Epidemiology and Global Impact of Chronic Obstructive Pulmonary Disease

 

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ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that causes a heavy health and increasing economic burden both in the United States and around the world. Most of the risk factors for COPD are well known and include smoking, occupational exposures, air pollution, airway hyperresponsiveness, asthma, and certain genetic variations, although many questions, such as why a minority of smokers develop significant airway obstruction, remain. Major medical organizations have agreed on a common definition of COPD, although newer measures, such as functional status or exercise capability, have emerged as important in determining the prognosis of COPD patients. In most of the world, COPD prevalence and mortality are still increasing and will likely continue to rise in response to increases in smoking, particularly by women and adolescents. Resources aimed at smoking cessation and prevention, COPD education and early detection, and better treatment will be of the most benefit in our continuing efforts against this important cause of morbidity and mortality.

REFERENCES

• 1 Pauwels R A, Buist A S, Calverley P M, Jenkins C R, Hurd S 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 Med. 2001;  163 1256-1276
  CrossrefPubMedGoogle Scholar
• 2 Celli B R, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper.  Eur Respir J. 2004;  23 932-946
  CrossrefPubMedGoogle Scholar
• 3 Mannino D M. COPD: epidemiology, prevalence, morbidity and mortality, and disease heterogeneity.  Chest. 2002;  121 121S-126S
  CrossrefPubMedGoogle Scholar
• 4 Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors.  BMJ. 2004;  328 1519-1528
  CrossrefPubMedGoogle Scholar
• 5 Trupin L, Earnest G, San Pedro M et al.. The occupational burden of chronic obstructive pulmonary disease.  Eur Respir J. 2003;  22 462-469
  CrossrefPubMedGoogle Scholar
• 6 Smith K R, Mehta S. The burden of disease from indoor air pollution in developing countries: comparison of estimates.  Int J Hyg Environ Health. 2003;  206 279-289
  PubMedGoogle Scholar
• 7 Romieu I, Trenga C. Diet and obstructive lung diseases.  Epidemiol Rev. 2001;  23 268-287
  PubMedGoogle Scholar
• 8 Shaheen S O, Barker D J, Holgate S T. Do lower respiratory tract infections in early childhood cause chronic obstructive pulmonary disease?.  Am J Respir Crit Care Med. 1995;  151 1649-1651
  PubMedGoogle Scholar
• 9 Silverman E K, Speizer F E. Risk factors for the development of chronic obstructive pulmonary disease.  Med Clin North Am. 1996;  80 501-522
  PubMedGoogle Scholar
• 10 Mayer A S, Newman L S. Genetic and environmental modulation of chronic obstructive pulmonary disease.  Respir Physiol. 2001;  128 3-11
  CrossrefPubMedGoogle Scholar
• 11 Lomas D A, Silverman E K. The genetics of chronic obstructive pulmonary disease.  Respir Res. 2001;  2 20-26
  CrossrefPubMedGoogle Scholar
• 12 O'Byrne P M, Postma D S. The many faces of airway inflammation: asthma and chronic obstructive pulmonary disease. Asthma Research Group.  Am J Respir Crit Care Med. 1999;  159 S41-S63
  PubMedGoogle Scholar
• 13 Sparrow D, O'Connor G, Weiss S T. The relation of airways responsiveness and atopy to the development of chronic obstructive lung disease.  Epidemiol Rev. 1988;  10 29-47
  PubMedGoogle Scholar
• 14 Ulrik C S, Backer V. Nonreversible airflow obstruction in life-long nonsmokers with moderate to severe asthma.  Eur Respir J. 1999;  14 892-896
  CrossrefPubMedGoogle Scholar
• 15 Meyer P A, Mannino D M, Redd S C, Olson D R. Characteristics of adults dying with COPD.  Chest. 2002;  122 2003-2008
  CrossrefPubMedGoogle Scholar
• 16 World Health Organization .The GOLD global strategy for the management and prevention of COPD. http://Available at: www.goldcopd.com Accessed April 5, 2005
  Google Scholar
