TY - JOUR
T1 - Prevalence and correlates of obstructive lung disease among people who inject drugs, San Diego, California
AU - Koslik, Hayley J.
AU - Joshua, Jisha
AU - Cuevas-Mota, Jazmine
AU - Goba, Daniel
AU - Oren, Eyal
AU - Alcaraz, John E.
AU - Garfein, Richard S.
N1 - Funding Information:
Dr. Garfein received a grant from the National Institutes of Health to conduct this study.
Funding Information:
The Study of Tuberculosis, AIDS and Hepatitis C Risk (STAHR II) was funded by the National Institutes of Drug Abuse (NIDA) grant #R01 DA031074 (PI: Richard S. Garfein). The funding source had no involvement in the study design, the collection, analysis and interpretation of data or in the writing of the report and in the decision to submit the article for publication.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: Pulmonary tissue damage leading to obstructive lung disease (OLD) could result from intravenous administration of insoluble particles found in illicit drugs. This study described the prevalence and identified correlates of OLD among people who inject drugs (PWID). Methods: In 2012–2016, a community-based cohort of PWID who had injected within the past month were enrolled in a study to assess HIV, hepatitis C virus (HCV) andMycobacterium tuberculosis (Mtb) infections and their related risk factors. Data were obtained through face-to-face interviews, serological testing and spirometry. Baseline data were used for a cross-sectional analysis of the prevalence and correlates of OLD, defined as FEV1/FVC < 0.7. Univariate and multivariable logistic regression were used to identify factors associated with OLD. Results: Among 516 participants who had complete spirometry and interview results, the mean age was 43.3 years, 73.6 % were male, 9.5 % were Black, 91.1 % smoked cigarettes and 18.2 % had OLD. Few (9.6 %) PWID with OLD reported a previous diagnosis of COPD although many (44.7 %) reported related symptoms. Black race (AOR = 2.66, 95 %CI: 1.37, 5.17), pack-years smoked (AOR = 1.06/5 years, 95 %CI: 1.01, 1.12), and duration of injection drug use (AOR = 1.13, 95 %CI: 1.01, 1.27) were independently associated with OLD after controlling for age. Conclusions: The prevalence of OLD was high in this cohort and associated with Black race and cigarette smoking—known risk factors. In addition, OLD prevalence increased with greater duration of injection drug use, suggesting a link between cumulative exposure to injected insoluble particles and OLD. Further examination of these adulterants and lung pathology are needed.
AB - Background: Pulmonary tissue damage leading to obstructive lung disease (OLD) could result from intravenous administration of insoluble particles found in illicit drugs. This study described the prevalence and identified correlates of OLD among people who inject drugs (PWID). Methods: In 2012–2016, a community-based cohort of PWID who had injected within the past month were enrolled in a study to assess HIV, hepatitis C virus (HCV) andMycobacterium tuberculosis (Mtb) infections and their related risk factors. Data were obtained through face-to-face interviews, serological testing and spirometry. Baseline data were used for a cross-sectional analysis of the prevalence and correlates of OLD, defined as FEV1/FVC < 0.7. Univariate and multivariable logistic regression were used to identify factors associated with OLD. Results: Among 516 participants who had complete spirometry and interview results, the mean age was 43.3 years, 73.6 % were male, 9.5 % were Black, 91.1 % smoked cigarettes and 18.2 % had OLD. Few (9.6 %) PWID with OLD reported a previous diagnosis of COPD although many (44.7 %) reported related symptoms. Black race (AOR = 2.66, 95 %CI: 1.37, 5.17), pack-years smoked (AOR = 1.06/5 years, 95 %CI: 1.01, 1.12), and duration of injection drug use (AOR = 1.13, 95 %CI: 1.01, 1.27) were independently associated with OLD after controlling for age. Conclusions: The prevalence of OLD was high in this cohort and associated with Black race and cigarette smoking—known risk factors. In addition, OLD prevalence increased with greater duration of injection drug use, suggesting a link between cumulative exposure to injected insoluble particles and OLD. Further examination of these adulterants and lung pathology are needed.
KW - Injection drug use
KW - Mycobacterium tuberculosis infection
KW - Obstructive lung disease
KW - Smoking
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U2 - 10.1016/j.drugalcdep.2020.108158
DO - 10.1016/j.drugalcdep.2020.108158
M3 - Article
C2 - 32652379
AN - SCOPUS:85087495445
VL - 214
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
SN - 0376-8716
M1 - 108158
ER -