Epidemiology of Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes o f morbidity and mortality in the industrialized and the developing countrie s. During 1997, COPD has been estimated to be the number four cause of deat h after cardiovascular diseases, tumors and cerebrovascular diseases in the United States. In 2020 COPD will probably become the third leading cause o f death all over the world, following the trend of increasing prevalence of lung cancer. The impact of this respiratory disease worldwide is expected to increase with a heavy economic burden on individuals and society. In the United States direct and indirect costs of COPD were estimated at about US D24 billion in 1993. Unfortunately, there are few data on health-care utili zation despite the great interest in COPD among researchers. As all chronic diseases, the prevalence of COPD is strongly associated with age. Data col lected in a general population sample (living in Italy) showed a progressiv e increase of the prevalence of chronic bronchitis and emphysema with age, both in males and in females. COPD is determined by the action of a number of various risk factors either singly or interacting among themselves in a synergistic way. Among these, the most important is cigarette smoking, ran king at the fi rst level for developing chronic bronchitis and emphysema. A lso air pollution and some occupational exposures represent risks for devel oping COPD. Many epidemiological studies have indicated an association betw een the prevalence of chronic bronchitis and a low socioeconomic status. Fu rthermore, in the etiology of COPD we must consider endogenous risk factors such as gender, genetic features, presence of respiratory troubles in chil dhood, and family history. To date, epidemiologic studies have been of grea t importance for the characterization of the disease at a population level, indicating possible causes and assessing its impact on the individual and on society as a whole. Unfortunately, international standards for the diagn osis of COPD are lacking, which complicates the organization of appropriate epidemiological surveys. Copyright(C)2001 S. Karger AG,Basel.