• 17 Celli B R, Halbert R J, Isonaka S, Schau B. Population impact of different definitions of airway obstruction.  Eur Respir J. 2003;  22 268-273
  CrossrefPubMedGoogle Scholar
• 18 Kohler D, Fischer J, Raschke F, Schonhofer B. Usefulness of GOLD classification of COPD severity.  Thorax. 2003;  58 825
  CrossrefPubMedGoogle Scholar
• 19 Dirksen A, Christensen H, Evald T et al.. Bronchodilator and corticosteroid reversibility in ambulatory patients with airways obstruction.  Dan Med Bull. 1991;  38 486-489
  PubMedGoogle Scholar
• 20 Bestall J C, Paul E A, Garrod R, Garnham R, Jones P W, Wedzicha J A. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease.  Thorax. 1999;  54 581-586
  CrossrefPubMedGoogle Scholar
• 21 Celli B R, Cote C G, Marin J M et al.. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease.  N Engl J Med. 2004;  350 1005-1012
  CrossrefPubMedGoogle Scholar
• 22 American Thoracic Society . Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 1995;  5 S77-S121
  PubMedGoogle Scholar
• 23 Snider G L. Chronic obstructive pulmonary disease: a definition and implications of structural determinants of airflow obstruction for epidemiology.  Am Rev Respir Dis. 1989;  140(suppl 3) S3-S8
  CrossrefPubMedGoogle Scholar
• 24 National Emphysema Treatment Trial Research Group . Patients at high risk of death after lung-volume-reduction surgery.  N Engl J Med. 2001;  345 1075-1083
  CrossrefPubMedGoogle Scholar
• 25 Sheffer A L, Taggart V S. The National Asthma Education Program. Expert panel report guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute.  Medical Care. 1993;  31(suppl 3) MS20-28
  PubMedGoogle Scholar
• 26 Mannino D M, Gagnon R C, Petty T L, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey, 1988-1994.  Arch Intern Med. 2000;  160 1683-1689
  CrossrefPubMedGoogle Scholar
• 27 Soriano J B, Davis K J, Coleman B, Visick G, Mannino D, Pride N B. The proportional Venn diagram of obstructive lung disease: two approximations from the United States and the United Kingdom.  Chest. 2003;  124 474-481
  CrossrefPubMedGoogle Scholar
• 28 Sharp D S, Burchfiel C M, Curb J D, Rodriguez B L, Enright P L. The synergy of low lung function and low body mass index predicting all-cause mortality among older Japanese-American men.  J Am Geriatr Soc. 1997;  45 1464-1471
  PubMedGoogle Scholar
• 29 Wouters E F, Creutzberg E C, Schols A M. Systemic effects in COPD.  Chest. 2002;  121 127S-130S
  CrossrefPubMedGoogle Scholar
• 30 Bowen J B, Votto J J, Thrall R S et al.. Functional status and survival following pulmonary rehabilitation.  Chest. 2000;  118 697-703
  CrossrefPubMedGoogle Scholar
• 31 Ferrer M, Villasante C, Alonso J et al.. Interpretation of quality of life scores from the St George's Respiratory Questionnaire.  Eur Respir J. 2002;  19 405-413
  CrossrefPubMedGoogle Scholar
• 32 Agusti A G. Systemic effects of chronic obstructive pulmonary disease.  Novartis Found Symp. 2001;  234 242-249
  PubMedGoogle Scholar
• 33 Eisner M D, Yelin E H, Trupin L, Blanc P D. The influence of chronic respiratory conditions on health status and work disability.  Am J Public Health. 2002;  92 1506-1513
  PubMedGoogle Scholar
• 34 Yohannes A, Baldwin R, Connolly M. Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire.  Int J Geriatr Psychiatry. 2000;  15 1090-1096
  CrossrefPubMedGoogle Scholar
• 35 Upshur R E, Knight K, Goel V. Time-series analysis of the relation between influenza virus and hospital admissions of the elderly in Ontario, Canada, for pneumonia, chronic lung disease, and congestive heart failure.  Am J Epidemiol. 1999;  149 85-92
  PubMedGoogle Scholar
• 36 National Center for Health Statistics . National Health Interview Survey: research for the 1995-2004 redesign.  Vital Health Stat. 1999;  2 1-119
  PubMedGoogle Scholar
• 37 Mannino D M, Homa D M, Akinbami L, Ford E S, Redd S C. Surveillance for Chronic Obstructive Pulmonary Disease: United States, 1971-2000.  MMWR Surveill Summ. 2002; 
