Patient Oriented Evidence that Matters
Full colour PDF of the “COPD” POEM.
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The burden of COPD
COPD imposes a significant personal, societal and financial burden on New Zealanders. In 1997, COPD was ranked third overall in its impact on the health of New Zealanders after ischaemic heart disease and stroke. It ranked second in men and fifth in women and was the fourth most common cause of death after cancer, heart disease and stroke.
In New Zealand it is probable that:
- Approximately 50,000 people aged >40 years have diagnosed COPD, and
- Approximately 180,000 people aged >40 years have undiagnosed COPD (Broad, 2003).
Tobacco smoking causes almost all COPD
Tobacco smoking causes approximately 85% of all cases of COPD. Half of all smokers are susceptible to the effects of tobacco smoke and will develop some limitation of airflow during their lifetime.
There are significant associations between occupations and the risk of respiratory symptoms and physiological abnormalities suggestive of early COPD. These occupations include food processors, bakers, chemical processors, spray painters and those who report occupational exposure to vapours, gases, dust or fumes.
It is likely that these occupational environments are risk factors for COPD, although the relative importance of the occupation weighed against other risk factors (such as pollution and cigarette smoke) will vary from worker to worker and industry to industry (Fishwick, 1997).
A small percentage of COPD sufferers will have a genetic predisposition, such as alpha-1 antitrypsin deficiency, and this should be suspected if a young person develops COPD or someone develops COPD in the absence of a significant smoking history.
In developing countries a frequent cause of COPD is indoor pollution. Often women are affected as they spend time cooking over open fires in confined spaces.
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