Pilot Study of Chronic Obstructive Pulmonary Disease in an Industrial Town in India

Background. The burden of chronic obstructive pulmonary disease (COPD) in India is not well understood. Due to geographical and environmental heterogeneity, the epidemiological profile of COPD may not be uniform across the country. Studies carried out in small geographical areas can help to determine the prevalence and risk factors of COPD. Objectives. The present study was conducted in one city in northwest India in order to calculate prevalence in small geographically determined areas within the city as well as across socio-economic strata and adjoining neighborhoods. Methods. The present study was conducted in Ludhiana, an industrial town in Punjab, India. Residential colonies were identified in an industrial and nonindustrial area and all households were screened for COPD using the Global Initiative for Chronic Obstructive Lung Disease criteria and confirmed by spirometry. Information about exposure to possible risk factors was also collected from suspected cases of COPD. Cases were mapped on a digital map of the city and hotspots were identified. Results. Fifty-six cases of COPD were detected. More than half (71%) were in the industrial area. The overall prevalence rate of COPD in the city was 3.17 per 1000. The highest prevalence (5.6-9.4 per thousand) was observed in the colonies of the industrial area. All surveyed colonies in the nonindustrial area showed a low prevalence (0.0 to 0.9 per thousand). Conclusions. Hotspots were located in the industrial area and there was no such aggregation in the nonindustrial area. This suggests a potential association of industrial air pollutants with COPD. A strength of the present study is that it provides important baseline data. However, the study was limited, as it did not show a temporal association of exposure to air pollution and smoking with COPD.