Etiology and clinical profile of COPD in non-smoker in urban area


  • Amar R. Pazare Department of Medicine, K. J. Somaiya Medical College, Mumbai, Maharashtra, India
  • Pankti K. Mehta Department of Medicine, Seth G. S. Medical College, Mumbai, Maharashtra, India



Air pollution, Biomass, Dyspnea


Background: Smoking is established as a causative risk factor for COPD as early as 1950. However, in the past decade it is shown that, other risk factors like indoor and outdoor air pollutants, workplace exposure to dust and fumes, poor nourishment and poor socioeconomic status are also associated with COPD. COPD is a disease associated poor quality of life due to recurrent exacerbations. Till to date focus has been on smoking as a risk factor for COPD, but other factors also need to be taken into consideration.

Methods: Study was conducted in 60 eligible patients from urban area for a period of 18 months. Individual patient was asked detailed personal demographic data, respiratory symptoms, exposure to passive smoking, family history of COPD. Detailed physical examination including Anthropometric measurements and other relevant general and systemic examination was carried out. Biochemical investigations, ECG, Chest X-ray, CT chest, spirometry and 2D echocardiography were carried out in all patients.

Results: The mean age of the patient was 65.7±7.95 with male preponderance. Common symptoms were dyspnea and cough and common signs were rhonchi and hyper resonance note on percussion. Common risk factors were indoor air pollution and low socioeconomic class. Most of the patients has hypoxia and hypercapnia. X-ray chest and CT chest showed hyperinflation, air trapping. Majority of patients had moderate FEV/FVC ratio on spirometry.

Conclusions: Non-smoker COPD patients usually present in old age. Common presentation is dyspnea followed by cough and rhonchi on examination. Most common risk factor for non- smoker COPD is indoor air pollution, low socioeconomic class and cotton mill workers. Amongst indoor pollution, LPG, kerosene and wood are the risk factors for non-smokers COPD in urban population.


Ko FW, Chan KP, Hui DS, Goddard JR, Shaw JG, Reid DW, Yang IA. Acute exacerbation of COPD. Respirology. 2016;21(7):1152-65.

Po JY, FitzGerald JM, Carlsten C. Respiratory disease associated with solid biomass fuel exposure in rural women and children: systematic review and meta-analysis. Thorax. 2011;66: 232-9.

Stoller JK, Aboussouan LS. A review of α1-antitrypsin deficiency. Am J Respirat Critical Care Med. 2012;185(3):246-59.

Mathew N, Xavier Z, Deshmukh AS, Deshmukh H, Jadhav S, Kasat S. The study of aetiology of chronic obstructive pulmonary disease (COPD) in Non-Smokers. J Pulmon Respir Med. 2015;5:304.

Shapiro SD, Ingenito EP. The pathogenesis of chronic obstructive pulmonary disease: advances in the past 100 years. Am J Respirat Cell Mole Biol. 2005;32(5):367-72.

Wig KL, Guleria JS, Bhasin RC, Holmes Jr E, Vasudeva YL, Singh H. Certain clinical and epidemiological patterns of chronic obstructive lung disease as seen in northern India. Indian J Chest Dis. 1964;6:183-94.

Jindal SK, Aggarwal AN, Gupta D, Agarwal R, Kumar R, Kaur T, et al. Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults (INSEARCH). Int J Tubercul Lung Dis. 2012;16(9):1270-7.

Bakr RM, Elmahallawy II. Prevalence characteristics of COPD in never smokers. Egyptian J Chest Dis Tuberculosis. 2012;61(3):59-65.

Zhou Y, Wang C, Yao W, Chen P, Kang J, Huang S, Chen B, et al. COPD in Chinese nonsmokers. European Resp J. 2009;33(3):509-18.

Wig KL, Guleria JS, Bhasin RC, Holmes Jr E, Vasudeva YL, Singh H. Certain clinical and epidemiological patterns of chronic obstructive lung disease as seen in northern India. Indian J Chest Dis. 1964;6:183-94.

Ekici A, Ekici M, Kurtipek E, Akin A, Arslan M, Kara T, Apaydin Z, Demir S. Obstructive airway diseases in women exposed to biomass smoke. Env Res. 2005;99(1):93-8.

Behrendt CE. Mild and moderate-to-severe COPD in nonsmokers: distinct demographic profiles. Chest. 2005;128(3):1239-44.

Kamdar DJ, Patel DK. A study of the clinical profile of 50 patients of COPD with correlation between clinical, radiological and spirometric evaluation. Int J Res Med Sci. 2017;5(5):1802-7.

Birring SS, Brightling CE, Bradding P, Entwisle JJ, Vara DD, Grigg J, et al. Clinical, radiologic, and induced sputum features of chronic obstructive pulmonary disease in nonsmokers: a descriptive study. Am J Resp Critical Care Med. 2002;166(8):1078-83.






Original Research Articles