Chronic obstructive pulmonary disease (COPD): risk factors

The most important risk factor for COPD in high and middle income countries is tobacco smoke. Depending on the diagnostic criteria used, the proportion of COPD cases caused by smoking (the population attributable risk) ranges between 50 and 70%. In low-income countries indoor air pollution (typically from cooking fires) is the greatest contributor to COPD and accounts for up to 20% of cases worldwide. Exposure to occupational dust, chemicals and fumes is another risk factor, with the greatest burden of such occupational exposures again falling on the developing world.

Other risk factors for COPD have been reviewed by Mannino and Buist (2007) and include: outdoor air pollution, increasing age, infections, genetic predisposition, socioeconomic status and factors associated with lung growth and development. More controversial are the roles of asthma, gender and nutrition.