomass (mean age: 69 years, men: 97%). The incidence rates of exacerbations were not significantly different between Less Tobacco-More Biomass and More Tobacco-Less Biomass (adjusted incidence rate ratio, 1.03; 95% confidence interval, 0.56-1.89; P = 0.921). No interaction between sex and tobacco and biomass smoke was observed. When propensity score matching with available covariates including age and sex was applied, a similar result was observed. Conclusions: Patients with COPD associated with biomass smoke and those with COPD associated with tobacco smoke had a similar risk of exacerbations. This suggests that patients with COPD associated with biomass smoke should be treated actively.

KW - Biomass smoke

KW - Chronic obstructive pulmonary disease

KW - Exacerbation

KW - Tobacco smoke

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