COPD: The statistics

<ul>
<li>COPD is a lung disease that affects almost 13% or one in seven Australians 40 or over. ¹</li>
<li> 7.5% of Australians 40 or over have COPD that has progressed sufficiently to where symptoms may already be present and affecting daily life.  Half of these people will not know they have it.¹</li>
<li> COPD is the second leading cause of avoidable hospital admissions.²</li>
<li> Despite falling death rates, COPD is still a leading cause of death and disease burden after heart disease, stroke and cancer.³</li>
<li>Australia has one of the highest rates of COPD deaths in the developed world – Australian mortality rates place Australia in the worst third of the 34 OECD countries.³</li>
<li>While there is no cure for COPD, there are things people can do to breathe easier, keep out of hospital and improve their quality of life.⁴</li>
<li>COPD is preventable and treatable.⁴</li>
</ul>
<p align="center"></p>
<strong>What is COPD?</strong>
<ul>
<li>Chronic Obstructive Pulmonary Disease (COPD) is a deadly long-term disease of the lungs which causes shortness of breath. While COPD has no cure, there are things that people can do to breathe easier, keep out of hospital and improve their quality of life.⁴</li>
<li>COPD is an umbrella term that includes emphysema, chronic bronchitis and chronic asthma.</li>
<li>COPD is usually characterised by:</li>
<ul>
<li>Shortness of breath</li>
<li>A repetitive cough with phlegm / mucus most days</li>
<li>History of cigarette smoking or exposure to other environmental pollutants (smokes and fumes) or industrial dust</li>
</ul>
</ul>
<strong>How does a person with COPD feel?</strong>

Symptoms for an individual with COPD tend to creep up gradually. Breathlessness may lead those with the condition to cut back on physical activities.  This gradual decline continues until simple daily activities like showering, dressing or making a cup of tea, become almost impossible. Depression and anxiety often affect those with COPD.

<strong>What Causes COPD?</strong>
<ul>
<li>In the western world, cigarette smoking is the single largest cause of COPD.⁴ However, despite being the highest risk group for COPD, regular smokers are less likely than the rest of the population to consider themselves at risk of developing COPD.⁵</li>
<li>Some 20% of COPD occurs in never smokers⁶.</li>
<li>Other known risk factors are passive smoking, especially during infancy when the lungs are still developing, exposure to environmental agents, including indoor and outdoor air pollutants and occupational dusts and chemicals.⁴</li>
<li>Women may be at greater risk than men of COPD from exposures at work and are more susceptible to COPD due to smaller lungs and airways and more sensitive airways.<strong>⁷</strong></li>
<li>Chronic asthma may evolve into COPD in later life, especially in those who have smoked and when appropriate medications have not been taken properly.⁴</li>
</ul>
<strong>Prevalence of COPD</strong>
<ul>
<li>The Australian Lung Foundation estimates that approximately 1.2 million Australians have some form of COPD.⁸ This represents approximately one in seven Australians over 40.¹</li>
</ul>
<ol>
<li>Of those with COPD currently, The Australian Lung Foundation estimates that over 680,000 Australians^1,8 have COPD that has progressed to a stage at which symptoms, such as breathlessness may already be present and affecting their daily lives. Half of these people do not have a doctor’s diagnosis of COPD and are therefore not taking the important steps to slow down the progression of the disease.¹</li>
<li>Nearly 520,000 Australians^1,8 have a mild form  of COPD where symptoms may not yet be present. Many of these will go on to develop more severe COPD.</li>
</ol>
<ul>
<li>People who unknowingly have COPD may mistake their symptoms as signs of ageing, lack of fitness or asthma – a simple lung function test from a GP can diagnose COPD.</li>
</ul>
<strong>The Burden of COPD</strong>
<ul>
<li>In Australia, despite falling death rates, COPD is still a leading cause of death and disease burden after heart disease, stroke and cancer³.</li>
<li>COPD is a significant cause of death in Australia.  Estimates range from 12,000 persons per year⁹where COPD was a contributing factor (or 9.5% of all deaths in 2005) to 16,000¹⁰ deaths a year as a result of COPD.</li>
<li>Australia has one of the highest rates of COPD deaths in the developed world – Australian mortality rates place Australia in the bottom third of the 34 OECD countries³.</li>
<li>COPD is the second leading cause of avoidable hospital admissions in Australia.²</li>
<li>In 2008-09 the median length of hospital stay for COPD was 5 days among people aged 55-69 years, rising to 6 days for those aged 85 years and over.¹⁹</li>
<li>In 2008, the total economic impact of COPD was estimated to be $98.2 billion of which $8.8 billion was attributed to financial costs and $89.4 billion to the loss of wellbeing.¹⁰</li>
</ul>
<ol>
<li>Of the financial costs ($8.8 billion), a large proportion is due to the loss of productivity due to COPD, ie lower employment, absenteeism and the workplace impact of premature death of Australians with COPD.¹⁰</li>
<li>The direct cost to the Australian health care system is estimated to be $900 million with hospital use contributing the largest share of health spending ($473 million).¹⁰</li>
<li>In addition to the above costs on the public and private sector purse, there are the costs that are harder to quantify – those of lost wellbeing as a result of COPD.  These are estimated to be some $90 billion.¹⁰</li>
</ol>
<ul>
<li>In terms of overall costs, COPD is more costly per case than cardiovascular disease, osteoporosis or arthritis.¹⁰</li>
</ul>
<strong>COPD diagnosis and treatment</strong>
<ul>
<li>COPD is preventable and treatable⁴.</li>
<li>While there is no cure for COPD, there is strong medical evidence to show that early diagnosis, combined with disease management programs at the early stages of the disease could reduce the burden of COPD, improving quality of life, slowing disease progression, reducing mortality and keeping people out of hospital.⁴</li>
<li>Lower costs and burden of disease can result if diagnosis is achieved early and optimally assessed, especially as treatment can reduce exacerbations.^13-18</li>
</ul>
<strong>Treatment</strong>

