title: Prevalence and underdiagnosis of airway obstruction among middle-aged adults in northern France: The ELISABET study 2011-2013.
abstract: BACKGROUND
  Airway obstruction (AO), mainly due to chronic obstructive pulmonary disease (COPD) in adults, is a major cause of mortality and poor quality of life. However, few data are available for France. This study was designed to calculate the prevalence AO among middle-aged adults in northern France, explore the associated risk factors and evaluate the underdiagnosis.
  
  
  METHODS
  The Enquête Littoral Souffle Air Biologie Environnement (ELISABET) was a cross-sectional study of a representative sample of 3276 adults aged from 40 to 64 in two urban areas in northern France (Lille and Dunkirk). Participants filled out a questionnaire and performed spirometry testing, without a reversibility test.
  
  
  RESULTS
  The age-standardized estimated prevalence [95% confidence interval] of AO was 16.0% [13.9; 17.9] in Lille and 13.7% [11.7; 15.7] in Dunkirk with the Global initiative for chronic Obstructive Lung Disease (GOLD) definition and 10.8% [9.2; 12.5] and 9.5% [7.9; 11.2] respectively with the lower limit of normal calculated with the Global Lung Initiative (GLI) 2012 equations. AO was associated with age, male gender, tobacco consumption and low body mass index. The underdiagnosis rate was greater than 70%. Previously undiagnosed participants with AO displayed more respiratory symptoms compared with participants without AO and less than participants with previously diagnosed AO.
  
  
  CONCLUSIONS
  The prevalence of AO in northern France ranged from 9.5 to 16.0%, depending on the centre and definition used. The high underdiagnosis rate observed here suggests that greater efforts should be made to identify individuals presenting with the symptoms and/or risk factors associated with AO.
authors.affiliation: University of Lille, Faculté de Médecine Henri Warembourg, F-59045, Lille Cedex, France; University Hospital of Lille, 2 Avenue Oscar Lambret, F-59000, Lille, France. Electronic address: alexandre.quach85@gmail.com.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Quach
authors.affiliation: University of Lille, Faculté de Médecine Henri Warembourg, F-59045, Lille Cedex, France; University Hospital of Lille, 2 Avenue Oscar Lambret, F-59000, Lille, France; Pasteur Institute of Lille, INSERM U1167 RID-AGE, 1 Rue du Professeur Calmette, F-59800, Lille, France. Electronic address: jonathan.giovannelli@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Giovannelli
authors.affiliation: University of Lille, Faculté de Médecine Henri Warembourg, F-59045, Lille Cedex, France; University Hospital of Lille, 2 Avenue Oscar Lambret, F-59000, Lille, France. Electronic address: nathalie.cherot@univ-lille2.fr.
authors.forename: Natalie
authors.initials: N
authors.lastname: Chérot-Kornobis
authors.affiliation: Pasteur Institute of Lille, INSERM U1167 RID-AGE, 1 Rue du Professeur Calmette, F-59800, Lille, France. Electronic address: alina.ciuchete@gmail.com.
authors.forename: Alina
authors.initials: A
authors.lastname: Ciuchete
authors.affiliation: University of Lille, Faculté de Médecine Henri Warembourg, F-59045, Lille Cedex, France; Pasteur Institute of Lille, INSERM U1167 RID-AGE, 1 Rue du Professeur Calmette, F-59800, Lille, France. Electronic address: gja.clement@gmail.com.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Clément
authors.affiliation: University of Lille, Faculté de Médecine Henri Warembourg, F-59045, Lille Cedex, France; University Hospital of Lille, 2 Avenue Oscar Lambret, F-59000, Lille, France. Electronic address: regis.matran@univ-lille2.fr.
authors.forename: Régis
authors.initials: R
authors.lastname: Matran
authors.affiliation: University of Lille, Faculté de Médecine Henri Warembourg, F-59045, Lille Cedex, France; University Hospital of Lille, 2 Avenue Oscar Lambret, F-59000, Lille, France; Pasteur Institute of Lille, INSERM U1167 RID-AGE, 1 Rue du Professeur Calmette, F-59800, Lille, France. Electronic address: philippe.amouyel@pasteur-lille.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Amouyel
authors.affiliation: University of Lille, Faculté de Médecine Henri Warembourg, F-59045, Lille Cedex, France; University Hospital of Lille, 2 Avenue Oscar Lambret, F-59000, Lille, France. Electronic address: jledme@univ-lille2.fr.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Edmé
authors.affiliation: University of Lille, Faculté de Médecine Henri Warembourg, F-59045, Lille Cedex, France; University Hospital of Lille, 2 Avenue Oscar Lambret, F-59000, Lille, France; Pasteur Institute of Lille, INSERM U1167 RID-AGE, 1 Rue du Professeur Calmette, F-59800, Lille, France. Electronic address: luc.dauchet@pasteur-lille.fr.
authors.forename: Luc
authors.initials: L
authors.lastname: Dauchet
mesh_terms: D000328:Adult; D017677:Age Distribution; D000402:Airway Obstruction / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D017678:Sex Distribution; D014504:Urban Health / Q000706:statistics & numerical data; D014797:Vital Capacity / Q000502:physiology
keywords: Airway obstruction; Chronic obstructive pulmonary disease; GLI 2012; GOLD; Prevalence; Underdiagnosis