Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.

https://www.who.int/respiratory/copd/GOLD_WR_06.pdf

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.

Air pollution and health.

Selected major risk factors and global and regional burden of disease

Representatives from many countries serve as a network for the dissemination and implementation of programs for diagnosis, management, and prevention of COPD. The GOLD Board of Directors is grateful to the many GOLD National Leaders who participated in discussions of concepts that appear in GOLD reports.

Global initiative for chronic obstructive lung disease.

This volume is a single up-to-date source on the entire global epidemiology of diseases, injuries and risk factors with a comprehensive statement of methods and a complete presentation of results. It includes refined methods to assess data, ensure epidemiological consistency, and summarize the disease burden. Global Burden of Disease and Risk Factors examines the comparative importance of diseases, injuries, and risk factors; it incorporates a range of new data sources to develop consistent estimates of incidence, prevalence, severity and duration, and mortality for 136 major diseases and injuries. Drawing from more than 8,500 data sources that include epidemiological studies, disease registers, and notifications systems, this book incorporates information from more than 10,000 datasets relating to population health and mortality, representing one of the largest syntheses of global information on population health to date.

/pdf/global-burden-of-disease-and-risk-factors-2kzkym6sp5.pdf

Global burden of disease and risk factors

Background: Air pollution contributes to mortality and morbidity. We estimated the impact of outdoor (total) and traffic-related air pollution on public health in Austria, France, and Switzerland. Attributable cases of morbidity and mortality were estimated. Methods: Epidemiology-based exposure-response functions for a 10 μg/m3 increase in particulate matter (PM10) were used to quantify the effects of air pollution. Cases attributable to air pollution were estimated for mortality (adults \textgreater30 years), respiratory and cardiovascular hospital admissions (all ages), incidence of chronic bronchitis (adults \textgreater25 years), bronchitis episodes in children (\textless15 years), restricted activity days (adults \textgreater20 years), and asthma attacks in adults and children. Population exposure (PM10) was modelled for each km2. The traffic-related fraction was estimated based on PM10 emission inventories. Findings: Air pollution caused 6% of total mortality or more than 40 000 attributable cases per year. About half of all mortality caused by air pollution was attributed to motorised traffic, accounting also for: more than 25 000 new cases of chronic bronchitis (adults); more than 290 000 episodes of bronchitis (children); more than 0·5 million asthma attacks; and more than 16 million person-days of restricted activities. Interpretation: This assessment estimates the public-health impacts of current patterns of air pollution. Although individual health risks of air pollution are relatively small, the public-health consequences are considerable. Traffic-related air pollution remains a key target for public-health action in Europe. Our results, which have also been used for economic valuation, should guide decisions on the assessment of environmental health-policy options.

Public-health impact of outdoor and traffic-related air pollution: a European assessment

BackgroundAir pollution contributes to mortality and morbidity. We estimated the impact of outdoor (total) and traffic-related air pollution on public health in Austria, France, and Switzerland. Attributable cases of morbidity and mortality were estimated.MethodsEpidemiology-based exposure-response func-tions for a 10 μg/m3 increase in particulate matter (PM10) were used to quantify the effects of air pollution. Cases attributable to air pollution were estimated for mortality (adults ≥30 years), respiratory and cardiovascular hospital admissions (all ages), incidence of chronic ronchitis (adults ≥25 years), bronchitis episodes in children (>15 years), restricted activity days (adults ≥20 years), and asthma attacks in adults and children. Population exposure (PM10) was modelled for each km2. The traffic-related fraction was estimated based on PM10 emission inventories.FindingsAir pollution caused 6% of total mortality or more than 40 000 attributable cases per year. About half of all mortality caused by air pollution was attributed to motorised traffic, accounting also for: more than 25 000 new cases of chronic bronchitis (adults); more than 290 000 episodes of bronchitis (children); more than 0·5 million asthma attacks; and more than 16 million persondays of restricted activities.InterpretationThis assessment estimates the public-health impacts of current patterns of air pollution. Although individual health risks of air pollution are relatively small, the public-health consequences are considerable. Traffic-related air pollution remains a key target for public-health action in Europe. Our results, which have also been used for economic valuation, should guide decisions on the assessment of environmental health-policy options.

V. Puybonnieux-Texier

Papers

Public-health impact of outdoor and traffic-related air pollution: a European assessment

Public-health impact of outdoor and traffic-related air pollution: a European assessment

Public health Impact of Outdoor and Traffic related Air Pollution