Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), Palermo, Italy.
Institute of Clinical Physiology (IFC), National Research Council (CNR), Pisa, Italy.
J Aerosol Med Pulm Drug Deliv. 2020 Aug;33(4):171-177. doi: 10.1089/jamp.2019.1576. Epub 2020 May 18.
Noncommunicable diseases (NCDs) and chronic respiratory diseases (CRDs) are the main causes of mortality and morbidity worldwide. The main evidences about the NCDs and CRDs burden and related risk factors, from updated international reports and results of original researches, were collected and described in this review. Most recent evidence is available from the Global Burden of Diseases Study (GBD) 2017 reports. There were 3.2 million deaths due to chronic obstructive pulmonary disease (COPD) and 495,000 deaths due to asthma. COPD was the seventh leading cause of years of life lost (YLLs). Overall, prevalent cases of CRDs were 545 million: about 50% for COPD and 50% for asthma. Incident cases of CRDs were 62 million, mostly due to asthma (69%) and COPD (29%). COPD accounted for 81.6 million disability-adjusted life years, asthma for 22.8 million. COPD prevalence of 9.1% has been found in a recent general population sample of North-Eastern Italy, while in Central Italy a 25-year follow-up of a general population sample has shown an increased prevalence of COPD and asthma up to 6.8% and 7.8%, respectively. In Central Italy, a COPD incidence of 8% and an asthma incidence of 3.2% have been found in adult subjects at an 18-year follow-up. Among the risk factors, a relevant role is played by smoking and high body mass index for asthma, while smoking, particulate matter pollution, ambient ozone pollution, occupational exposure to particulate matter, gases and fumes, as well as second-hand smoke, play an important role for COPD. Forecasting the YLLs by 2040 indicates a rising toll from several NCDs due to population growth and aging, with COPD expected to reach the fourth leading cause. Several recent studies and international reports highlighted the huge global health burden of CRDs and other major NCDs, pointing out the need for implementing international collaborations to fight this epidemic trend.
非传染性疾病(NCDs)和慢性呼吸系统疾病(CRDs)是全球死亡和发病的主要原因。本综述收集并描述了最新国际报告和原始研究结果中关于 NCDs 和 CRD 负担及相关危险因素的主要证据。最近的证据来自 2017 年全球疾病负担研究(GBD)报告。慢性阻塞性肺疾病(COPD)导致 320 万人死亡,哮喘导致 49.5 万人死亡。COPD 是导致寿命损失年(YLLs)的第七大原因。总的来说,CRD 患者为 5.45 亿:约 50%为 COPD,50%为哮喘。CRD 的新发病例为 6200 万,主要由哮喘(69%)和 COPD(29%)引起。COPD 导致 8160 万伤残调整生命年,哮喘导致 2280 万伤残调整生命年。在意大利东北部的一个近期一般人群样本中发现 COPD 的患病率为 9.1%,而在意大利中部,一项对一般人群样本的 25 年随访显示,COPD 和哮喘的患病率分别增加到 6.8%和 7.8%。在意大利中部,一项对成年患者的 18 年随访显示,COPD 的发病率为 8%,哮喘的发病率为 3.2%。在危险因素中,吸烟和高体重指数与哮喘的发生密切相关,而吸烟、颗粒物污染、环境臭氧污染、职业性接触颗粒物、气体和烟雾以及二手烟与 COPD 的发生密切相关。对 2040 年 YLLs 的预测表明,由于人口增长和老龄化,几种 NCDs 的负担将增加,预计 COPD 将成为第四大死因。最近的几项研究和国际报告强调了 CRD 和其他主要 NCDs 给全球带来的巨大健康负担,指出需要开展国际合作来应对这一流行趋势。