You are on page 1of 4

Respiratory disease

Respiratory diseases are the major causes of illness and mortality in Australia, placing great stress on the health care system. Chronic respiratory diseases are a diverse group of illnesses and conditions affecting the breathing and oxygen process. Greater attention is now being paid to the extent, nature, risk factors, protective factors, population groups and the influential determinants. They are highly prevalent in the community and constitute a significant health problem in Australia. Nevertheless, effective prevention of chronic respiratory diseases is possible because they have risk factors that are identifiable and avoidable. This report is a brief summary of the prevalence and consequences of a selection of chronic respiratory diseases affecting Australians. The report highlights the following diseases: COPDa disease characterised by progressive development of airflow limitation that is not fully reversible. In most instances emphysema is the underlying condition, although people with COPD often also have chronic bronchitis. Asthmaa chronic inflammatory disorder of the airways characterised by reversible airflow obstruction and resulting in cough, wheeze, chest tightness and shortness of breath.

The nature of respiratory disease


COPD
Respiratory disease, or chronic obstructive pulmonary disease (COPD), is a disease that destroys the lung tissue and narrows the air passages to obstruct oxygen intake, causing chronic shortness of breath. A person with COPD is prone to episodes where shortness of breath is more severe and he or she has fits of coughing with mucus. The lung damage is mainly due to the long-term inhalation of irritant gases and particles, and by far the main cause of this is cigarette smoking. Common COPDs are emphysema and chronic bronchitis. COPD most commonly arises from the gradual destruction of lung tissue due to the unopposed action of enzymes stimulated by inhaled irritants. This destruction of lung tissues, known as emphysema and mostly caused by tobacco smoking, makes the lungs floppy and less able to move air in and out, thereby limiting the ability of the lungs to exchange oxygen and carbon dioxide.

Asthma
Asthma is a chronic inflammatory condition of the airways causing episodes of wheezing, breathlessness and tightness in the chest. It affects a persons ability to carry air in and out of the lungs ranging from mild symptoms to severe, life threatening attack. In severe asthma attacks, the airways may close so much (as shown in figure 1.2/c) that there is not enough oxygen reaching vital organs, with fatal results if medical attention is not sought. The air way walls become inflamed and the muscles tighten, therefore constricting the airflow. Symptoms of asthma can usually be managed, either by preventer treatment or reliever treatments. The symptoms of asthma are usually reversible, either spontaneously or with treatment. Many people with asthma, particularly those with more severe or persistent symptoms, are allergic to environmental allergens from dust mites, cockroaches, pollens, moulds and/or pets (especially cats and dogs). A large proportion of asthma is developed in early. Some young children with mild and occasional episodes of wheezing or cough, particularly those who are not allergic, have a self-limiting disease that resolves in later childhood.

Figure 1.2 (Normal airway/B and airway during asthma symptoms/C)

Extent of and trends in RD


COPD
An international survey of people aged 2044 years ranked Australia third out of 16 out of high-income countries in the prevalence of mild COPD. In this survey, Australia had the lowest prevalence of the identified groups considered at risk of respiratory disease. About 3.5% of the Australian population was estimated to have COPD which has decreased from 2001. Figure 1.3 shows the prevalence of COPD in Australia to have dropped from 4.2% in 1995 through to 2.5% in 2008. Deaths due to respiratory disease were 45.2 per cent and 3.7 per cent of all deaths. The death rate among males was almost double the female rate. Overall, the death rate for COPD has fallen over the last 25 years (as seen in figure 1.4). In males, the death rate due to COPD fell every year for the last 10 years, except in 2002. In females, the rate appeared to level off after peaking in 1997 until a small fall in 2005.

1.3 Trends in prevalence of COPD

1.4 Trends in COPD mortality, 1980-2007

Asthma
The severity of asthma is illustrated in the recent epidemiological study of the disease in Australia have shown important changes in the prevalence of asthma Recent data show an estimated 10.0% of the Australian population had current asthma in 200708. This trend is shown in figure 1.5, among those aged under 15 years, prevalence of asthma is higher for males than females but, among those aged 15 years and over, the reverse is true. Overall, females had a significantly higher prevalence of current asthma (10.9%) than males (8.9%) in 200708, although the highest prevalence occurred in males aged 59 years (15.1%). In 2007, asthma was certified as the underlying cause of 385 deaths. This corresponds to an asthma mortality rate of 1.67 per 100,000 populations, representing 0.28% of all deaths worldwide. The death rate from asthma is shown in figure 1.6, and it can be seen to be dropping from 1991 onwards. Since the peak in deaths from asthma in the late 1980s, the mortality rate has fallen by about 70%. Overall, the rate is higher in females than males.

