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There is much documented evidence linking long-term lung conditions and respiratory infections with smoking. But, with more non-smokers than ever before being diagnosed with such conditions, a renewed focus is now being placed on the effects of environmental factors such as pollutants in the workplace.

Wednesday 21st November is World COPD Day when the effects of Chronic Obstructive Pulmonary Disease (COPD) – an umbrella term for a group of conditions which affect the airways including emphysema and chronic bronchitis – are highlighted across the globe.

There are many who don’t fully understand the term COPD and millions are suffering with the condition without even knowing it, with thousands more people every year getting officially diagnosed. A worldwide study estimated that in 1990 there were 227.3m over 30s with COPD - just two decades later this had risen to 384m1.

Evidence of the huge numbers affected is backed up by the World Health Organisation (WHO), which states that 65 million people across the globe have ‘moderate to severe’ COPD2.  By 2030 it is predicted that COPD will be the third leading cause of death globally, outranked only by ischaemic heart disease and strokes3.

While the well-publicised link between smoking and lung disease is undeniable, there are many non-smokers who are increasingly being diagnosed across the world.  In the US, it’s estimated between ten and 20 per cent of those with COPD have never smoked4.

This subsequently means that other contributing factors must be looked at – with researchers identifying links with a genetic condition called alpha-1 antitrypsin deficiency, as well as links with occupational exposure to air pollutants such as oil mist and dust.

In fact, the highest prevalence of COPD (20.2%) seen in south west China compared with the rest of the country has already been potentially attributed to exposure to dust or chemicals in the workplace. There were more than 0.9m deaths in China in 2013 caused by COPD, making it the third leading cause of death across the country5. This compares with around two per cent of the entire population (4.5 per cent of over 40s) in the UK6. According to the European Respiratory Society, COPD prevalence ranges from four to ten per cent of the adult population in Europe7.

So, it’s clear it’s not just as simple as getting people to quit smoking (or not start in the first place), and while work continues on encouraging people to stub out the habit and more research is conducted into the genetic causes of COPD, continuing to drive up standards of air quality in workplaces could also have an impact on the numbers being diagnosed.

Despite the wealth of regulations governing outdoor air pollution worldwide, there are still some countries including most of China which do not have formal guidelines in place to protect employees against exposure to oil mist and other harmful airborne contaminants.  However, the focus on occupational health by the Central People’s Government in China has strengthened considerably over the past few decades, with increased recognition of the impact of exposure to harmful substances8.  

Acknowledging the issue of poor-quality indoor air is certainly a step in the right direction and one which is leading employers in both China and the rest of the World to recognise the importance of protecting their workers from airborne contaminants, both now and in the future.   

Visit https://goldcopd.org/world-copd-day/ to find out more about World COPD Day.

Sources:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693508/
2. http://www.who.int/respiratory/copd/burden/en/
3. https://www.who.int/healthinfo/global_burden_disease/projections/en/
4. https://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=77
5. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(18)30200-5/fulltext
6. https://statistics.blf.org.uk/copd
7. https://www.ersnet.org/images/stories/pdf/COPD.pdf
8. https://pdfs.semanticscholar.org/3a3c/c07e4af16e2b0fb18b2d6bc560de82cf7d03.pdf

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