Primary-care providers should make a point of screening people with known risk factors for chronic obstructive pulmonary disease (COPD), recent study results indicate.

Investigators performed spirometry testing on 1,003 primary-care patients, aged 40 years and older, who had a smoking history of at least 20 pack-years. One fifth of these individuals were found to have COPD, but only about a third had been aware of their diagnosis before the study (CMAJ. 2010;183:673-678).

“Success of early intervention in this population could result in important reductions in mortality, morbidity, and health-care expenditures related to COPD,” wrote the researchers. “For practitioners, our results call for a higher index of suspicion for the presence of COPD in patients aged 40 years or older with a substantial smoking history, as well as a wider use of spirometry for diagnosis.”

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In another study focusing on smoking-related respiratory issues, investigators learned that nearly 40% of chronic rhinosinusitis diagnoses are linked to secondhand smoke (Arch Otolaryngol Head Neck Surg. 2010;136:327-334). The examination of 306 nonsmokers with chronic rhinosinusitis and 306 nonsmoking controls demonstrated that the risk of exposure to secondhand smoke is even higher in the workplace and in private social settings than in the home or in bars, restaurants, or other public areas.

“Assuming a causal relationship, elimination of exposure to [secondhand smoke] could prevent approximately 40% of [chronic rhinosinusitis] cases,” noted the researchers. n