Convergence analysis of Prevalence and Risk Factors of chronic obstructive pulmonary disease among Non-smokers

비흡연자 만성폐쇄성폐질환의 유병률과 위험인자의 융합적 분석

  • 송혜영 (이화여자대학교 간호학과) ;
  • 방윤이 (이화여자대학교 간호학과)
  • Received : 2017.11.13
  • Accepted : 2018.01.20
  • Published : 2018.01.28


The purpose of the study was to investigate the prevalence and risk factors of chronic obstructive pulmonary disease(COPD) among nonsmokers from the 6th Korea National Health and Nutrition Examination Survey(2013-2015). We used complex sample cross analysis and logistic regression analysis on 4, 911 non-smokers among the patients with chronic obstructive pulmonary disease over 40 years of age. In general characteristics, the prevalence of COPD is higher in the old(p<.001), men(p<.001), rural(p=.044), without spouses(p<.001), less educated(p<.001), agriculture(p<.001). Also, the non-smoker's COPD risk factor is age(p<.001), gender(p<.001), education(p=.022), occupation(p=.022), pulmonary tuberculosis(p<.001), asthma(p<.001). It is necessary to develop a respiratory rehabilitation and intervention program that can be applied in clinical practice based on nursing assessment considering the COPD prevalence and risk factors.


The 6th Korea National Health and Nutrition Examination Survey;chronic obstructive pulmonary disease;Non-smoker;Prevalence;Risk factor


