COPD in China is widespread with 8.6% of the country’s adult population¬†(almost 100 million people) suffering from the chronic lung disease, according to a new Tulane University study published in The Lancet.

The study, which provided lung-function screenings for more than 50,990 participants, is the largest survey of COPD across age groups ever conducted in China, researcher say.

COPD, an inflammatory lung disease that causes obstructed airflow into the lungs, is the third leading cause of death in China. It is caused by long-term exposure to irritants in the air, including cigarette smoke. During the past decade, ambient air pollution has become a major public-health crisis in the country while cigarette smoking remains high, especially among men, says senior author Dr. Jiang He, Joseph S. Copes Chair of Epidemiology at Tulane University School of Public Health & Tropical Medicine.

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