title: Low prevalence of obstructive lung disease in a suburban population of Malaysia: A BOLD collaborative study.
abstract: As a Burden of Obstructive Lung Disease (BOLD) collaboration, we studied the prevalence of chronic obstructive pulmonary disease (COPD) and its associated risk factors in a suburban population in Malaysia.
  
  
  
  Nonhospitalized men or women of age ≥ 40 years from a Penang district were recruited by stratified simple random sampling. Participants completed detailed questionnaires on respiratory symptoms and exposure to COPD risk factors. Prebronchodilator and post-bronchodilator spirometry conducted was standardized across all international BOLD sites in device and data quality control.
  
  
  
  Of the 1218 individuals recruited for the study, 663 (340 men and 323 women) had complete questionnaire data and acceptable post-bronchodilator spirometry. The estimated population prevalence of Global Initiative for Chronic Obstructive Lung Disease (GOLD) ≥ stage I was 6.5% or 3.4% based on either fixed forced expiratory volume in 1 s/forced vital capacity ratio of <0.7 or National Health and Nutritional Examination Survey-derived lower limit of normal ratio while the prevalence of GOLD ≥ stage II was either 4.6% or 3.1%, respectively. Multivariate logistic regression analysis showed independent association between all stages of COPD with cigarette smoking pack years (adjusted odds ratio per 10-year increase: 1.73; 95% confidence interval: 1.09-2.75), use of biomass fuel for cooking (1.61; 1.10-2.36) and exposure to dusty job (1.50; 1.09-2.06).
  
  
  
  This study represented the first robust population-based epidemiology data on COPD for Malaysia. Compared with other sites globally, our estimated population prevalence was relatively low. In addition to cigarette smoking, use of biomass fuel and exposure to dusty job represented significant risk to the development of COPD.
authors.affiliation: Department of Medicine, Penang Medical College, Penang, Malaysia.
authors.forename: Li Cher
authors.initials: LC
authors.lastname: Loh
authors.affiliation: Department of Public Health, Penang Medical College, Penang, Malaysia.
authors.forename: Abdul
authors.initials: A
authors.lastname: Rashid
authors.affiliation: Department of Medicine, Penang Medical College, Penang, Malaysia.
authors.forename: Siti
authors.initials: S
authors.lastname: Sholehah
authors.affiliation: National Heart & Lung Institute, Imperial College, London, United Kingdom.
authors.forename: Louisa
authors.initials: L
authors.lastname: Gnatiuc
authors.affiliation: National Heart & Lung Institute, Imperial College, London, United Kingdom.
authors.forename: Jaymini H
authors.initials: JH
authors.lastname: Patel
authors.affiliation: National Heart & Lung Institute, Imperial College, London, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Burney
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013147:Spirometry / Q000379:methods / Q000706:statistics & numerical data; D013383:Suburban Population / Q000706:statistics & numerical data
keywords: Malaysia; Penang; chronic obstructive pulmonary disease; prevalence; risk factor