  1. J. Vestbo, S. S. Hurd, A. G. Agusti, P. W. Jones, C. Vogelmeier, A. Anzueto, P. J. Barnes, L. M. Fabbri, F. J. Martinez, M. Nishimura, R. A. Stockley, D. D. Sin, R. Rodriguez-Roisin, "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary," Am J Respir Crit Care Med, Vol. 187, No. 4, pp. 347-365, 2013.
  2. T. Shah, M. M. Churpek, M. C. Perraillon, R. T. Konetzka, "Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion," Chest, Vol. 147, No. 5, pp. 1219-1226, 2015.
  3. A. Blakemore, C. Dickens, E. Guthrie, P. Bower, E. Kontopantelis, C. Afzal, P. A. Coventry, "Depression and anxiety predict health-related quality of life in chronic obstructive pulmonary disease: systematic review and meta-analysis," Int J Chron Obstruct Pulmon Dis, Vol. 9, pp. 501-512, 2014. 2014.
  4. World Health Organization, "Chronic Respiratory Diseases, Burden of COPD,"
  5. C. F. Vogelmeier, G. J. Criner, F. J. Martinez, A. Anzueto, P. J. Barnes, J. Bourbeau, B. R. Celli, R. Chen, M. Decramer, L. M. Fabbri, "Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease 2017 Report," Respirology, Vol. 22, No. 3, pp. 575-601, 2017.
  6. Statistics Korea, "2014 Report for Cause of death,"
  7. D. Price, D. Freeman, J. Cleland, A. Kaplan, F. Cerasoli. "Earlier diagnosis and earlier treatment of COPD in primary care," Primary Care Respiratory Journal, Vol. 20, No. 1, pp. 15-22, 2010. https://doi:10.4104/pcrj.2010.00060
  8. S. H. Lee, E. D. Hwang, J. E. Lim, S. Moon, Y. A. Kang, J. Y. Jung, M. S. Park, S. K. Kim, J. Chang, Y. S. Kim, S. Y. Kim, "The Risk Factors and Characteristics of COPD Among Nonsmokers in Korea: An Analysis of KNHANES IV and V," Lung, Vol. 194, No. 3, pp. 353-361, 2016.
  9. T. Mahmood, R. K. Singh, S. Kant, A. D. Shukla, A. Chandra, R. K. Srivastava, "Prevalence and etiological profile of chronic obstructive pulmonary disease in nonsmokers," Lung India, Vol. 34, No. 2, pp. 122-126, 2017.
  10. S. S. Salvi, P. J. Barnes, "Chronic obstructive pulmonary disease in non-smokers," Lancet, Vol. 374, No. 9691, pp. 733-743, 2009.
  11. Korea Centers for Diseases Control and Prevention, "2014 Korean National Health and Nutrition Examination Survey (KNHANES VI-2)"
  12. World Health Organization, Obesity: preventing and managing the global epidemic, World Health Organization, 2000.
  13. B. Lamprecht, M. A. McBurnie, W. M. Vollmer, G. Gudmundsson, T. Welte, E. Nizankowska-Mogilnicka, M. Studnicka, E. Bateman, J. M. Anto, P. Burney, D. M. Mannino, S. A. Buist, BOLD Collaborative Research Group, "COPD in never smokers: results from the population-based burden of obstructive lung disease study," Chest, Vol. 139, No. 4, pp. 752-763, 2011.
  14. M. K. Lee, A. Jo, S. O. Lim, "Community Health Convergence through Analysis of Chronic Disease Influencing Factors: Focusing on 30-40s Adults in Sejong City," J Korea Convergence Soc, Vol. 8, No. 5, pp. 127-135, 2017.
  15. S. J. Lee, S. W. Kim, K. A. Kong, Y. J. Ryu, J. H. Lee, J. H. Chang, "Risk factors for chronic obstructive pulmonary disease among never-smokers in Korea," Int J Chron Obstruct Pulmon Dis, Vol. 10, pp. 497-506, 2015.
  16. Y. Zhou, C. Wang, W. Yao, P. Chen, J. Kang, S. Huang, B. Chen, C. Wang, D. Ni, X. Wang, D. Wang, S. Liu, J. Lu, J. Zheng, N. Zhong, P. Ran, "COPD in Chinese nonsmokers," Eur Respir J, Vol. 33, No. 3, pp. 509-518, 2009.
  17. K. Husman, M. Koskenvuo, J. Kaprio, E. O. Terho, I. Vohlonen, "Role of environment in the development of chronic bronchitis," Eur J Respir Dis Suppl, Vol. 152, pp. 57-63, 1987.
  18. R. P. Benzo, B. Abascal-Bolado, M. M. Dulohery, "Self-management and quality of life in chronic obstructive pulmonary disease (COPD): The mediating effects of positive affect," Patient Educ Couns, Vol. 99, No. 4, pp. 617-623, 2016.
  19. M. A. Spruit, S. J. Singh, C. Garvey, R. ZuWallack, L. Nici, C. Rochester, et al., "An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation," Am J Respir Crit Care Med, Vol. 188, No. 8, pp. e13-e64, 2013.
  20. P. A. Mahesh, B. S. Jayaraj, S. T. Prahlad, S. K. Chaya, A. K. Prabhakar, A. N. Agarwal, S. K. Jindal, "Validation of a structured questionnaire for COPD and prevalence of COPD in rural area of Mysore: A pilot study," Lung India, Vol. 26, No. 3, pp. 63-69, 2009.
  21. R. Kohansal, P. Martinez-Camblor, A. Agusti, A. S. Buist, D. M. Mannino, J. B. Soriano, "The natural history of chronic airflow obstruction revisited: an analysis of the Framingham offspring cohort," Am J Respir Crit Care Med, Vol. 180, No. 1, pp. 3-10, 2009.
  22. K. H. Cho, C. M. Nam, E. J. Lee, Y. Choi, K. B. Yoo, S. H. Lee, E. C. Park, "Effects of individual and neighborhood socioeconomic status on the risk of all-cause mortality in chronic obstructive pulmonary disease: A nationwide population-based cohort study, 2002-2013," Respir Med, Vol. 114, pp. 9-17, 2016.
  23. S. J. Park, W. J. Lee, "An Analysis of Convergence Factors on the Unmet Health Needs of the Indigent Elderly," J Korea Convergence Soc, Vol. 8. No. 1, pp. 221-229, 2017.
  24. H. S. Kim, S. S. Kim, "A Converged Study about Influences of Job Stress, Job Security, Depression, Family Bond, Subjective Health Status, Social Support on Quality of Life in Married Middle-Aged Male," J Korea Convergence Soc, Vol. 8, No. 3, pp. 101-114, 2017.
  25. S. Hagstad, H. Backman, A. Bjerg, L. Ekerljung, X. Ye, L. Hedman, A. Lindberg, K. Toren, J. Lotvall, E. Ronmark, B. Lundback, "Prevalence and risk factors of COPD among never-smokers in two areas of Sweden -Occupational exposure to gas, dust or fumes is an important risk factor," Respir Med, Vol. 109, No. 11, pp. 1439-1445, 2015. doi:
  26. J. S. Oh, S. H. Park, M. K. Kwak, C. H. Pyo, K. H. Park, H. B. Kim, S. Y. Shin, H. J. Choi, “Ambient Particulate Matter and Emergency Department Visit for chronic obstructive pulmonary disease,” J Korean Soc Emerg Med, Vol. 28, No. 1, pp. 32-39, 2017.
  27. D. A. Stern, W. J. Morgan, A. L. Wright, S. Guerra, F. D. Martinez, “Poor airway function in early infancy and lung function by age 22 years: a non-selective longitudinal cohort study,” Lancet, Vol. 370, No. 9589, pp. 758-764, 2007.
  28. Y. M. Jung, H. Y. Lee, “Chronic Obstructive Pulmonary Disease in Korea: Prevalence, Risk Factors, and Quality of Life,” Journal of Korean Academy of Nursing, Vol. 41, No. 2, pp. 149-156, 2011.