Focus on COPD
10/23/2009
Dr. Suzanne Hurd on the toll of chronic obstructive pulmonary disease
Chronic Obstructive Pulmonary Disease (COPD) is a global public health problem of growing concern. Data from the World Health Organization Global Burden of Disease Project1 indicates that COPD is a leading cause of death worldwide, surpassed only by heart attack, stroke, and acute lung infections. COPD kills more people than cancer and as many people as HIV/AIDS. Use of tobacco products and - especially in developing countries - exposure to biomass fuels, and fumes from indoor cooking and heating are the reasons for the increased morbidity and mortality from COPD. Another reason for the increased number of people diagnosed with COPD is the worldwide increase in the age of the population.
COPD is a lung disease characterized by airflow limitation (lung damage) that is usually progressive and is associated with an inflammatory response of the lungs to noxious particles making breathing difficult. Symptoms of COPD include coughing, bringing up phlegm or mucus, and shortness of breath.
Unfortunately, COPD is under-diagnosed, and under-treated. Fortunately, research scientists, medical professionals and members of the pharmaceutical industry around the world are gaining a better understanding of the causes for the lung damage that leads to COPD; this should eventually lead to better ways to treat this chronic lung disease.
Early diagnosis, key to implementation of therapy, is based on the degree of airflow limitation determined by spirometry, a simple, painless test that is done at a clinic or doctor's office. The spirometry test measures the amount of air a person can breathe out, and the amount of time taken to do so. Although there are no current medications that will reverse the lung damage caused by smoking or exposure to fumes, there are medications that provide relief of the symptoms. The medications are prescribed based on the severity of COPD as measured by spirometry, and include bronchodilators and anti-inflammatory medications such as inhaled glucocorticosteroids. These medications can provide patients with symptomatic relief and improve quality of life. Increasing concerns related to the impact of co-morbid conditions, such as heart disease, arthritis, osteoporosis and diabetes, and their impact on the care of patients who also suffer from COPD, are leading doctors to examine a variety of management approaches.
In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung and Blood Institute, and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). In 2002, with its increasing success as a global COPD initiative, GOLD became an independent organization working with a large number of international COPD experts and national organizations. Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely from it or its complications. To meet its objectives, GOLD has a series of reports - Global Strategy for the Diagnosis, Management and Prevention of COPD - that are based on the best scientific evidence available, and are updated annually.
The GOLD program coordinates activities for World COPD Day held annually on the third Wednesday of November. The goals are to raise awareness of the burden of COPD among health care workers, public health officials, and the public. A large number of events - spirometry screening, workshops, smoking cessation clinics - are organized at the local level. This year World COPD Day is on November 18 and will carry the theme "Breathless Not Helpless." Information about World COPD Day, and materials prepared by GOLD can be found on the website.
GOLD is truly a global program. Through a network of international experts - GOLD National Leaders - research investigations have been launched on the causes and prevalence of COPD in their countries, and innovative approaches for the dissemination and implementation of COPD management guidelines have been developed. Through this work, patients with COPD should eventually benefit by receiving earlier diagnosis, more effective treatment and become aware of ways to prevent the onset of this disease.
Reference
1 Lopez AD, Shibuya K, Rao C, Mathers CD, Hansell AL, Held LS, et al. Chronic Obstructive Pulmonary Disease: Current Burden and Future Projections. Eur Respir J 2006;27(2):397-412.
Suzanne S. Hurd, PhD is scientific director of the Global Initiative for COPD (GOLD).
Very Good !
— Dr.R.P.Ilangho on 2009-11-13
I’m an occupational therapy practitioner and certified yoga instructor who treats patients with COPD. Thank you for a informative article. I also find that there are specific breathing and COPD techniques that make a remarkable difference in lung capacity. I measure my patients oxygen saturation throughout treatment and the increase is progressively better 8 out of 10 times providing the patient no longer smokes.
Suzanne Andrews, host of Functional Fitness COPD DVD
— Suzanne Andrews on 2010-01-20