Biostatistics

Question:

The incidence of chronic pulmonary disease in a community is 1.5 times greater than the national rate. If successful, which of the following interventions would provide the greatest decrease in chronic pulmonary disease in this community?

Correct Answer: A.  Decrease the prevalence of cigarette smoking

COPD describes patients with chronic bronchitis and/or emphysema who have a decreased forced expiratory volume. The overwhelming majority of patients with chronic bronchitis are smokers, up to 90% of all cases. Cigarette smoking also has been shown to be the major cause of emphysema. Therefore, decreasing the prevalence of cigarette smoking would lead to the greatest decrease in COPD in the community.

Persons with COPD are advised to get the flu and pneumococcal immunizations to help prevent serious infections in patients with compromised lung function. Patients with COPD have increased frequency and severity of lung infections and this likely plays a role in the etiology and progression of COPD, but not nearly to the extent of cigarette smoking. Therefore, increasing the rate of flu and pneumococcal immunizations would not lead to the greatest decrease of COPD.

Similarly, decreasing radon levels may decrease the prevalence of COPD, but only to a smaller extent when compared with cigarette smoking.

Increasing exercise will not decrease COPD in this community, especially if they continue to smoke cigarettes.