( its burden. “Our results show tha...)Cough and Phlegm Cause Fourfold Increase in COPD Incidence,Health

its burden.

“Our results show that the presence of chronic cough and phlegm is not an innocent symptom, but is an early marker of airflow obstruction,” said Dr. Cerveri.

In addition to cough and phlegm in participants, researchers considered such factors as sex, age, dyspnea (breathlessness), smoking habits and level of education. All participants received lung function tests and blood workups at the beginning and end of the study.

In an editorial on the research in the same issue of the journal, J?rgen Vestbo, M.D., of Hvidovre University Hospital in Denmark and the University of Manchester in the United Kingdom, wrote: “The virtue of the study by Drs. Cerveri and colleagues lies in its size and thus the ability to calculate estimates with acceptable reliability. In this respect, it adds to previous work from the same group and indicates that the statement ‘15 percent of smokers will develop COPD’ is wrong and that lifetime risk of COPD in smokers is significantly higher, probably about 35 to 50 percent.”

He continued: “The predictive value of chronic cough and phlegm is probably more surprising given the fact that this cohort was young and had normal lung function at baseline.”

Dr. Vestbo concluded: “How does the study impact our understanding of the natural history of COPD? As recently reported in this journal, it has taken the respiratory community a painstakingly long time to do properly sized studies in young adults with sound methodology and state-of-the-art analysis. With COPD epidemiology growing in the European Community Respiratory Health Survey and other cohorts of young adults, we may get a better picture of early events in COPD---although our colleagues in pediatric epidemiology will probably continue to claim that we are still only looking at ‘the elderly’!”

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