Survey and Research on The Global Impact of

Respiratory Diseases.
Global Impact of Respiratory Disease
What Can We Do, Together, to Make a Difference?

Stephanie M. Levine, MD, FCCPa and Darcy D. Marciniuk, MD, Master FCCPb,∗

Author information Article notes Copyright and License information PMC Disclaimer

The third edition of the Global Impact of Respiratory Disease 1 begins with the statement “We take
our breathing and our respiratory health for granted, but our lungs enable us to live, laugh, love,
and enjoy activities.” At no time in our recent history has that truth become more evident and more
relevant. The COVID-19 pandemic, in a short period of 24 months, has claimed the lives of > 5.7
million people,2 largely all from respiratory causes. But even before the pandemic, three
respiratory diseases were entrenched in the top 10 causes of death in the world.
COPD is the third-leading cause of death worldwide, killing 3.2 million individuals every year and
accounting for an astounding 81.7% of the total number of deaths from chronic respiratory disease.
Pneumonia is a leading cause of death among children < 5 years old outside the neonatal period
and in adults > 65 years old. Lung cancer is the deadliest of nearly all cancers, with 5-year survival
rates of only 10% to 20%, even in developed countries. We know that asthma is the most common
chronic disease of childhood, and the prevalence of asthma has been rising for the past three
decades. TB would be the greatest single infectious cause of death if it were not for the current
COVID-19 pandemic, with an estimated 500,000 new cases of rifampicin-resistant or multidrug-
resistant TB in 2019 alone. In addition to the top five conditions mentioned here, the report also
highlights the significant global burden of sleep-disordered breathing, pulmonary hypertension,
occupational lung diseases, in addition to the harmful effects of air pollution and climate change.

The Global Impact of Respiratory Disease 1 was compiled by the Forum of International
Respiratory Societies, a coalition of the leading international professional societies in the world.
Together, the American College of Chest Physicians, American Thoracic Society, Asian Pacific
Society of Respirology, Asociación Latinoamericana de Tórax, European Respiratory Society,
International Union Against Tuberculosis and Lung Disease (The Union), Pan African Thoracic
Society, Global Initiative for Asthma, and the Global Initiative for Chronic Obstructive Lung Disease
joined in the collective goal of empowering respiratory health worldwide through global advocacy.
These societies continue to work hard to reduce the global burden of lung disease and to ensure
everyone can and is able to breathe freely. The third edition of the Global Impact of Respiratory
Disease is an important step; it provides the means for meeting those goals, outlines major causes
of respiratory disease and death, and lays out clear recommendations for global action. The
executive summary of the report has been translated into eight languages.

But the report goes far beyond only highlighting the problems and consequences. Representing >
100,000 professional members worldwide who care about lung health, the Forum of International
Respiratory Societies also clearly identified the following eight essential actions to reduce the
burden of respiratory disease and improve global health.

1.Improve public and policy makers’ awareness that respiratory health is vital to global health and
that childhood respiratory disease has long-term negative consequences on adult health.

2.Reduce, and then eliminate, the use of all tobacco and smoking products.
2
References
1. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality
for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the
Global Burden of Disease Study 2017. Lancet. 2018;392:1736–1788.

Crossref

PubMed

Google Scholar

2. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators: Global, regional, and national
incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries
and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet.
2018;392:1789–1858.

Crossref

PubMed

Google Scholar

3. European Lung Foundation: Lung Health in Europe. Facts and Figures. A better understanding of
lung disease and respiratory care in Europe. 2013. GJ Gibson, R Loddenkemper, Y Sibille, B Lundbäck,
and M Fletcher,
(eds). www.europeanlung.org/assets/files/publications/lung_health_in_europe_facts_and_figures_web
.pdf (last accessed April 9, 2020).

Google Scholar

4. Gibson GJ, Loddenkemper R, Sibille Y, and Lundback B (eds). The European Lung White Book:
Respiratory health and disease in Europe. European Respiratory Society, Sheffield UK, 2013.

3.Adopt and adhere to World Health Organization (WHO) standards, at a minimum, to reduce
ambient, indoor, and occupational air pollution for all countries.

4.Implement universal access to quality health care, including the availability of affordable, quality-
assured, essential medicines and universal coverage for all effective childhood and adult
immunizations.

3
5.Improve the prevention and early diagnosis of respiratory diseases.

6.Increase education and training of health care professionals in respiratory disease worldwide.

7.Standardize the monitoring and reporting of the prevalence, severity, and management of
respiratory diseases to enable development of better-informed national strategies through
programs of WHO and governmental and nongovernmental organizations.

8.Boost funding for respiratory research to develop programs, tools, and strategies to better
prevent and treat respiratory disease.

4
So you might be thinking “What can I do to help make a difference?” or maybe “This is so big and
complicated: what can really be achieved?”

