title: Targeting Persons With or At High Risk for Chronic Obstructive Pulmonary Disease by State-based Surveillance.
abstract: The Behavioral Risk Factor Surveillance System (BRFSS) survey is used to estimate chronic obstructive pulmonary disease (COPD) prevalence and could be expanded to describe respiratory symptoms in the general population and to characterize persons with or at high risk for the disease. Tobacco duration and respiratory symptom questions were added to the 2012 South Carolina BRFSS. Data concerning sociodemographics, chronic illnesses, health behaviors, and respiratory symptoms were collected in 9438 adults ≥ 35 years-old. Respondents were categorized as having COPD, high risk, or low risk for the disease. High risk was defined as no self-reported COPD, ≥ 10 years' tobacco use, and ≥ 1 respiratory symptom (frequent productive cough or shortness of breath (SOB), or breathing problems affecting activities). Prevalence of self-reported and high-risk COPD were 9.1% and 8.0%, respectively. Overall, 17.3%, 10.6%, and 5.2% of all respondents reported activities limited by breathing problems, frequent productive cough, and frequent SOB, respectively. The high-risk group was more likely than the COPD group to report a productive cough and breathing problems limiting activities as well as being current smokers, male, and African-American. Health impairment was more severe in the COPD than the high-risk group, and both were worse than the low-risk group.
  
  
  CONCLUSIONS
  Persons at high risk for COPD share many, but not all, of the characteristics of persons diagnosed with the disease. Additional questions addressing smoking duration and respiratory symptoms in the BRFSS identifies groups at high risk for having or developing COPD who may benefit from smoking cessation and case-finding interventions.
authors.affiliation: a Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, and Durham VA Medical Center , Durham , North Carolina , USA.
authors.forename: Roy A
authors.initials: RA
authors.lastname: Pleasants
authors.affiliation: b Chronic Disease Epidemiology Office, South Carolina Department of Health and Environmental Control , Columbia , South Carolina , USA.
authors.forename: Khosrow
authors.initials: K
authors.lastname: Heidari
authors.affiliation: c Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , Georgia , USA.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Wheaton
authors.affiliation: d Section on Pulmonary, Critical Care, Allergy & Immunologic Disease, Wake Forest University School of Medicine , Winston-Salem , North Carolina , USA.
authors.forename: Jill A
authors.initials: JA
authors.lastname: Ohar
authors.affiliation: e Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina , Charleston , South Carolina , USA.
authors.forename: Charlie
authors.initials: C
authors.lastname: Strange
authors.affiliation: f Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta , Georgia.
authors.forename: Janet B
authors.initials: JB
authors.lastname: Croft
authors.affiliation: g Consultant, North Carolina COPD Taskforce , Cary, North Carolina , USA.
authors.forename: Winston
authors.initials: W
authors.lastname: Liao
authors.affiliation: h Division of Pulmonary, Critical Care, and Sleep Medicine, Pulmonary Epidemiology Research Laboratory, University of Kentucky , Lexington , Kentucky , USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Mannino
authors.affiliation: i Department of Medicine, University of Arizona College of Medicine , Tucson , Arizona , USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Kraft
mesh_terms: D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D018570:Risk Assessment; D057566:Self Report; D012907:Smoking; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: chronic obstructive pulmonary disease; population surveillance; respiratory symptoms; tobacco exposure; underdiagnosis