Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand

Purpose: The present study aimed to determine the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among agriculturists in a remote rural community in central Thailand. Methods: A cross-sectional study was conducted in January 2020. Face-to-face interviews were conducted using standardized questionnaires to determine demographic characteristics and risk behaviors. COPD was defined by the spirometric criterion for airflow limitation constituting a postbronchodilator fixed ratio of FEV1/FVC <0.70 following the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines 2019. Multivariable logistic regression analysis was used to determine the risk factors for COPD, and the magnitude of association was presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI). Results: A total of 546 agriculturists were enrolled in the study. The overall prevalence of COPD was 5.5% (95% CI: 3.6-7.4). The prevalence of COPD among males was 8.0% (95% CI: 4.7-11.3), and 3.2% (95% CI: 1.1-5.2) among females. The risk factors of COPD included age >= 60 years old (AOR 2.7, 95% CI: 1.1-7.0), higher intensity of smoking (AOR 1.1, 95% CI: 1.0-1.1), swine farm worker (AOR 4.1, 95% CI: 1.7-10.3), cattle farm worker (AOR 3.3, 95% CI: 1.4-8.2) and home cooking (AOR 2.7, 95% CI: 0.8-9.7). Conclusion: Our data emphasized that COPD was one of the significant health problems among agriculturists in a rural community. Agricultural jobs such as animal farmers and behavioral factors such as smoking were associated with COPD. Effective public health interventions, especially, modifying risk behaviors, should be promoted in remote rural areas to prevent the disease and reduce its morbidity and mortality.