Those are great questions, as are the answers.

Imagine if, together, we could influence policies or decision-makers to further enable respiratory
health? What impact could we make if we acted together to further reduce the harmful effect of
tobacco and work towards completely eliminating smoking? What would be the impact of better
trained and supported health care professionals working together and health care systems and
policies that more effectively aided the prevention and optimal management of lung disease for all?
What investment in respiratory research and researchers would lead to breakthroughs, to cures,
and to a future in which our children, all around the world, could almost take their breathing for
granted because lung diseases were not listed prominently in the top ten causes of death in the
world? What more could we do, either as members of these societies or as individuals who fully
appreciate the destructive forces of lung disease and the benefits of respiratory health, to advance
these tangible outcomes?

Let’s talk specifics and specifics close to home.

Imagine better access to pulmonary rehabilitation and supplemental oxygen therapy, more
available and affordable medications and therapies, and health care systems that are accessible
and served everyone. Imagine equitable access to quality care and populations that we serve with
descriptors that do not begin with “disadvantaged” or “underserviced.” Imagine funding for training
and respiratory research that is equitable and aligned with the enormous burden of respiratory
disease and that more completely nourishes the genuine possibilities of breakthroughs and cures
afforded by our researchers and research teams. One easily could imagine even more.

The pandemic has highlighted starkly the reality that what is far away can become so close to
home in a matter of days. The world’s issues are inexplicably our issues. The pandemic has also
shown that what we do locally can help many far beyond our own borders. And all of us who have

5
cared for patients know that someone who is short of breath, no matter where they live or work or
play, is suffering.

The Global Impact of Respiratory Disease 1 has made clear the consequences, around the world,
of lung diseases and the benefits and the path to respiratory health. Let us now together eliminate
that suffering and amplify the benefits of working together in our own clinics and our own hospitals
and laboratories, not only for those individuals we care for, but also for millions of other patients
around the world.

The next edition of this report is proposed to be co-developed with the WHO for release in 2025 at
the High-Level United Nations NCD Meeting. This publication will be aimed specifically at a target
audience of high-level health care policy makers and will include an Executive Policy Briefing with
recommendations directed at both global and national levels.

There is much work to be done before that next step.

Go to:

Footnotes

FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST the following:

S. M. Levine is an employee of the University of Texas and serves as Deputy Editor, Contributor
Equity and Experience, CHEST. D. D. Marciniuk has undertaken consulting with Alberta Health
Services, Canadian Foundation for Healthcare Improvement, Health Canada, Lung Association of
Saskatchewan, Ontario Ministry of Health and Long-Term Care, Saskatchewan Health Authority,
and Yukon Health and Social Services; has provided research advisory and received research
funding (held and managed by the University of Saskatchewan) from AstraZeneca, Boehringer
Ingelheim, Canadian Institute of Health Research, GlaxoSmithKline, Grifols, Lung Association of
Saskatchewan, Lung Health Institute of Canada, Novartis, Sanofi, Saskatchewan Health Research
Foundation, Schering-Plough; and is an employee of the University of Saskatchewan and serves
as Deputy Editor. Outreach, CHEST.

6
Want to insert a picture from your files or add a shape or text box? You got it! On the Insert tab of
the ribbon, just tap the option you need.

References

1. Forum of International Respiratory Societies . 3 rd Edition. European Respiratory Society; 2021.

The Global Impact of Respiratory Disease. Accessed December 30, 2021.
http://www.firsnet.org/images/publications/FIRS_Master_09202021.pdf. [Google Scholar]

2. WHO Coronovirus (COVID-19) Dashbaord, World Health Organization. Accessed February 9,

2022. https://covid19.who.int.

Abstract

Background: Noncommunicable diseases (NCDs) and chronic respiratory diseases (CRDs) are the
main causes of mortality and morbidity worldwide.

Methods: 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.

Results: 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.

Conclusions: 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.

7
References

1. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific
mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic
analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1736–1788.

Crossref

PubMed

Google Scholar

2. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators: Global, regional,
and national incidence, prevalence, and years lived with disability for 354 diseases and
injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global
Burden of Disease Study 2017. Lancet. 2018;392:1789–1858.

Crossref

PubMed

Google Scholar

3. European Lung Foundation: Lung Health in Europe. Facts and Figures. A better
understanding of lung disease and respiratory care in Europe. 2013. GJ Gibson, R
Loddenkemper, Y Sibille, B Lundbäck, and M Fletcher, (eds).
www.europeanlung.org/assets/files/publications/lung_health_in_europe_facts_and_figures_
web.pdf (last accessed April 9, 2020).