The key aims of COPD treatment are to reduce symptoms, improve quality of life, increase the capacity for exercise and ultimately, keep people well and out of hospital. There are a number of steps people with COPD can take to breathe easier and improve their quality of life.
<ul>
<li>Stop smoking – helps improve symptoms and slow down the rate the disease progresses.^4,14</li>
<li>Inhaled medications – reduce symptoms, improve quality of life, reduce activity limitation and prevent exacerbations associated with hospital admissions.⁴</li>
<li>Pulmonary rehabilitation –reduces breathlessness, fatigue, anxiety and depression, improves exercise capacity, emotional function and health-related quality of life and enhances patients’ sense of control over their condition. Pulmonary rehabilitation reduces hospitalisation and has been shown to be cost-effective.⁴</li>
<li>Regular vaccinations against influenza and pneumonia.⁴</li>
<li>Support groups/services – as COPD worsens and patients feel less able to carry on their normal activities, patients become increasingly isolated.  Support groups/services can help meet the emotional and social needs of people with the condition, helping them realise that they are not alone.</li>
<li>Oxygen therapy – helps those people with advanced lung disease who are unable to absorb sufficient oxygen to supply their vital organs.⁴</li>
<li>People over 40 with a history of cigarette smoking should speak with their GP if they do any of the following:</li>
<li>Cough several times most days</li>
<li>Bring up phlegm or mucous most days</li>
<li>Are short of breath compared with others their age</li>
</ul>
<strong>Lung Foundation Australia</strong>
<ul>
<li>Lung Foundation Australia is the premier organisation for lung health in Australia, providing medical and support group representation nationwide.</li>
<li>Lung Foundation Australia produces a range of clinical resources to support evidence-based diagnosis and management of COPD.</li>
<li>Lung Foundation Australia offers a national network of patient support groups for people with COPD and other lung conditions.  Patients are supported with information via <strong><a href="http://www.lungfoundation.com.au/">www.lungfoundation.com.au</a> </strong> a quarterly health education newsletter, telephone information and toll free support hotline (<strong>1800 654 301</strong>).</li>
</ul>
<strong>For further information please contact:</strong>

<strong>Elizabeth Harper, Director COPD National Program, Lung Foundation Australia</strong>

