Obstructive lung disease among the urban homeless
Obstructive lung disease among the urban homeless
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DOI：
10.1378/chest.125.5.1719
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发表时间：
2004-05-01
期刊：
影响因子：
9.6
通讯作者：
Eisner, MD
中科院分区：
文献类型：
--
作者：
Snyder, LD;Eisner, MD
研究目的：在美国，无家可归是一个日益严重的问题，可能会严重损害身体健康。无家可归者吸烟、营养不良和不良环境暴露的患病率很高，这可能导致阻塞性肺病（OLD）。尽管存在这种风险，无家可归者中老年人的患病率仍然未知。我们的目的是系统地评估老年痴呆症的患病率在城市homeless.Design，设置，和participants：我们进行了一项横断面研究老年痴呆症的患病率在旧金山弗朗西斯科无家可归的人。通过随机抽样，我们招募了68名居住在一个无家可归者收容所的成年人参加结构化访谈调查和肺功能评估。我们采用多方面的方法来评估OLD，包括呼吸道症状，自我报告的哮喘、慢性支气管炎、肺气肿或COPD的医生诊断，以及肺功能测定（定义为FEV 1 < 80%预测值和FEV 1/FVC比值< 0.70）。无家可归的成年人可能无家可归不到1年，而且是第一次无家可归。吸烟率很高（75%曾经吸烟，68%目前吸烟）。提示OLD的症状的患病率较高，包括咳嗽（29%）、喘息（40%）、慢性支气管炎症状（21%）和劳力性呼吸困难（29%）。相当大比例的无家可归受试者表示先前诊断为哮喘（24%）、慢性支气管炎（19%）和COPD（4%）。根据肺功能测定，老年痴呆症的患病率为15%（95%的置信区间，8至26%），这是超过两倍的预期患病率在一般的美国population.Conclusions：老年痴呆症是一个主要的死亡原因在美国，它是重要的是要识别它的早期治疗。无家可归者的老年人患病率高于预期。公共卫生干预措施应针对无家可归的老年人进行预防和治疗。
Study objectives: Homelessness is a growing problem in the United States that may significantly impair physical health. The homeless have a high prevalence of cigarette smoking, poor nutrition, and adverse environmental exposures, which could contribute to obstructive lung disease (OLD). Despite this risk, the prevalence of OLD among the homeless remains unknown. We aimed to systematically assess the prevalence of OLD among the urban homeless.Design, setting, and participants: We conducted a cross-sectional study of the prevalence of OLD among homeless individuals in San Francisco. By random sampling, we recruited 68 adults living in one homeless shelter to participate in a structured interview survey and spirometry assessment. We used a multifaceted approach to assess OLD, including respiratory symptoms, self-reported physician diagnosis of asthma, chronic bronchitis, emphysema, or COPD, and spirometry (defined as FEV1 < 80% predicted and FEV1/FVC ratio < 0.70).Results: Sixty-eight adults completed the survey, and 67 adults completed the spirometry. Homeless adults were likely to be homeless < 1 year and homeless for the first time. There was a high prevalence of cigarette smoking (75% ever smokers, 68% current smokers). The prevalence of symptoms suggestive of OLD was high, including cough (29%), wheezing (40%), chronic bronchitis symptoms (21%), and dyspnea on exertion (29%). A substantial proportion of homeless subjects indicated a prior diagnosis of asthma (24%), chronic bronchitis (19%), and COPD (4%). Based on spirometry, the prevalence of OLD was 15% (95% confidence interval, 8 to 26%), which was more than double the expected prevalence in the general US population.Conclusions: As OLD is a leading cause of death in the United States, it is important to identify it early for treatment. Homeless individuals have a higher-than-expected prevalence of OLD. Public health interventions should target the homeless population for prevention and treatment of OLD.