Background: Chronic bronchitis (CB) has been studied using standardized questionnaires for decades. From being the key element in the ‘British hypothesis’ chronic bronchitis was reduced to being an innocent disorder in the 1980s. However, there is now good evidence that chronic bronchitis is associated with an increased risk from both overall and chronic obstructive pulmonary disease (COPD) specific mortality. Presumably through increasing the frequency of lower respiratory tract infections chronic bronchitis is associated with excess decline in lung function, hospital admission and other disease specific outcomes. The prevalence of chronic bronchitis increases with increasing age and the burden associated with chronic bronchitis in this growing proportion of the population is large. Vital prognosis in the elderly is affected by CB and this condition presumably deserves more attention from the medical profession.
1. Ciba Guest Symposium . Terminology, definitions and classification of chronic pulmonary emphysema and related conditions . Thorax1959; 14: 286-299 .
2.
2. Medical Research Council's committee on the aetiology of chronic bronchitis . Standardized questionnaires on respiratory symptoms . Br Med J1960; 2: 1665-1665 .
3.
3. Medical Research Council . Instructions for the use of the questionnaire on respiratory symptoms. Devon: W.J. Holman Ltd. , 1966.
4.
4. Cochrane AL , Chapman PJ , Oldham PD . Observer's errors in taking medical histories . Lancet1951; i: 1007-1009 .
5.
5. Fairbarn AS , Wood CH , Fletcher CM . Variability to answers to a questionnaire on respiratory symptoms . Br J Prev Soc Med1959; 13: 175-193 .
6.
6. Fletcher CM , Tinker CM . Chronic bronchitis. A further study of simple diagnostic methods in a working population . Br Med J1961; i: 1491-1498 .
7.
7. Lange P , Groth S , Nyboe J et al. Chronic obstructive lung disease in Copenhagen: cross-sectional epidemiological aspects . J Intern Med1989; 226: 25-32 .
8.
8. Pride NB , Burrows B . Development of impaired lung function: natural history and risk factors. In Calverley P , Pride NB , eds Chronic Obstructive Pulmonary Disease. London: Chapman & Hall , 1995.
9.
9. Fletcher CM , Peto R , Tinker C , Speizer FE . The natural history of chronic bronchitis and emphysema. Oxford: Oxford University Press , 1976.
10.
10. Fletcher C , Peto R . The natural history of chronic airflow obstruction . Br Med J1977; 1: 1645-1648 .
11.
11. Kauffmann F , Drouet D , Lellouch J , Brille D . Twelve years spirometric changes among Paris area workers . Int J Epidemiol1979; 8: 201-212 .
12.
12. Higgins MW , Keller JB , Becker M et al. An index of risk for obstructive airways disease . Am Rev Respir Dis1982; 125: 144-151 .
13.
13. Peto R , Speizer FE , Cochrane AL et al. The relevance in adults of airflow obstruction, but not of mucus hypersecretion, to mortality from chronic lung disease . Am Rev Respir Dis1983; 128: 491-500 .
14.
14. Ebi-Kryston KL . Respiratory symptoms and pulmonary function as predictors of 10-year mortality from respiratory disease, cardiovascular disease, and all causes in the Whitehall study . J Clin Epidemiol1988; 41: 251-260 .
15.
15. Wiles FJ , Hnizdo E . Relevance of airflow obstruction and mucus hypersecretion to mortality . Respir Med1991; 85: 27-35 .
16.
16. Annesi I , Kauffmann F . Is respiratory mucus hypersecretion really an innocent disorder?Am Rev Respir Dis1986; 134: 688-693 .
17.
17. Vollmer WM , McCamant LE , Johnson LR , Buist AS . Respiratory symptoms, lung function, and mortality in a screening center cohort . Am J Epidemiol1989; 129: 1157-1169 .
18.
18. Speizer FE , Fay ME , Dockery DW , Ferris BG Jr . Chronic obstructive pulmonary disease mortality in six U.S. cities . Am Rev Respir Dis1989; 140 (Suppl): S49-S55 .
19.
19. Lange P , Nyboe J , Appleyard M , Jensen G , Schnohr P . Relation of ventilatory impairment and of chronic mucus hypersecretion to mortality from obstructive lung disease and from all causes . Thorax1990; 45: 579-585 .
20.
20. Sherman CB , Xu X , Speizer FE , Ferris Jr BG , Weiss ST , Dockery DW . Longitudinal lung function decline in subjects with respiratory symptoms . Am Rev Respir Dis1992; 146: 855-859
21.
21. Vestbo J , Prescott E , Lange P , and The Copenhagen City Heart Study Group . Association of chronic mucus hypersecretion with FEV1 decline and COPD morbidity . Am J Respir Crit Care Med1996; 153: 1530-1535 .
22.
