Lack of action on COPD as big a threat as global financial crisis

22 June 2012

In the run up to World Spirometry Day on 27 June the European COPD Coalition (ECC) is calling on policy makers across Europe to recognise that chronic diseases such as COPD, present as great a threat as the global financial crisis [1], and is urging collective international action.

To support this, several West Midlands NHS foundation trusts will be offering free public spirometry, the most effective test of lung heath, in Birmingham as the ECC asks Members of the European Parliament (MEPs) to make lung testing a basic health right for all across Europe and to place greater emphasis on training for healthcare professionals.

With lung diseases now the leading cause of death globally, mortality due to COPD has doubled in the last three decades [2] and is furthermore projected to increase by more than 30 per cent in the next 10 years worldwide without interventions to cut risks [3]. Regular and early lung testing would help people identify the debilitating condition before too much damage is done; giving them a chance to slow the disease’s progression before it completely ruins their lung function.

However, with COPD still underdiagnosed in 75% of cases, research amongst healthcare professionals suggests spirometry is either not being used or is being used ineffectively, leading to inaccurate results[4].

According to ECC, better testing promises to reduce the significant burden of COPD, which is currently costing the individual health services across the EU in excess of €8 billion [5] every year. They argue that more needs to be done to ensure healthcare professionals are educated and trained both to provide and to accurately interpret, spirometry tests. Funding needs to be made available to allow this to happen.

English COPD policy exemplary model

Heralding England as an exemplar, with its action plan on COPD[6], the ECC also pointed to the dearth of health promotion activity to drive awareness of COPD across Europe and to the very limited investment in research on COPD. According to the latest data, considerably less money is devoted to research on respiratory diseases in most European countries than the impact of the condition justifies. What’s more, only a tenth of the budget currently dedicated to respiratory diseases goes to asthma and COPD, despite these posing the most significant challenge [7].

The ECC is demanding policy-makers follow the English example and help establish action plans on COPD across the EU — prioritising spirometry testing; training programmes like the European Spirometry Driving Licence; and prevention and innovative approaches like exercise-on-prescription, which recognises the important impact exercise has on lung health.

Quick win

Catherine Hartmann, Secretary General of the European COPD Coalition said: “Despite the magnitude of its current impact, dealing with COPD could actually be a relatively quick win for policy makers. Earlier diagnosis stands to reduce the burden of the disease considerably, both for patients and the health service. The need for quality spirometry testing as standard, and adequate training for the clinicians who deliver it, must finally be put on the agenda.”

Monica Fletcher, Chair of the European Lung Foundation (ELF), a member of the ECC said: “For too long lung diseases like COPD have been ignored at a European level with other diseases taking priority. With up to 10% of adults in Europe living with COPD[8], it’s time for this to change. The number one focus must be on early diagnosis to ensure people are started on the correct treatments when they can still make a difference — and that includes keeping physically active. Spirometry can play a key part in this diagnosis and we’d urge policy makers to make it a basic right for all.”

Doctors and nurses will take to the streets across Europe on World Spirometry Day on 27 June to run public lung testing events to raise awareness of spirometry testing. Spirometry testing should be seen as an “MOT for your lungs” to remind people just how critical lung testing is.

Further information

1. According to the Global Risks Report from the World Economic Forum, chronic diseases are a global risk equal in cost to the current global financial crisis

2. Jemal A, Ward E, Hao Y, et al. Trends in the leading causes of death in the United States, 1970-2002. JAMA 2005; 294: 1255 - 1259


4. Research amongst 310 healthcare professions across 30 countries in 2012, suggests that no formal training takes place for spirometry, with nearly 100% saying training takes place mainly on the job and 64% unaware of any potential training courses.

5. This combines the cost for outpatient care (4.7bn) and inpatient care (2.7bn), as quoted in the ERS European Lung White Book


7. ERS European Lung White Book, analysis of the 7th Framework Programme for Research and Technological development FP7 (2007-13) budget showed that of the 4.8% that was devoted to respiratory diseases, only 0.5% went to asthma and COPD

8. EU Public Health Information System (Halbert et al, 2003, Interpreting COPD prevalence estimates: what is the true burden of the disease?. Chest, 2003; 123(5):1684-92



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