title: Chronic obstructive pulmonary disease prevalence in Lebanon: a cross-sectional descriptive study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) continues to increase worldwide. The objective of this study was to determine the prevalence of COPD in Lebanese adults.
  
  
  METHODS
  A cross-sectional study was carried out using a multistage cluster sample from all over Lebanon. Residents aged 40 years and over were enrolled. Subjects underwent baseline spirometry and answered a questionnaire. After an albuterol + ipratropium bromide bronchodilator, a posttest was performed.
  
  
  RESULTS
  Of 2201 individuals, only 33.3% had never smoked. The prevalence of COPD by the Global Initiative for Chronic Obstructive Lung Disease definition, was 9.7% (95% confidence interval [CI]: 8.5%-10.9%). According to the 5% lower limit of normal definition of COPD, the prevalence was 12.5% (95% CI: 11.2%-13.9%). A total of 20.2% were already diagnosed by a physician. No differences in symptoms across stages of COPD were found, but there was a significant trend for a higher number of visits to the emergency room and to the doctor (P < 0.001), and a higher number of hospitalizations (P < 0.001). Older individuals had an increased risk of COPD (adjusted odds ratio [OR(a)] = 1.05); so did "ever" cigarette smokers (OR(a) = 4.88) and water-pipe smokers (OR(a) = 2.53).
  
  
  CONCLUSIONS
  This is the first epidemiological study in Lebanon that determined COPD prevalence and the link with water-pipe smoking.
authors.affiliation: Saint George Hospital University Medical Center, Beirut, Lebanon.
authors.forename: Mirna
authors.initials: M
authors.lastname: Waked
authors.forename: George
authors.initials: G
authors.lastname: Khayat
authors.forename: Pascale
authors.initials: P
authors.lastname: Salameh