Causal Factors
There are several factors that have
contributed to the development and prevalence of this disease. These factors
are not only seen at an individual level but also at societal and global
levels. Here are a few of the major risk factors;
Smoking (including
secondhand smoking) is by far the most significant determinant of developing
COPD.
Pollution can also
contribute to this disease (fumes/chemicals and other harmful irritants in the
community and workplace).2
Genetics also has a
big influence on COPD, in particular a deficiency in a protein called alpha-1
antitrypsin that protects the lung from damage.2
The British Lung Foundation has
developed an interactive pathway showing the life of a COPD sufferer from
symptom recognition to end of life:
A person’s socioeconomic status
(wealth, education, occupation etc.) also plays a large part in the development
of COPD.3 In poorer countries, the proportion of smokers and the degree of
exposure to pollution in both the community and the workplace are far higher
than in wealthy countries.4 As such, it’s easy to see why
these less developed countries are suffering from a higher prevalence of the
disease than countries such as Australia. The following table5 highlights
the correlation between smoking and socioeconomic status.
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Fast facts
Here are some facts that give you a quick snapshot into the reality of COPD and its consequences both in Australia and worldwide.
Australia
A staggering 1 in 20 Australians
(5.7% of the population or 310,700 people) aged 55 and over suffer from COPD.6
In 2012, COPD was the fifth
leading cause of death in Australia behind heart disease, stroke, dementia and
lung cancer - that’s 4% of all deaths.6 $929 dollars was spent on
COPD alone in 2008-2009 (1.3% of all disease expenditure).7
It is the
2nd leading cause of avoidable hospital admissions.7
In spite of the associations between smoking and COPD, 20% of COPD sufferers have never smoked.8
The self-reported prevalence of
COPD is 2.5x greater in Aboriginal Australians in comparison to non-Aboriginal
Australians.9
Around 4% of adult Aboriginals report suffering from COPD.9
Worldwide
65 million people worldwide
currently suffer from moderate to severe COPD.10
An astounding 90% of all deaths
attributable to COPD occur in low to middle income countries.10
In 2012, COPD represented 6% of all
global deaths (more than 3 million people).10
74% of those who are affected by COPD remain untreated, with the majority of this figure being made up from people of low income countries.10
References
1. Prevention and control of
noncommunicable diseases: guidelines for primary health care in low resource
settings [Internet]. Geneva: World Health Organization; 2012 [cited 2015
Mar 26]. NLM classification: W 84.6. Available from:
http://apps.who.int/iris/bitstream/10665/76173/1/9789241548397_eng.pdf
2. Global Strategy for the Diagnosis,
Management, and Prevention of COPD [Internet]. Global Initiative for Chronic
Obstructive Lung Disease; 2013 [cited 2015 Mar 26]. Available from:
http://www.goldcopd.org/uploads/users/files/GOLD_Report_2015_Feb18.pdf
3. Kanervisto M, Vasankari T, Laitinen
T, Heliövaara M, Jousilahti P Saarelainen S. Low socioeconomic status is
associated with chronic obstructive airway diseases. Resp Med [Internet]. 2011
[cited 2015 Mar 26];105(8):1140-6. Available from:
http://www.sciencedirect.com/science/article/pii/S0954611111000965
4. Hiscock R, Bauld L, Amos A, Fidler
JA, Munafò M. Socioeconomic status and smoking: a review. Ann N Y Acad Sci
[Internet]. 2012 [cited 2015 Mar 26]; 1248:107-23. Available from:
http://onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.2011.06202.x/full
5. Australian Institute of Health and
Welfare. National Drug Strategy Household Survey: survey report [Internet].
2011 [cited 2015 Mar 26]; AIHW cat. no. PHE 145. Available from:
http://www.aihw.gov.au/publication-detail/?id=32212254712&libID=32212254712&tab=2
6. Australian Institute of Health and
Welfare. Australian Centre for Asthma Monitoring [internet]. 2011 [cited 2015
Mar 26]; AIHW cat. no. ACM 22. Available from :
http://www.aihw.gov.au/publication-detail/?id=10737420159
7. Page A, Abrose S, Glover J ,Hetzel
D. Atlas of Avoidable Hospitalisations in Australia: ambulatory care-sensitive
conditions [Internet]. Adelaide: Adelaide PHIDU. University of
Adelaide; April 2007. Available from:
https://www.adelaide.edu.au/phidu/publications/pdf/2005-2009/avoidable-hospitalisations-aust-2007/avoidable_hospitalisations_full.pdf
8. Lamprecht B, McBurnie MA, Vollmer
WM, Gudmundsson G, Welte T, Nizankowska-Mogilnicka E, Studnicka M, Bateman E,
Anto JM, Burney P, Mannino DM, Buist SA. COPD in Never Smokers: Results From
the Population-Based Burden of Obstructive Lung Disease Study. Chest
[Internet]. 2011[cited 2015 Mar 26]; 139(4):752-63. Available from:
http://journal.publications.chestnet.org/article.aspx?articleid=1087839
9. Australian Institute of Health and
Welfare. Coronary heart disease and chronic obstructive pulmonary disease in
Indigenous Australians [internet]. 2014 [cited 2015 Mar 26]; AIHW cat. no. IHW
126. Available from : http://www.aihw.gov.au/publication-detail/?id=60129547716
10. Global surveillance, prevention and control of chronic respiratory
diseases [Internet]. Geneva: World Health Organization; 2007 [cited 2015
Mar 26]. NLM classification: WF 140. Available from: http://whqlibdoc.who.int/publications/2007/9789241563468_eng.pdf?ua=1
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