Early Detection of Chronic Obstructive Pulmonary Disease in Limestone Quarry Communities with Puma Score and Portable Spirometry
DOI:
https://doi.org/10.37287/ijghr.v8i5.2805Keywords:
chronic obstructive pulmonary disease, limestone quarry, portable spirometry, puma questionnaire, smokingAbstract
Chronic obstructive pulmonary disease (COPD) remains underdiagnosed in primary care, particularly in communities with occupational dust exposure and limited access to spirometry. Objective: This study described COPD risk profiles and examined factors associated with airflow obstruction among adults in a limestone quarry community in Ungasan, Bali. A community-based cross-sectional study design was utilized in this research, with a total of 50 participants selected via a consecutive sampling technique. Data included demographic characteristics, body mass index, smoking history, occupational and biomass exposure, PUMA questionnaire score, and portable spirometry. Airflow obstruction was defined from spirometric interpretation recorded in the screening database. Categorical associations were analysed using two-sided exact tests and odds ratios. Results: Participants had a mean age of 50.0 ± 19.8 years; 56.0% were male and 46.0% were obese. Nine participants (18.0%) were classified as high-risk by PUMA, while airflow obstruction was found in six participants (12.0%). Ever or current smoking was associated with obstruction (31.2% versus 2.9%; OR 15.00; 95% CI 1.58-142.73; p=0.010). Brinkman Index ≥200 and high-risk PUMA status showed elevated odds but did not reach statistical significance. Targeted community screening using PUMA and portable spirometry can identify undetected airflow obstruction in dusty occupational settings, with smoking history remaining the clearest risk marker.
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