American Journal of Epidemiology Vol. 141, No. 11: 1080-1088
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health
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Educational Level and Obstructive Lung Disease Given Smoking Habits and Occupational Airborne Exposure: A Norwegian Community Study
Department of Thoracic Medicine, University of Bergen Bergen, Norway.
The relation of educational level to obstructive lung disease, spirometric airflow limitation, and respiratory symptoms was examined in a two-phase cross-sectional study of a Norwegian general population aged 18–73 years in 1985–1988. The first phase was a questionnaire survey. In the second phase, a stratified sample of those who responded in the first phase was invited to a clinical and respiratory physiologic examination. Altogether, 714 subjects attended, representing 84% of those Invited. The prevalences of obstructive lung disease and spirometric airflow limitation were 7.8% and 4.5%, respectively. A total of 18% of the population had completed college, a further 60% had completed secondary school, and 21% had obtained a primary school education alone. The prevalence of both smoking and occupational airborne exposure decreased with increasing educational level. The sex-, age-, smoking-, and occupational exposure-adjusted odds ratio of obstructive lung disease in primary- versus university-educated subjects was 2.9 (95% confidence interval (Cl) 1.3–6.5); in secondary- versus university-educated subjects it was 1.4 (95% Cl 0.7–2.8). The corresponding values for spirometric airflow limitations were 5.2 (95% Cl 2.0–13.4) and 1.8 (95% Cl 1.2–2.7). All of the respiratory symptoms except breathlessness grade 2 were significantly associated with educational level after allowing for sex, age, smoking, and occupational airborne exposure. The survey indicates that educational level is a risk factor for airway disorders independent of smoking and occupational airborne exposure. Am J Epidemiol 1995;141:1080–8.
airway obstruction; asthma; occupational exposure; smoking; social class
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