Pulmonary Emphysema in a Non-smoking Population

¹ Department of Preventive Medicine, School of Medicine, Loma Linda University
² Thoracic Surgeon, The Loma Linda University

Smoking and air pollution appear in the literature to be the two etiologic variables most strongly associated with a risk for developing pulmonary emphysema. In most populations, however, it is difficult to separate these variables. This preliminary report presents the five-year emphysema mortality experience in an essentially non-smoking population of 64,256 Seventhday Adventists in California. They do not appear to differ greatly from the general population in respect to exposure to air pollution. There were four deaths due to emphysema as the "underlying cause" among SDA men whereas 22 would have been expected at concurrent California mortality rates for men. An additional 14 deaths attributed a secondary role to emphysema, whereas 51 would have been expected. The deceased with such a diagnosis appear to be drawn primarily from the SDA minority with a long-term smoking history. Other population variables do not appear able to explain this degree of difference, and it is concluded that smoking, particularly cigarettes, may indeed be an important differential factor related to the risk of mortality from pulmonary emphysema.