Rushi Rabari, Kalpesh Patel
Background and Aim: According to World Health Organization, globally chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity. The present study was done: to study the clinical profile of COPD in non-smokers and to identify the other risk factors (other than smoking) of COPD. Material and Methods: Eighty patients who were non-smokers and presented with history of cough, sputum, breathlessness or wheezing of more than 3 months duration to the medical outpatient department or admitted in medical wards of Gujarat Adani Institute of Medical Science, Bhuj, Kutch were subjected to pre and post bronchodilator pulmonary function testing. Data was collected meeting the objectives of the study with a pre-tested proforma. Detailed history was taken, clinical examination was done and necessary investigations were carried out. A computerized spirometer was used to perform lung function tests. Three satisfactory efforts from the test were recorded and the best effort among them was considered. Bronchodilation was done using 400 µg of inhaled salbutamol using a metered dose inhaler and test was repeated after 15 minutes. Results: Cough and sputum were present in all of the patients while breathlessness was present in 62.5%, wheezing in 20%, fatigue in 17.5%, weight loss in 12.5%, swelling of lower limbs in 13.7%, fever in 11.2% and chest pain in 6.2% of the patients. Out of 80 patients, only 22 patients gave history of occupational exposure, 15 patients gave history of exposure to dust, 4 patient gave history of exposure to dust and husk, 4 patients gave history of exposure to husk, 6 patients gave history of exposure to coal dust and 5 patient gave history of exposure to textile mill dust. 20 percent of the patients gave history of exposure to air pollution. Conclusion: On the basis of these findings, it can be concluded that nonsmokers contribute a significant proportion of COPD patients. Multiple risk factors other than smoking also play a major role in development of COPD, particularly exposure to biomass smoke, treated pulmonary tuberculosis, and long standing asthma. Other nonsmoking risk factors are occupational exposure, exposure to outdoor air pollution, lower respiratory tract infection during childhood and low socioeconomic status.
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