View source for 21. Epidemiology and prevention of chronic obstructive pulmonary disease

* Epidemiology
** Fourth most common cause of death worldwide
** Leading cause of morbidity in developed countries
** Male > female
** 6% prevalence in US
* Etiology
** Smoking
*** 20 – 30 pack years gives 80-90% risk
** Passive smoking
** Air pollution
** Occupational exposure to dust
** Respiratory tract infections
** Premature birth
** Asthma
** Low socioeconomic status
** Physical inactivity
** Alpha-1-antitrypsin deficiency
* Diagnosed by spirometry
** Decreased Tiffeneau index < 70%
** <12% amelioration by bronchodilators
* Scoring
** GOLD – groups according to risk and symptoms
** BODE index – prognosis
** mMRC dyspnoea scale
* Prevention
** Primary
*** Health education
*** Promote smoking prevention
*** Air pollution control
** Secondary
*** Screening for A1ATD – family members too
*** Screening of high-risk individuals
** Tertiary
*** Stop smoking
*** Oxygen therapy
*** Pulmonary rehabilitation
*** Vaccination
**** Influenza
**** Pneumococcus
*** Exercise

[[Category:Public health 5 - Detailed epidemiology]]