1.5 Prevalence of Asthma in Australia

1.6 Trends in Asthma mortality 1980-2006

Risk factors and protective factors for respiratory disease


Risk factors increases livelihood. Conversely protective factors can prevent or reduce the incidence of respiratory diseases. Non modifiable factors that impact on members of the community are : age, sex, ethnicity and genetic makeup. Other risk factors in the community include environmental determinants, such as socioeconomic status, working conditions and environmental health.

COPD
Tobacco smoking is the most important risk factor for COPD. Other risk factors for COPD may worsen respiratory symptoms or may contribute to the risk of developing the disease, either independently or in conjunction with tobacco smoking. These include respiratory infections and exposure to environmental (passive) tobacco smoke, indoor and outdoor air pollution, and occupational dusts and chemicals. Reducing tobacco use is the most effective strategy for reducing the burden of COPD, and early diagnosis and management of COPD is also important. Australias national tobacco strategy includes preventing the uptake of smoking and encouraging smokers to quit. International and Australian guidelines encourage clear, consistent and repeated non-smoking messages, smoke-free homes and smoke-free schools, public places and work environments.

Asthma
A family history of asthma increases the chances of developing asthma. Causes of asthma are not fully understood, but environmental and lifestyle factors are important, as well as allergic conditions. An asthma attack can often be triggered by many factors such as cold and flu, inhaled allergens (pollens, animal fur, and dust mites), strong odors and scents, certain drugs, food preservatives, flavoring and colorings. In some instances exercise can induce asthma, although physical activity is also viewed as a protective factor. People with asthma should consult their doctor to find out their Asthma Action Plan a set of instructions that helps people to prevent an attack, as well as manage and treat their asthma at different times. Asthma cannot be cured, but it can be effectively managed so that people with asthma can lead healthy and active lives.

Socio-cultural, socio-economic and environmental determinants


COPD
Social factors that influence the risk of COPD include socio-economic status. People of low socioeconomic status are more likely to smoke. Thus, children of low socio-economic status are more likely to be exposed to passive smoking in the home. Cultural backgrounds can be a determinant, prevalence of COPD is higher for Aboriginal and Torres Strait Islander peoples as smoking rates are twice those of non-Aboriginal Australians. Socioeconomically disadvantaged people have higher rates of COPD, largely due to this group being more likely to smoke. Thus, children from low SES families are more likely to be exposed to passive smoking. They also tend to live in areas close to factories or high-density housing near industrial areas, work in hazardous jobs involving chemicals and be less likely to obtain medical care.

Asthma
The death rate from asthma is higher in rural and remote locations than in capital cities. Children from low socioeconomic groups might be less likely to obtain adequate medical care regarding asthma prevention, control and treatment. Asthma might be more common in people from low socio-economic areas because they are more likely to work in hazardous jobs involving chemicals and fibres.Environmental air pollution exposure can trigger asthma episodes. Different types of allergic reactions can be seen in figure 1.7.

1.7 Asthmatic environmental allergic reactions

Groups at risk of COPD and Asthma


Groups at risk of COPD are those aged over 65 years, people who smoke and people prone to allergies. Young children are at highest risk of developing asthma. In particular, Aboriginal and Torres Strait Islander peoples, people from low socio-economic areas and people from non-English speaking backgrounds are also at risk of COPD. Groups at risk of COPD and asthma are: smokers people whose employment has exposed them to long-term inhalation of irritant gases and particles older people - aged over 65 years young children (asthma incidence rates are higher) Aboriginal and Torres Strait Islander peoples socioeconomically disadvantaged peoples People living in rural and remote areas less access to emergency services resulting in higher death rate from asthma. Morbidity

The purpose of this report was to provide a concise summary of the prevalence and consequences of a selection of chronic respiratory diseases affecting Australians. In the case of COPD, the greatest health system expenditure involves hospitalisation and is associated mostly with those aged over 65 years. In the case of asthma, the greatest health system expenditure involves medication and is associated mostly with those aged under 65 years. To a large extent, the effective prevention of the onset and consequences of chronic respiratory diseases is possible. This is because many of their risk factors can be identified and avoided, or at least managed. Tobacco smoking is by far the greatest risk factor for COPD. Exposure to environmental tobacco smoke, particularly in childhood, may lead to the development of asthma or intensify symptoms among those with asthma. Tobacco smoke has therefore received much importance in public health research and policy.

Bibliography: http://hsc.csu.edu.au/pdhpe/ http://www.blackwellpublishing.com/specialarticles/jcn_ 9_188.pdf http://www.mhcs.health.nsw.gov.au/publication_pdfs/8 095/AHS-8095-ENG.pdf PDHPE HSC complete course 2

You might also like