1 World Lung Foundation, New York, New York.
Ann Am Thorac Soc. 2014 Mar;11(3):407-16. doi: 10.1513/AnnalsATS.201312-420PS.
As described in a recently released report of the Forum of International Respiratory Societies, four of the leading causes of death in the world are chronic obstructive pulmonary disease, acute respiratory tract infections, lung cancer, and tuberculosis. A fifth, asthma, causes enormous global morbidity. Not enough progress has been made in introducing new therapies and reducing disease burden for these illnesses in the last few decades, despite generous investments and some notable progress in biomedical research. Four external and modifiable drivers are responsible for a substantial percentage of the disease burden represented by the major lung diseases: tobacco, outdoor air pollution, household air pollution, and occupational exposures to lung toxins. Especially in low- and middle-income countries, but in highly developed economies as well, pressures for economic development and lax regulation are contributing to the continued proliferation of these drivers. Public health approaches to the most common lung diseases could have enormous effects on reducing morbidity and mortality. There must be increased advocacy from and mobilization of civil society to bring attention to the drivers of lung diseases in the world. The World Health Organization should negotiate accords similar to the Framework Convention on Tobacco Control to address air pollution and occupational exposures. Large increases in funding by government agencies and nongovernmental organizations around the world are needed to identify technologies that will reduce health risks while allowing populations to enjoy the benefits of economic development. This paradigm, focused more on public health than on individual medical treatment, has the best chance of substantial reduction in the burden of lung disease around the world in the next several years.
正如最近发布的国际呼吸学会论坛报告所描述的那样，世界上四个主要的死亡原因是慢性阻塞性肺疾病、急性呼吸道感染、肺癌和结核病。第五个原因是哮喘，它在全球范围内造成了巨大的发病率。尽管在生物医学研究方面进行了大量投资并取得了一些显著进展，但在过去几十年中，这些疾病的新疗法的引入和疾病负担的减轻并没有取得足够的进展。导致主要肺部疾病疾病负担的四个外部和可改变的驱动因素是：烟草、室外空气污染、室内空气污染和职业性肺部毒素暴露。特别是在中低收入国家，但在高收入国家也是如此，经济发展的压力和宽松的监管导致这些驱动因素持续增加。针对最常见肺部疾病的公共卫生方法可以对降低发病率和死亡率产生巨大影响。必须有来自民间社会的更多倡导和动员，以引起人们对全球肺部疾病驱动因素的关注。世界卫生组织应该就类似《烟草控制框架公约》的协议进行谈判，以解决空气污染和职业性暴露问题。世界各地的政府机构和非政府组织需要大幅增加资金，以确定既能降低健康风险又能让人们享受经济发展带来的好处的技术。这种更注重公共卫生而不是个人医疗的模式，最有机会在未来几年内大幅减轻全球肺部疾病的负担。
