Identifying risk factors for COPD and adult-onset asthma: an umbrella review.

BACKGROUND

COPD and adult-onset asthma (AOA) are the most common noncommunicable respiratory diseases. To improve early identification and prevention, an overview of risk factors is needed. We therefore aimed to systematically summarise the nongenetic (exposome) risk factors for AOA and COPD. Additionally, we aimed to compare the risk factors for COPD and AOA.

METHODS

In this umbrella review, we searched PubMed for articles from inception until 1 February 2023 and screened the references of relevant articles. We included systematic reviews and meta-analyses of observational epidemiological studies in humans that assessed a minimum of one lifestyle or environmental risk factor for AOA or COPD.

RESULTS

In total, 75 reviews were included, of which 45 focused on risk factors for COPD, 28 on AOA and two examined both. For asthma, 43 different risk factors were identified while 45 were identified for COPD. For AOA, smoking, a high body mass index (BMI), wood dust exposure and residential chemical exposures, such as formaldehyde exposure or exposure to volatile organic compounds, were amongst the risk factors found. For COPD, smoking, ambient air pollution including nitrogen dioxide, a low BMI, indoor biomass burning, childhood asthma, occupational dust exposure and diet were amongst the risk factors found.

CONCLUSIONS

Many different factors for COPD and asthma have been found, highlighting the differences and similarities. The results of this systematic review can be used to target and identify people at high risk for COPD or AOA.

Informations de copyright

Copyright ©The authors 2023.

Déclaration de conflit d'intérêts

Provenance: Submitted article, peer reviewed. Conflict of interest: A.H. Maitland-Van der Zee is the PI of P4O2 (Precision Medicine for more Oxygen) public–private partnership sponsored by Health Holland involving many private partners who contribute in cash and/or in kind. Partners in the Precision Medicine for more Oxygen (P4O2) consortium are the Amsterdam UMC, Leiden University Medical Center, Maastricht UMC+, Maastricht University, UMC Groningen, UMC Utrecht, Utrecht University, TNO, Aparito, Boehringer Ingelheim, Breathomix, Clear, Danone Nutricia Research, Fluidda, MonitAir, Ncardia, Ortec Logiqcare, Philips, Proefdiervrij, Quantib-U, RespiQ, Roche, Smartfish, SODAQ, Thirona, TopMD, Lung Alliance Netherlands (LAN) and the Lung Foundation Netherlands (Longfonds). The consortium is additionally funded by the PPP Allowance made available by Health Holland, Top Sector Life Sciences & Health (LSHM20104; LSHM20068), to stimulate public-private partnerships and by Novartis. A.H. Maitland-Van der Zee has received grants from Boehringer Ingelheim, Vertex Innovation Award, Dutch Lung Foundation, Stichting Asthma Bestrijding, and Innovative Medicine Initiative (IMI). A.H. Maitland-Van der Zee has received consulting fees from AstraZeneca and Boehringer Ingelheim. A.H. Maitland-Van der Zee has received GSK honarium for a lecture. A.H. Maitland-Van der Zee is the chair of DSMB SOS BPD study and advisory board member of the CHAMP study. A.H. Maitland-Van der Zee is the president of the federation of innovative drug research in the Netherlands (FIGON) and president of the European Association of systems medicine (EASYM). The remaining authors have no conflicts to declare.