Objective: Asthma-chronic obstructive pulmonary disease overlap (ACO) indicates that its characteristics with pulmonary exaggerated reactivity and airflow limitation chronically. We aimed to investigate the differences among women non smoker participants who have asthma, chronic obstructive pulmonary disease (COPD) and ACO with biomass smoke exposure.
Method: Patients were examined at the outpatient clinic from September 2017 to March 2020. Non-smoker women patients aged ≥40 years, diagnosed with obstructive pulmonary disease were included in the study. pulmonary function tests (PFT), early reversibility testing (bronchodilator test), and sputum eosinophil analysis were performed to all patients.
Results: A total of 102 patients were included. The mean age was 46.95±9.50 years. In the differential diagnosis, 65 patients (63.7%) had asthma and 37 patients (36.3%) had COPD. Among COPD patients, 10 (27.0%) were diagnosed with ACO. The actual prevalence rates of COPD and ACO were 26.5% and 9.8%, respectively. Poisson regression analysis showed that COPD compared to asthma, while holding the others variable constant in the model, are expected to have 2.976 times greater rate for exacerbations.( IRR, 95%CI ,2.976 (0.687 to 1.494), 5.296 (1.203 to 2.130), P<0.001, Coef. 1.091, 1.667 respectively). Logistic Regression analysis demonstrated that, the count of sputum, blood eosinophil and total IgE results were correlated with the exacerbation times.
Conclusion: Biomass smoke exposure in the women population is revealed as a significant factor for the diagnosis of ACO.
A burning need to redefine airways disease: Biomass smoke exposure identified as a unique risk factor for asthma–chronic obstructive pulmonary disease overlap in low- and middle-income countries