1. ©LTPHN 2008 Respiratory Diseases Name Speaker

2. ©LTPHN 2008 Respiratory Disease – Global Burden Very common worldwide Substantial preventable morbidity and mortality Major cost – human and economic Cause 16% of deaths worldwide (2 nd commonest cause of death after CVD) Developing countries commonest causal agent: Infection Developed countries commonest causal agent: Smoking

3. ©LTPHN 2008 Respiratory Disease – Global Burden 2 Major cause of death Major cause of morbidity – 1)Ill health 2)Reduced quality of life

4. ©LTPHN 2008 Importance in the UK Asthma prevalence : 8% of adults; women > men Asthma prevalence: 12.5-15.5% of children; boys > girls Asthma: 1500 deaths annually COPD prevalence : 1-4% of adults [virtually no children]; but c.15% 45-68y COPD: >30,000 deaths annually

5. ©LTPHN 2008 COPD: Definition Airflow obstruction Usually progressive Not fully reversible Not changing markedly over several months Predominantly caused by smoking

6. ©LTPHN 2008 Prevalence of COPD Difficult to ascertain because: Definition not universally applied Measurement of airflow obstruction not always available Cannot be accurately counted on clinical findings alone Many cases subclinical Estimate(UK): 1000-4000 cases per 100,000 pop

7. ©LTPHN 2008 Lifestyle factors - Smoking Stopping smoking can prevent or ameliorate or slow progression of several respiratory conditions Passive smoking important in causation and exacerbation Increases risks of comorbidity – eg CVD Stopping smoking can reduce medication requirements

8. ©LTPHN 2008 Smoking and Respiratory Diseases 54% of deaths from all respiratory diseases including: 90% of lung cancer deaths 70% of COPD deaths 14% of deaths from other respiratory diseases

9. ©LTPHN 2008 Primary Prevention Reduce exposure to tobacco smoke: - Smoking: cessation or not starting - Environmental exposure (passive smoking) Reduce occupational exposure to smoke and other industrial pollutants

10. ©LTPHN 2008 Air pollution Causes and/or exacerbates some respiratory conditions A problem of developed and developing countries Improved air quality reduces emergency admissions for cardiorespiratory diseases

11. ©LTPHN 2008 Economic Facts of COPD (UK) 3 million people affected 1.4 million GP consultations pa 1million inpatient hospital days pa 24 million working days lost annually Direct NHS costs >£800m every year Direct NHS costs £1.3m per 100,000 pop

12. ©LTPHN 2008 Further information World Health Organisation www.who.int/respiratory/en/ London Health Observatory www.lho.org.uk/viewResource.aspx?id=9576