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Browsing by Author "Wouters, Emiel F."

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  • Chronic airflow obstruction and ambient particulate air pollution
    Publication . Amaral, Andre F.; Burney, Peter G.; Patel, Jaymini; Minelli, Cosetta; Mejza, Filip; Mannino, David M.; Seemungal, Terence A.; Mahesh, Padukudru Anand; Lo, Li Cher; Janson, Christer; Juvekar, Sanjay; Denguezli, Meriam; Harrabi, Imed; Wouters, Emiel F.; Cherkaski, Hamid; Mortimer, Kevin; Jogi, Rain; Bateman, Eric D.; Fuertes, Elaine; Al Ghobain, Mohammed; Tan, Wan; Obaseki, Daniel O.; El Sony, Asma; Studnicka, Michael; Aquart-Stewart, Althea; Koul, Parvaiz; Lawin, Herve; Nafees, Asaad Ahmed; Awopeju, Olayemi; Erhabor, Gregory E.; Gislason, Thorarinn; Welte, Tobias; Gulsvik, Amund; Nielsen, Rune; Gnatiuc, Louisa; Kocabas, Ali; Marks, Guy B.; Sooronbaev, Talant; Mbatchou Ngahane, Bertrand Hugo; Barbara, Cristina; Buist, A. Sonia; BOLD Collaborative Research Group; Dias, Hermínia Brites
    Smoking is the most well-established cause of chronic airflow obstruction (CAO) but particulate air pollution and poverty have also been implicated. We regressed the sex-specific prevalence of CAO from 41 Burden of Obstructive Lung Disease study sites against smoking prevalence from the same study, the gross national income per capita, and the local annual mean level of ambient particulate matter (PM2.5) using negative binomial regression. The prevalence of CAO was not independently associated with PM2.5 but was strongly associated with smoking and was also associated with poverty. Strengthening tobacco control and improving understanding of the link between CAO and poverty should be prioritized.
    2021-12Journal article Open access Show more
  • Geographical variation in lung function: results from the multicentric cross-sectional BOLD study
    Publication . Burney, Peter G.; Potts, James; Knox-Brown, Ben; Erhabor, Gregory; Hacene Cherkaski, Hamid; Mortimer, Kevin; Anand, Mahesh Padukudru; Mannino, David M.; Cardoso, Joao; Ahmed, Rana; Elsony, Asma; Barbara, Cristina; Nielsen, Rune; Bateman, Eric; Paraguas, Stefanni Nonna; Cher Loh, Li; Rashid, Abdul; Wouters, Emiel F.; Franssen, Frits M.; Dias, Hermínia Brites; Gislason, Thorarinn; Ghobain, Mohammed A.; Biaze, Mohammed El; Agarwal, Dhiraj; Juvekar, Sanjay; Rodrigues, Fatima; Obaseki, Daniel O.; Koul, Parvaiz A.; Harrabi, Imed; Nafees, Asaad A; Seemungal, Terence; Janson, Christer; Vollmer, William M; Amaral, Andre F.; Buist, A Sonia
    Spirometry is used to determine what is "unusual" lung function compared with what is "usual" for healthy non-smokers. This study aimed to investigate regional variation in the forced vital capacity (FVC) and in the forced expiratory volume in one second to FVC ratio (FEV1/FVC) using cross-sectional data from all 41 sites of the multinational Burden of Obstructive Lung Disease study. Participants (5,368 men; 9,649 women), aged ≥40 years, had performed spirometry, had never smoked and reported no respiratory symptoms or diagnoses. To identify regions with similar FVC, we conducted a principal component analysis (PCA) on FVC with age, age2 and height2, separately for men and women. We regressed FVC against age, age2 and height2, and FEV1/FVC against age and height2, for each sex and site, stratified by region. Mean age was 54 years (both sexes), and mean height was 1.69 m (men) and 1.61 m (women). The PCA suggested four regions: 1) Europe and richer countries; 2) the Near East; 3) Africa; and 4) the Far East. For the FVC, there was little variation in the coefficients for age, or age2, but considerable variation in the constant (men: 2.97 L in the Far East to 4.08 L in Europe; women: 2.44 L in the Far East to 3.24 L in Europe) and the coefficient for height2. Regional differences in the constant and coefficients for FEV1/FVC were minimal (<1%). The relation of FVC with age, sex and height varies across and within regions. The same is not true for the FEV1/FVC ratio.
    2025Journal article Open access Show more
  • Quality of life associated with breathlessness in the multinational Burden of Obstructive Lung Disease (BOLD) study: a cross-sectional analysis
    Publication . Müller, Alexander; Wouters, Emiel F.; Burney, Peter; Potts, James; Cardoso, Joao; Al Ghobain, Mohammed; Studnicka, Michael; Obaseki, Daniel; Elsony, Asma; Mortimer, Kevin; Mannino, David; Jögi, Rain; Ahmed, Rana; Nafees, Asaad; Hermínia Brites Dias
    Introduction: Evidence of an association between breathlessness and quality of life from population-based studies is limited. We aimed to investigate the association of physical and mental quality of life with breathlessness across several low-, middle- and high-income countries. Methods: We analyzed data from 19,714 adults (31 sites, 25 countries) from the Burden of Obstructive Lung Disease (BOLD) study. We measured both mental and physical quality of life components using the SF-12 questionnaire and defined breathlessness as grade ≥2 on the modified Medical Research Council scale. We used multivariable linear regression to assess the association of each quality-of-life component with breathlessness. We pooled site-specific estimates using random-effects meta-analysis. Results: Both physical and mental component scores were lower in participants with breathlessness compared to those without. This association was stronger for the physical component (coefficient = -7.59; 95%CI -8.60, -6.58; I2 = 78.5%) than for the mental component (coefficient = -3.50; 95%CI -4.36, -2.63; I2 = 71.4%). The association between physical components and breathlessness was stronger in high-income countries (coefficient = -8.82; 95%CI -10.15, -7.50). Heterogeneity across sites was partly explained by sex and tobacco smoking. Conclusion: Quality of life is worse in people with breathlessness, but this association varies widely across the world.
    2025-04Journal article Open access Show more