<strong> (07) 3251-3644</strong>

<a href="mailto:elizabeth@lungfoundation.com.au">elizabeth@lungfoundation.com.au</a>
<h3><strong>References</strong></h3>
<ol>
<li>Toelle B, Xuan W, Bird T, Abramson M, Burton D, Hunter M, Johns D, Maguire G, Wood-Baker R, Marks G.  COPD in the Australian burden of lung disease (BOLD) study.  Respirology 2011;16 (Suppl 1):12</li>
<li>Page A, Abrose S, Glover J et al. Atlas <em>of Avoidable Hospitalisations in Australia: ambulatory care-sensitive conditions</em>.  Adelaide PHIDU. University of Adelaide.  2007</li>
<li>AIHW 2012. Australia's health 2012. Australia's health no. 13. Cat. no. AUS 156. Canberra: AIHW.</li>
<li>McKenzie DK, Frith PA, Burdon <em>et al</em> on behalf of The Australian Lung Foundation. The COPDX Plan: Australian and New Zealand Guidelines for the Management of Chronic Obstructive Pulmonary Disease 2008, found at <a href="http://www.copdx.org.au/">www.copdx.org.au</a></li>
<li>Newspoll Market Research. Conducted by telephone in October 2007 among a representative sample of 688 adults aged 45 and over across Australia.</li>
<li>Lamprecht B et al, COPD in Never Smokers: Results From the Population-Based Burden of Obstructive Lung Disease Study. <em>Chest</em> 2011; 139; 752-763; Prepublished online Septemberr 30, 2010; DOI 10.1378/chest.10-1253.</li>
<li>Petty T. The Rising Epidemic of COPD in Women: Why women are more susceptible; how treatment should differ.  <em>Women’s Health in Primary Care</em> Dec 1999;<strong>2</strong>(12)</li>
<li>Based on ABS census data — CData Online 2006 Census, Australian population over 40.</li>
<li>AIHW 2010. <em>Australia’s Health 2010, </em>found at <a href="http://www.aihw.gov.au/publication-detail/?id=6442468376">http://www.aihw.gov.au/publication-detail/?id=6442468376</a><em>.</em></li>
<li>Access Economics. <em>Economic impact of COPD and cost effective solutions. 2008</em>.</li>
<li>Buist AS, McBurnie MA, Vollmer WM <em>et al</em>. International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study. <em>Lancet</em> 1 September 2007; <strong>370</strong>: 741-750</li>
<li>AIHW 2010. <em>Australia’s Health 2010, </em>found at <a href="http://www.aihw.gov.au/publication-detail/?id=6442468376">http://www.aihw.gov.au/publication-detail/?id=6442468376</a> <em>.</em></li>
<li>Crockett AJ, Cranston JM, Moss JR. <em>Economic Case Statement. Chronic Obstructive Pulmonary Disease. Australian Lung Foundation,</em> Sept 2002</li>
<li>Fletcher C, Peto R. The natural history of chronic airflow obstruction. <em>B Med J</em> 1977;<strong>1</strong>:1645-1648</li>
<li>Abramson M et al. <em>Managing chronic obstructive pulmonary disease. </em>Aust Prescr 2007;30:64-7. Available at: <em><a href="http://www.australianprescriber.com/magazine/30/3/64/7">http://www.australianprescriber.com/magazine/30/3/64/7</a></em></li>
<li>Lacasse Y, Brosseau L, Milne S <em>et al</em>. <em>Pulmonary rehabilitation for chronic obstructive pulmonary disease</em>. Cochrane Database of Systematic Review. 2001; Issue 4</li>
<li>Griffiths TL, Phillips CJ, Davies S <em>et al</em>.  <em>Cost effectiveness of an outpatient multidisciplinary pulmonary rehabilitation programme</em>.  <em>Thorax</em>  2001;<strong>56</strong>:779-784</li>
<li>Golmohammadi K, Jacobs P, Sin DD.  <em>Economic evaluation of a community-based pulmonary rehabilitation program for chronic obstructive pulmonary disease</em>.  <em>Lung</em>  2004;<strong>182</strong>:187-196</li>
<li>Australia Centre for Asthma Monitoring 2011.  Asthma in Australia 2011. AIHW Series no.4. Cat. No. ACM 22. Canberra: AIHW.</li>
</ol>