  PubMedGoogle Scholar
• 38 Plan and operation of the Third National Health and Nutrition Examination Survey, 1988-94. Series 1: programs and collection procedures.  Vital Health Stat. 1994;  32 1-407
  PubMedGoogle Scholar
• 39 Standardization of spirometry-1987 update: statement of the American Thoracic Society.  Am Rev Respir Dis. 1987;  136 1285-1298
  CrossrefPubMedGoogle Scholar
• 40 Kanner R E, Connett J E, Altose M D et al.. Gender difference in airway hyperresponsiveness in smokers with mild COPD. The Lung Health Study.  Am J Respir Crit Care Med. 1994;  150 956-961
  PubMedGoogle Scholar
• 41 Enright P L, Johnson L R, Connett J E, Voelker H, Buist A S. Spirometry in the Lung Health Study, I: Methods and quality control.  Am Rev Respir Dis. 1991;  143 1215-1223
  PubMedGoogle Scholar
• 42 Chang J T, Moran M B, Cugell D W, Webster Jr J R. COPD in the elderly: a reversible cause of functional impairment.  Chest. 1995;  108 736-740
  PubMedGoogle Scholar
• 43 Halbert R J, Isonaka S, George D, Iqbal A. Interpreting COPD prevalence estimates: what is the true burden of disease?.  Chest. 2003;  123 1684-1692
  CrossrefPubMedGoogle Scholar
• 44 Mannino D M, Buist A S, Petty T L, Enright P L, Redd S C. Lung function and mortality in the United States: data from the First National Health and Nutrition Examination Survey follow-up study.  Thorax. 2003;  58 388-393
  CrossrefPubMedGoogle Scholar
• 45 Mannino D M, Ford E S, Redd S C. Obstructive and restrictive lung disease and functional limitation: data from the Third National Health and Nutrition Examination.  J Intern Med. 2003;  254 540-547
  CrossrefPubMedGoogle Scholar
• 46 Slusarcick A L, McCaig L F. National Hospital Ambulatory Medical Care Survey: 1998 outpatient department summary.  Adv Data. 2000;  317 1-23
  PubMedGoogle Scholar
• 47 McCaig L F. National Hospital Ambulatory Medical Care Survey: 1998 emergency department summary.  Adv Data. 2000;  313 1-23
  PubMedGoogle Scholar
• 48 Dennison C, Pokras R. Design and operation of the National Hospital Discharge Survey: 1988 redesign.  Vital Health Stat. 2000;  1 1-42
  PubMedGoogle Scholar
• 49 Popovic J R, Kozak L J. National hospital discharge survey: annual summary, 1998.  Vital Health Stat. 2000;  13 1-194
  PubMedGoogle Scholar
• 50 Murphy S L. Deaths: Final data for 1998.  Natl Vital Stat Rep. 2000;  48 1-106
  PubMedGoogle Scholar
• 51 Mannino D M, Brown C, Giovino G A. Obstructive lung disease deaths in the United States from 1979 through 1993: an analysis using multiple-cause mortality data.  Am J Respir Crit Care Med. 1997;  156 814-818
  PubMedGoogle Scholar
• 52 Camilli A E, Robbins D R, Lebowitz M D. Death certificate reporting of confirmed airways obstructive disease.  Am J Epidemiol. 1991;  133 795-800
  PubMedGoogle Scholar
• 53 Sullivan S D, Ramsey S D, Lee T A. The economic burden of COPD.  Chest. 2000;  117 5S-9S
  CrossrefPubMedGoogle Scholar
• 54 National Heart Lung and Blood Institute .Chronic Obstructive Pulmonary Disease. Available at: http://www.nhlbi.nih.gov/health/public/lung/other/copd_fact.pdf Accessed April 6, 2005
  Google Scholar
• 55 Wouters E F. Economic analysis of the Confronting COPD survey: an overview of results.  Respir Med. 2003;  97(suppl C) S3-S14
  PubMedGoogle Scholar
• 56 Halpern M T, Stanford R H, Borker R. The burden of COPD in the U.S.A.: results from the Confronting COPD survey.  Respir Med. 2003;  97(suppl C) S81-S89
  PubMedGoogle Scholar
• 57 Michaud C M, Murray C J, Bloom B R. Burden of disease: implications for future research.  JAMA. 2001;  285 535-539
  CrossrefPubMedGoogle Scholar
• 58 Lopez A D, Murray C C. The global burden of disease, 1990-2020.  Nat Med. 1998;  4 1241-1243
  CrossrefPubMedGoogle Scholar

David M ManninoM.D. 

Division of Pulmonary and Critical Care Medicine, University of Kentucky School of Medicine

800 Rose St., MN 614, Lexington, KY 40536

Email: dmmann2@email.uky.edu