22. Pauwels R , Buist A , Calverley P , Jenkins C , Hurd S . Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. NHLBI/WHO global initiative for chronic obstructive lung disease (GOLD) workshop summary . Am J Respir Crit Care Med2001; 163: 1256-1276 .
23.
23. Fabbri LM , Hurd S , for the GOLD Scientific Committee. Global strategy for diagnosis, management and prevention of COPD: 2003 update . Eur Respir J2003; 22: 1-2 .
24.
24. Vestbo J , Lange PCan GOLD Stage 0 provide information of prognostic value in chronic obstructive pulmonary disease?Am J Respir Crit Care Med2002; 166: 329-332 .
25.
25. Kanner RE , Anthonisen NR , Connett JE for the Lung Health Study Research Group . Lower respiratory illnesses promote FEV1 decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease . Am J Respir Crit Care Med2001; 164: 358-364 .
26.
26. Donaldson GC , Seemungal TAR , Bhowmik A , Wedzicha JA . Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease . Thorax2002; 57: 847-852 .
27.
27. Patel IS , Seemungal TER , Wilks M , Lloyd-Owen J , Donaldson GC , Wedzicha JA . Relationship between bacterial colonisation and the frequency, character, and severity of COPD exacerbations . Thorax2002; 57: 759-764 .
28.
28. Prescott E , Lange P , Vestbo J . Chronic mucus hypersecretion in COPD and death from pulmonary infection . Eur Respir J1995; 8: 1333-1338 .
29.
29. Vestbo J , Rasmussen FV Respiratory symptoms and FEVy as predictors of hospitalization and medication in the following 12 years due to respiratory disease . Eur Respir J1989; 2: 710-715 .
30.
30. Jedrychowski WSickness absence caused by chest disease in relation to smoking and chronic bronchitis symptoms . Br J Ind Med1976; 33: 243-248 .
31.
31. Fletcher CM . Chronic bronchitis. Its prevalence, nature, and pathogenesis . Am Rev Respir Dis1959; 80: 483-494 .
32.
32. Ames RG , Trent RB . Respiratory impairment and symptoms as predictors of early retirement with disability in US underground coal miners . Am J Public Health1984; 74: 837-838 .
33.
33. Vestbo J . Predictors of mortality, COPD morbidity, and cancer. With special reference to respiratory symptoms, lung function, and occupational exposure to cement dust . Dan Med Bull1993; 40: 1-16 .
34.
34. Halbert RJ , Isonaka S , George D , Iqbal A . Interpreting COPD prevalence estimates . Chest2003; 123: 1684-1692 .
35.
35. Chen Y , Breithaupt K , Muhajarine N . Occurrence of chronic obstructive pulmonary disease among Canadians and sex-related risk factors . J Clin Epidemiol2000; 53: 755-761 .
36.
36. Lange P , Parner J , Prescott, Vestbo J . Chronic bronchitis in an elderly population . Age Ageing2003; 32: 636-642 .
37.
37. Lange P , Groth S , Nyboe J et al. Phlegm production in plain cigarette smokers who changed to filter cigarettes or quit smoking . J Intern Med1990; 228: 115-120 .
38.
38. Lange P , Groth S , Nyboe J et al. Determinants of chronic mucus hypersecretion in a general population with special reference to the type of tobacco smoked . Int J Epidemiol1989; 18: 882-887 .
39.
39. Haynes WJ , Krstulovic V , Bell AJ . Smoking habit and incidence of respiratory tract infections in a group of adolescent males . Am Rev Respir Dis1966; 93: 730-735 .
40.
40. Lange P , Vestbo J , Nyboe J . Risk factors for death and hospitalisation from pneumonia. A prospective study of a general population . Eur Respir J1995; 8: 1694-1698 .
41.
41. Almirall J , Gonzalez C , Balanzo X , Bolibar I . Proportion of community-acquired pneumonia cases attributable to tobacco smoking . Chest1999; 116: 375-379 .
42.
42. Godtfredsen NS , Vestbo J , Osler M , Prescott E . Risk of hospital admission for COPD following smoking cessation and reduction: a Danish Population study . Thorax2002; 57: 967-972 .
43.
43. Godtfredsen NS , Holst C , Prescott E , Vestbo J , Petersen L , Osler M . Smoking reduction, smoking cessation, and all-cause mortality. A 16-year follow-up of 19,709 men and women from the Copenhagen Centre for Prospective Population Studies . Am J Epidemiol2002; 156: 994-1001 .
44.
44. Nicolson P , Anderson PQuality of life, distress and self-esteem: a focus group study of people with chronic bronchitis . Br J Health Psychol2003; 8: 251-270 .
45.
45. Connolly MJ . Chronic bronchitis: an old man's enemy?Age Ageing2003; 32: 561-562 .
