CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Chronic Obstructive Pulmonary Disease (COPD) is a slowly progressive disease of the airways that is characterized by a gradual loss of lung function. In the U.S., the term COPD includes chronic bronchitis, chronic obstructive bronchitis, or emphysema, or combinations of these conditions. It represents the fourth leading cause of death in the U.S. The symptoms of COPD can range from chronic cough and sputum production to severe disabling shortness of breath. In some individuals, chronic cough and sputum production are the first signs that they are at risk for developing the airflow obstruction and shortness of breath characteristic of COPD. In others, shortness of breath may be the first indication of the disease. In the U.S., the most important risk factor for COPD by far is cigarette smoking. Pipe, cigar, other types of tobacco smoking, and passive exposure to cigarette smoke are also risk factors. Other documented causes of COPD include occupational dusts and chemicals.
Outdoor air pollution adds to the total burden of inhaled particles in the lungs, but its role in causing COPD is uncertain. The most important measure for preventing COPD - and for stopping disease progression - is avoidance of smoking.
The diagnosis of COPD is confirmed by the presence of airway obstruction on testing with spirometry. There is no known cure for COPD at the present time. Treatment is usually supportive and designed to relieve symptoms and improve quality of life.
With continued exposure to cigarettes or noxious particles, the disease progresses and individuals with COPD increasingly lose their ability to breathe. Acute infections or certain weather conditions may temporarily worsen symptoms (exacerbations), occasionally where hospitalization may be required.
12.1 million adults ages 25 and older reported being diagnosed with COPD in 2001.
About 24 million adults have evidence of impaired lung function indicating that COPD is underdiagnosed.
The prevalence of self-reported COPD is higher in females than males and in whites than blacks.
About 119,000 adults ages 25 and older died from COPD in 2000.
While the COPD death rate for females more than doubled between 1980 and 2000, and the number of deaths for females surpassed the number for males in 2000, the overall age-adjusted death rate for COPD remained higher for males in 2000. The age-adjusted COPD death rate was about 46 percent higher in males than females and 63 percent higher in whites than blacks.
COPD is the fourth leading cause of death in the U.S. and is projected to be the third leading cause of death for both males and females by the year 2020.
Emergency Department Visits and Hospitalizations
About 1.5 million emergency department visits by adults 25 and older were made for COPD in 2000.
More emergency department visits for COPD were made by adult females than adult males (898,000 vs. 651,000).
About 726,000 hospitalizations for COPD occurred in 2000. More females than males were hospitalized for COPD (404,000 vs. 322,000).
The total estimated cost of COPD in 2002 was $32.1 billion ($18 billion direct costs and $14.1 billion indirect costs)
National Heart, Lung, and Blood Institute