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Obstructive airway disease in urban populations

Drummond, M. Bradley

Current Opinion in Pulmonary Medicine: March 2014 - Volume 20 - Issue 2 - p 180–185
doi: 10.1097/MCP.0000000000000025

Purpose of review Obstructive lung disease (OLD), including asthma and chronic obstructive pulmonary disease, has a more substantial prevalence and morbidity in urban populations. This review highlights recent publications examining the epidemiology, risk factors and interventions concerning OLD in urban populations.

Recent findings Using a variety of approaches, estimates of asthma prevalence in urban populations range from 5 to 25%. Early life exposures including in-utero cigarette smoke, postnatal bisphenol A, home and school particulates, and environmental air pollution contribute to increased OLD prevalence and symptom manifestations. Individuals with increased exposure to traffic-related pollution demonstrate abnormal inflammatory and lung function profiles. Obesity, more common in urban populations, is likely both a risk factor for asthma as well as contributor to poor control. Interventions targeted at home-based education and assessments are efficacious and cost-effective in improving outcomes of OLD in urban settings.

Summary The burden of OLD in urban populations is driven by maternal, environmental and acquired factors. There are few recent data regarding risk factors and interventions for urban cohorts with chronic obstructive pulmonary disease. The complex interplay of race, socioeconomic status, environmental exposures and healthcare access in the urban population requires continued research efforts.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA

Correspondence to M. Bradley Drummond, MD, MHS, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Circle, JHAAC 4B.74, Baltimore, MD 21224, USA. Tel: +1 410 550 6431; fax: +1 410 550 2612; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins