Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa.Professor of “Health Effects of Pollution”, School of Environmental Sciences, University of Pisa - Italy President, European Respiratory Society (ERS) GARD Launch in Latin America August 17, 11:15-11:30

The Lancet 2005;366:1514

Horton, The Lancet 2005

Strong et al, Lancet 2005

Presidents of respiratory societies participating in FIRS

Minino, NVSS 2006

2° edition: in preparation

EUROPEAN LUNG WHITE BOOK, 2003

Chapman et al, ERJ 2006

Lopez et al, ERJ 2006

Part III of IV MALES

Lopez et al, ERJ 2006Part IV of IV FEMALES

Mannino et al, ERJ 2006

Part I of II Zielinski et al, ERJ 2006 (Viegi’s part) MALES

Part II of II Zielinski et al, ERJ 2006 (Viegi’s part) FEMALES

Why is the Burden of COPD Increasing? In 2002: 1 in 10 is  60 yrs (629M) By 2020: 1 in 5 will be  60 yrs (2B) By 2150: 1in 3.3 will be  60 yrs

Why is the Burden of COPD Increasing?  The WHO estimates 1.1 billion smokers worldwide, increasing to 1.6 billion by  In low- and middle-income countries, smoking rates are increasing at an alarming rate.  The WHO estimates 1.1 billion smokers worldwide, increasing to 1.6 billion by  In low- and middle-income countries, smoking rates are increasing at an alarming rate.

Eur Respir J Apr 12; [Epub ahead of print] Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM

Halbert, Eur Respir J 2006 Adults over 40 yr

Menezes, Lancet 2005

Respir Med Feb;97(2): Not 15 but 50% of smokers develop COPD?--Report from the Obstructive Lung Disease in Northern Sweden Studies. Lundback B, Lindberg A, Lindstrom M, Ronmark E, Jonsson AC, Jonsson E, Larsson LG, Andersson S, Sandstrom T, Larsson K; Obstructive Lung Disease in Northern Sweden Studies. In 1996, 5892 of the Obstructive Lung Disease in Northern Sweden (OLIN) Study's first cohort could be traced to a third follow-up survey, and 5189 completed responses (88%) were received corresponding to 79% of the original cohort from December Of the responders, a random sample of 1500 subjects were invited to a structured interview and a lung function test, and 1237 of the invited completed a lung function test with acceptable quality. In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, while it was 14% according to the GOLD criteria and approximately a half of elderly smokers fulfilled the criteria for COPD according to both the BTS and the GOLD criteria. Of those fulfilling the BTS criteria for COPD, 94% were symptomatics, 69% had chronic productive cough, but only 31% had prior to the study been diagnosed as having either chronic bronchitis, emphysema, or COPD. The corresponding figures for COPD according GOLD were 88, 51, and 18%.

Masoli et al, Allergy 2004

GARD WG-1: Epidemiology and Surveillance (G Viegi): Chair: G. Viegi, Italy (ERS); Co-Chairs: S. Buist, USA (GOLD), Y. Fukuchi (APSR). WHO-Liaison Officers: E. Mantsouranis. Proposed initial composition: I. Annesi (ERS), R. Beasley (?), P. Burney (GA2LEN), W. Canonica (WAO), B. Chipps (ACAAI), E. Duran (ERS), J. Jardim (ALAT), D.S. Kim (APSR), A. Kocabas (TTS), C. Lai (AAAF), Lee Todd (BOLD), B. Lundback (ERS), J. Mallol (?), D. Mannino (ATS?), D. Nugmanova (WONCA), J.A. Odhiambo (IUATLD?), R Pawankar (ARIA?), J Vestbo (ERS).

General Objective The goal of this WG is to develop a standardized process to obtain data risk factors, disease burden, trends, quality and affordability of care and the economic burden of chronic respiratory diseases (CRD) and allergies that can then be compared across countries.

Aims: 1.Use WHO programmes and non-WHO programmes to make an inventory of existing studies/reports that have collected data on prevalence, risk factors, severity, and economic burden of chronic respiratory diseases. 2. Collect these data at a country-based level. 3. Expand WHO internal initiatives (routine statistics, information systems, projection models) to cover respiratory and allergic diseases.