Clinical Features, Burden, and Risk Factors for Chronic Obstructive Pulmonary Disease in Nonsmokers

Introduction

Chronic obstructive pulmonary disease (COPD) is characterized by not fully reversible airflow limitation and a range of pathology changes in the lung, consisting of a mixture of inflammation in the small airways and parenchyma destruction 1. In the past years, it was usually considered a smoking-related disease 2. Based on this consideration, most researches focused on COPD with smoking. As the result, COPD has not been well characterized among those nonsmokers. However, increasing evidence showed that some patients with COPD were nonsmokers, indicating that factors other than smoking may be involved in the development of COPD . Here we review on the burdens, clinical characteristics, and the risk factors of COPD among nonsmokers who have never smoked during their lifetime, especially in China and to acquire more research interest..

Abstract

Smoking is regarded as a major causative risk factor for COPD. However, increasing evidence showed that a number of nonsmokers could also develop COPD. The COPD patients who never smoke reportedly have a distinct clinical feature from COPD patients who are smokers. Other than smoking, COPD was also shown to be associated with exposure to biomass fuel, environmental tobacco smoke, occupational exposure to dust/gas/fume/vapor, outdoor air pollution, history of pulmonary tuberculosis, chronic asthma, respiratory tract infections during childhood, poor socioeconomic status, individual genetic differences, and so on. Differences in environmental exposure, lifestyle, and behavior may be the underlying causes of the varying prevalence, characteristics, and potential risk factors regarding nonsmoker's COPD across countries and areas. Here we review risk factors and clinical characteristics of nonsmoking COPD patients in China as well as the related burden, aiming to provide more information about COPD among nonsmokers who have never smoked during their lifetime.

Keywords

Nonsmoker, COPD, risk factor