burden of chronic diseases giovanni viegi, md. director of research, italian national research...

45
Burden of chronic diseases Giovanni Viegi, MD . Director of Research, Italian National Research Council . Head, Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa .Professor of “Health Effects of Pollution”, School of Environmental Sciences, University of GARD Launch in Latin America August 17, 11:15-11:30

Upload: joy-hodges

Post on 17-Jan-2018

219 views

Category:

Documents


0 download

DESCRIPTION

Horton, The Lancet 2005

TRANSCRIPT

Page 1: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Burden of chronic diseases

Giovanni Viegi, MD. Director of Research, Italian National Research Council

. Head, Pulmonary Environmental Epidemiology Unit,CNR Institute of Clinical Physiology, Pisa

.Professor of “Health Effects of Pollution”, School of Environmental Sciences, University of Pisa - Italy

. 2005-06 President, European Respiratory Society (ERS)

GARD Launch in Latin America

August 17, 11:15-11:30

Page 2: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

The Lancet 2005;366:1514

Page 3: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Horton, The Lancet 2005

Page 4: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Horton, The Lancet 2005

Page 5: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Horton, The Lancet 2005

Page 6: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 7: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Strong et al, Lancet 2005

Page 8: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Strong et al, Lancet 2005

Page 9: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Strong et al, Lancet 2005

Page 10: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Strong et al, Lancet 2005

Page 11: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 12: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 13: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Presidents of respiratory societies participating in FIRS

Page 14: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 15: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 16: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 17: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Minino, NVSS 2006

Page 18: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

2° edition:in preparation

Page 19: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

EUROPEAN LUNG WHITE BOOK, 2003

Page 20: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

EUROPEAN LUNG WHITE BOOK, 2003

Page 21: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 22: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Chapman et al, ERJ 2006

Page 23: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 24: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Lopez et al, ERJ 2006

Page 25: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Lopez et al, ERJ 2006 Part III of IV MALES

Page 26: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Lopez et al, ERJ 2006 Part IV of IV FEMALES

Page 27: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 28: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Mannino et al, ERJ 2006

Page 29: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 30: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Part I of II

Zielinski et al, ER

J 2006

(Viegi’s part)

MALES

Page 31: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Part II of II

Zielinski et al, ER

J 2006

(Viegi’s part)

FEMALES

Page 32: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Why is the Burden of COPD Increasing?

• In 2002: 1 in 10 is 60 yrs (629M)

• By 2020: 1 in 5 will be 60 yrs (2B)

• By 2150: 1in 3.3 will be 60 yrs

Page 33: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Why is the Burden of COPD Increasing?

The WHO estimates 1.1 billion smokers worldwide, increasing to 1.6 billion by 2025.

In low- and middle-income countries, smoking rates are increasing at an alarming rate.

Page 34: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Eur Respir J. 2006 Apr 12; [Epub ahead of print]

Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM

Page 35: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Halbert, Eur Respir J 2006

Adults over 40 yr

Page 36: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 37: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Menezes, Lancet 2005

Page 38: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Respir Med. 2003 Feb;97(2):115-22. Not 15 but 50% of smokers develop COPD?--Report from the Obstructive Lung Disease in Northern Sweden Studies.Lundback B, Lindberg A, Lindstrom M, Ronmark E, Jonsson AC, Jonsson E, Larsson LG, Andersson S, Sandstrom T, Larsson K; Obstructive Lung Disease in Northern Sweden Studies.In 1996, 5892 of the Obstructive Lung Disease in Northern Sweden (OLIN) Study's first cohort could be traced to a third follow-up survey, and 5189 completed responses (88%) were received corresponding to 79% of the original cohort from December 1985. Of the responders, a random sample of 1500 subjects were invited to a structured interview and a lung function test, and 1237 of the invited completed a lung function test with acceptable quality. In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, while it was 14% according to the GOLD criteria and approximately a half of elderly smokers fulfilled the criteria for COPD according to both the BTS and the GOLD criteria. Of those fulfilling the BTS criteria for COPD, 94% were symptomatics, 69% had chronic productive cough, but only 31% had prior to the study been diagnosed as having either chronic bronchitis, emphysema, or COPD. The corresponding figures for COPD according GOLD were 88, 51, and 18%.

Page 39: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,
Page 40: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Masoli et al, Allergy 2004

Page 41: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Masoli et al, Allergy 2004

Page 42: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Masoli et al, Allergy 2004

Page 43: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

GARD

WG-1: Epidemiology and Surveillance (G Viegi): Chair: G. Viegi, Italy (ERS); Co-Chairs: S. Buist, USA (GOLD), Y. Fukuchi (APSR).WHO-Liaison Officers: E. Mantsouranis.

Proposed initial composition: I. Annesi (ERS), R. Beasley (?), P. Burney (GA2LEN), W. Canonica (WAO), B. Chipps (ACAAI), E. Duran (ERS), J. Jardim (ALAT), D.S. Kim (APSR), A. Kocabas (TTS), C. Lai (AAAF), Lee Todd (BOLD), B. Lundback (ERS), J. Mallol (?), D. Mannino (ATS?), D. Nugmanova (WONCA), J.A. Odhiambo (IUATLD?), R Pawankar (ARIA?), J Vestbo (ERS).

Page 44: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

General Objective

The goal of this WG is to develop a standardized process to obtain data risk factors, disease burden, trends, quality and affordability of care and the economic burden of chronic respiratory diseases (CRD) and allergies that can then be compared across countries.

Page 45: Burden of chronic diseases Giovanni Viegi, MD. Director of Research, Italian National Research Council. Head, Pulmonary Environmental Epidemiology Unit,

Aims:

1. Use WHO programmes and non-WHO programmes to make an inventory of existing studies/reports that have collected data on prevalence, risk factors, severity, and economic burden of chronic respiratory diseases.

2. Collect these data at a country-based level.

3. Expand WHO internal initiatives (routine statistics, information systems, projection models) to cover respiratory and allergic diseases.