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Fighting for breath In recognition of World COPD Day, WIN looks at the impact of this and other respiratory diseases on global health
Three million people die from chronic obstructive pulmonary disease (COPD) every year, making it the third leading cause of death worldwide, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). To raise awareness and improve the care of the 384 million people currently living with the condition, GOLD has themed this year’s World COPD Day – which takes place on November 20 – ‘All Together to End COPD’. The day’s activities are organised in each partici- pating country by healthcare providers, educators and members of the public. 1 The definition of COPD was amended in the 11th revision of the World Health Oganization’s (WHO) International Classi- fication of Diseases (ICD-11) 2 to recognise the importance of precipitating factors. According to ICD-11, COPD is a prevent- able, treatable respiratory condition characterised by airflow limitation and persistent respiratory symptoms including: • Shortness of breath • A repetitive cough • Increased phlegm or mucus production • Feeling tired • More frequent chest infections from which it takes the patient longer to recover. Significant COPD risk factors include smoking and exposure to indoor and out- door chemicals, as well as occupational dust particles. In Ireland While there is currently no data avail- able at a national level on the prevalence or incidence of COPD in Ireland, it is esti- mated that nearly 500,000 people aged 40 years and over could have COPD, approximately half of whom are likely to be undiagnosed, 3 and COPD as a primary diagnosis accounts for approximately 15,000 inpatient hospitalisations, accord- ing to the Irish National Healthcare Quality Recording System. Ireland also has one of the highest age-standardised death rates from COPD in Europe. 4 A number of public health initiatives are underway, backed by health sup- port groups, aimed at easing the burden of COPD and other respiratory diseases
Adapted from Forum of International Respiratory Societies infographic for World Lung Day.See www.firsnet.org
study, Forum of International Res- p i r a t o r y So c i e t i e s env i r onmen t a l committee member Dr Teresa To from the University of Toronto said: “The study shows extremely compelling data that suggest inhalable and fine particulate matter does not just represent a common annoyance but is associated with human mortality most affecting our most vulnera- ble populations who suffer from underlying cardiac and respiratory illness. It should prompt not only medical providers, but also policymakers to take notice.” Further information The first World COPD Day was held in 2002. Now every year, GOLD chooses a theme and uses the day to raise awareness of the disease and coordinate the distri- bution of related materials and resources such as its annual strategy report, the latest iteration of which is available on the GOLD website – www.goldcopd.org Healthcare professionals can also share details of World COPD Day activities taking place in their workplace via the same website. – Max Ryan References 1.Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019.www.goldcopd.org/world-copd-day/ 2.World Health Organization 2019. International Classification of Diseases for Mortality and Morbidity Statistics: Eleventh Revision.https://icd.who.int/en 3. Irish Thoracic Society.Respiratory Health of the Nation, 2018.www.irishthoracicsociety.com 4.Department of Health.National Healthcare Quality Reporting System Annual Report 2018 5.Cong Liu et al.Ambient Particulate Air Pollution and Daily Mortality in 652 Cities.N Eng J Med 2019; 381:705- 715.DOI: 10.1056/NEJMoa1817364
in Ireland. The Asthma Society recently called on the government to publish its clean air strategy to improve the health of people with COPD, asthma, lung cancer and heart disease. It is urging TDs to press for the introduction of a national ban on smoky coal, first announced two years ago but blocked by threats of legal action by suppliers. According to the society, people with chronic respiratory diseases are particu- larly vulnerable to high particulate levels in the air caused by burning solid fuel and nitrogen dioxide from vehicle emissions. Though Ireland’s air quality is within EU legislative limits, the Environmental Pro- tection Agency has found that it exceeds the stricterWHO guidelines for fine particu- lates, ozone and nitrogen dioxide. The Irish Heart Foundation and the Irish Cancer Society also recently called on the government to do more to help smokers to quit as part of World No Tobacco Day on May 31. Global impact A recent study published in the New England Journal of Medicine 5 analysed health and environmental data from 652 urban areas across 24 countries and found significant associations between short term exposure to toxins contained in par- ticulate matter and increased respiratory mortality risk. Of the 59.6 million deaths recorded in this large population-based study, nearly 10% occurred as a result of respiratory illness. Commenting on the findings of the
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