Epidemiology of COPD: Why Is the Disease So Poorly Recognized?
COPD is currently ranked third in the cause of death around the world. The habit of smoking cigarettes is obviously related to occurrence of COPD, and many cases of COPD are caused by heavy cigarette smoking. However, besides cigarette smoking, occupation
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Epidemiology of COPD: Why Is the Disease So Poorly Recognized? Yoko Shibata
Abstract COPD is currently ranked third in the cause of death around the world. The habit of smoking cigarettes is obviously related to occurrence of COPD, and many cases of COPD are caused by heavy cigarette smoking. However, besides cigarette smoking, occupational exposure to airborne particulates and pollutants are also known to be risk factors for developing COPD. Particularly, the indoor use of biomass fuel has been pointed out as one of the major risk factors for the occurrence COPD in developing countries. COPD develops after a long period of exposure to cigarette smoke; thus, it is characterized by a gradual progression of symptoms. Many patients are not diagnosed with COPD until their symptoms have considerably worsened or acute exacerbation due to respiratory inflammation. Health damage by COPD has a great impact on society as well as on the individual patient; hence, it is important to make a diagnosis early and prevent patients from exposure to risk factors. Keywords Epidemiology • Incidence • Prevalence • Decline in FEV1 • Cigarette smoking • Biomass fuel
2.1
Introduction
COPD is a lifestyle-related disease developed due to damage in airway and alveoli after toxic particle inhalation, including long-term cigarette smoke. Chronic airway inflammation by cigarette smoking causes peripheral airway wall thickening and increase of airway secretions, moreover, destruction of the alveolar wall leading to, especially, elastic fiber fragmentation. This causes a loss of alveolar attachment in the peripheral airways, resulting in the reduction of elasticity of the alveolar wall itself. A series of these changes increases peripheral airway resistance, and then causes airflow obstruction upon expiration. This airflow obstruction leads to a
Y. Shibata (*) Department of Cardiology, Pulmonology and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata City, Yamagata 990-9585, Japan e-mail: [email protected] © Springer Science+Business Media Singapore 2017 H. Nakamura, K. Aoshiba (eds.), Chronic Obstructive Pulmonary Disease, Respiratory Disease Series: Diagnostic Tools and Disease Managements, DOI 10.1007/978-981-10-0839-9_2
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18 Fig. 2.1 Top 10 cause of death in the world in 2012 (World Health Organization reported COPD as top 3 cause of death in the world in 2012 http://www.who. int/mediacentre/factsheets/ fs310/en/)
Y. Shibata
The 10 leading cause of death in the world in 2012 (million) 8
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Fig. 2.2 Top 10 cause of death in Japan in 2013 (Japanese Ministry of Health, Labour and Welfare reported COPD as top 9 cause of death in Japan in 2013. http://www.mhlw.go. jp/toukei/saikin/hw/jinkou/ kakutei13/dl/10_h6.pdf)
The 10 leading cause of death in Japan in 2013
(thousand) 400 350 300 250 200
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symptom of dyspnea through air trapping in the lung. In COPD, inflammation as well as chronic airway inflammation spills ove
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