The term chronic respiratory diseases (CRDs) describes a range of diseases of the airways and the other structures of the lungs. They include asthma and respiratory allergies, chronic obstructive pulmonary disease (COPD), occupational lung diseases, sleep apnea syndrome and pulmonary hypertension. Allergic rhinitis or “hay fever”, sleep apnea and pulmonary hypertension are other chronic respiratory conditions that affect the lives of millions worldwide.
The burden of chronic respiratory diseases
Although breath is fundamental to life, lung health is less well recognized as a critical health factor than other indicators, such as weight and blood pressure. However, anyone who has struggled to breathe, even for a short time, knows how essential it is. • Worldwide 235 million people are affected by asthma. It is the most common chronic disease among children and also affects adults.
The causes of asthma and the reasons for its increasing prevalence in low- and middle-income countries are not well understood.
64 million people suffer from chronic respiratory diseases, a term that covers emphysema and chronic bronchitis. 90% live in low- and middle-income countries.
chronic respiratory diseases caused more than 3 million deaths in 2005. The number of chronic respiratory diseases deaths is expected to increase by more than 30% in the next 10 years; and WHO projects it will be the 3rd leading cause of death worldwide by 2030.
Prevention of chronic respiratory diseases
Prevention and Risk Factors
The major risk factors for lung disease are well known. Mitigation of these risks can prevent or reduce the impact of lung disease. For example: • Tobacco Control
Direct or indirect exposure to tobacco smoke is a major risk factor for all lung diseases, as well as other major NCDS, including cardiovascular disease, cancer and diabetes. Effective tobacco control is essential to any strategy for preventing lung disease.
Preventive measures, such as adequate ventilation and early detection are vital to addressing occupational lung diseases.
Indoor and Outdoor Air Quality
Improvements in cook stove technology can help reduce exposure to indoor air pollution in homes. Smoke free legislation protects air quality in workplaces, public places, health care facilities, educational facilities and public transportation. Other air quality controls can reduce and eliminate exposure from industrial emissions, traffic, etc.
Diet and Nutrition
Associations have been reported between chronic respiratory disease and diet. It is therefore feasible that dietary strategies compatible with those already existing for the control of coronary heart disease, diabetes and cancer could be developed for the primary and secondary prevention of CRDs as well.
Evidence shows that a child’s health in the first year of life affects the subsequent respiratory health. Maternal smoking during pregnancy adversely affects the lung function of the child at birth.
Is asthma a lifestyle disease?
Asthma is a major noncommunicable disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. Symptoms may occur several times in a day or week in affected individuals, and for some people become worse during physical activity or at night.
During an asthma attack, the lining of the bronchial tubes swell, causing the airways to narrow and reducing the flow of air into and out of the lungs. Recurrent asthma symptoms frequently cause sleeplessness, daytime fatigue, reduced activity levels and school and work absenteeism. Asthma has a relatively low fatality rate compared to other chronic diseases.
Facts about Asthma
WHO estimates that 235 million people currently suffer from asthma. Asthma is the most common noncommunicable disease among children. Most deaths occur in older adults.
Asthma is a public health problem not just for high-income countries; it occurs in all countries regardless of the level of development. Most asthma-related deaths occur in low- and lower-middle income countries.
Asthma is under-diagnosed and under-treated. It creates substantial burden to individuals and families and often restricts individuals’ activities for a lifetime.
Causes of asthma
The fundamental causes of asthma are not completely understood. The strongest risk factors for developing asthma are a combination of genetic predisposition with environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways, such as:
- indoor allergens (for example, house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander)
- outdoor allergens (such as pollens and moulds)
- tobacco smoke
- chemical irritants in the workplace
- air pollution.
Other triggers can include cold air, extreme emotional arousal such as anger or fear, and physical exercise. Even certain medications can trigger asthma: aspirin and other non-steroid anti-inflammatory drugs, and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine).
Urbanization has been associated with an increase in asthma. But the exact nature of this relationship is unclear.
Reducing the asthma burden
Although asthma cannot be cured, appropriate management can control the disease and enable people to enjoy a good quality of life. Short-term medications are used to relieve symptoms. Medications such as inhaled corticosteroids are needed to control the progression of severe asthma and reduce asthma exacerbation and deaths.
People with persistent symptoms must take long-term medication daily to control the underlying inflammation and prevent symptoms and exacerbations. Inadequate access to medicines and health services is one of the important reasons for the poor control of asthma in many settings.
Medication is not the only way to control asthma. It is also important to avoid asthma triggers – stimuli that irritate and inflame the airways. With medical support, each asthma patient must learn what triggers he or she should avoid.
Although asthma does not kill on the scale of chronic obstructive pulmonary disease (COPD) or other chronic diseases, failure to use appropriate medications or to adhere to treatment can lead to death.