Google Scholar

4. Gibson GJ, Loddenkemper R, Sibille Y, and Lundback B (eds). The European Lung White
Book: Respiratory health and disease in Europe. European Respiratory Society, Sheffield
UK, 2013.
5. The most common respiratory diseases are asthma, chronic obstructive pulmonary disease,
cystic fibrosis, lung cancer, tuberculosis, bronchitis, and pneumonia. Some respiratory
diseases are acute, like an infection that will get better with treatment, while others are or
become chronic and need to be managed. This article will look at the seven most common
respiratory diseases, their symptoms, diagnosis, and what causes them. Asthma Asthma
affects 25 million people in the United States. People with a family history of asthma,
respiratory allergies, or severe childhood respiratory illness are at a higher risk of

8
 developing asthma. Asthma is a chronic inflammatory disease that causes breathing
problems when the airways become narrowed by inflammation or blocked by mucus.

The condition’s severity varies from person to person, but most people take daily preventive
medication to control their symptoms and prevent flare-ups. Chronic Obstructive Pulmonary
Disease (COPD) Chronic obstructive pulmonary disease (COPD) is an umbrella term used to
describe two primary types of obstructive lung disease that used to be classified separately:
emphysema and chronic bronchitis.3 Emphysema develops when the tiny air sacs in the lungs
(alveoli) become damaged and less elastic. As these air sacs become damaged and die off, your
lungs have fewer working parts to move oxygen from the air you breathe into your blood.4 This can
lead to a lack of oxygen in the blood (hypoxia) and a buildup of toxic waste products.3 Smoking is
a leading contributor to emphysema, but exposure to other pollutants and chemicals can also
cause it. Age and obesity are also risk factors for emphysema. Chronic bronchitis is a condition
where the lining of the bronchial tubes becomes irritated and inflamed. The swelling can make it
more difficult to breathe and cause an overproduction of mucus.3 With chronic bronchitis, the
inflammation is caused by repeated exposure to irritants like cigarette smoke or pollution. Chronic
bronchitis does not go away. You may have periods of relief along with periods where it gets worse
(exacerbations), especially if you get a cold or another respiratory infection. Nearly 15 million
people have been diagnosed with COPD in the United States, and another 12 million are believed
to have the disease but do not have an official diagnosis. Cystic Fibrosis

Cystic fibrosis (CF) is a genetic condition that affects about 35,000 people in the United States. It
can cause both breathing and digestive problems because the disease makes the mucus in the
body very thick. While the disease can involve several organs, it tends to cause specific problems
in the lungs, such as blockages from thick mucus that trap harmful bacteria and lead to infections.
Lung Cancer Lung cancer is one of the most common types of cancer, ranking third in the United
States with more than 218,000 people affected.8 It can develop as either small cell lung cancer or
non-small cell lung cancer. The latter is the more common of the two. Cigarette smoking—both
direct and secondhand—is one of the biggest risk factors for lung cancer. Tuberculosis
Tuberculosis is a bacterial lung disease caused by Mycobacterium tuberculosis. More than 1.8
billion people around the world have tuberculosis, but the disease is only considered active in 10
million of them. People with strong immune systems sometimes carry an inactive form of the
disease, called latent tuberculosis. In people with weaker immune systems, the bacteria attacks
lung tissue. It can also spread and cause damage to other parts of the body. Pneumonia
Pneumonia is a generic diagnosis. Even though there are different types of pneumonia, the way
that the condition affects the lungs is similar in each one. With pneumonia, a virus, bacteria, or
another infectious agent causes the tiny air sacs in the lungs (alveoli) to fill with fluid or pus. These
air sacs are what help exchange oxygen and other gases between the air that is breathed in and
the blood. When these sacs are filled with fluid, the body’s ability to exchange gases is reduced.18
The several types of pneumonia are:

9
 Viral

• Bacteria

• Mycoplasma (also called “walking pneumonia”)

• Fungal

• Aspiration

There are several types of lung diseases that can affect your breathing and cause chronic
symptoms like cough. Many of these diseases share symptoms. If you have a cough that won’t go
away or you are experiencing frequent shortness of breath, call your healthcare provider. They can
do testing to confirm what type of lung disease is causing your respiratory problems and may refer
you to a doctor that specifically treats lung disease.

S. Respiratory Scope of the Prevention Treatment Control and

no disease disease elimination
(Name)
1 Asthama Chronic lung • Vaccine • Medications Take different
disease • Identify (Bronchodilator, medicines or
affecting people asthma Steroid and Anti- higher doses of
of all ages triggers inflammatory) medicine.
• Avoid smoking • Self-care
areas (Quitting smoking)
• Take your • Supportive
asthma care
medications (Oxygen therapy)

2 Chronic The lungs can • Stop smoking. • Medications short-acting

obstructive get damaged or • Keep active (Bronchodilator and bronchodilator
pulmonary clogged with with exercise. Steroi inhalers are the
disease phlegm • Lungs in • Supportive first treatment
Action care used.
• Self-care
Physical exercise,
Quitting smoking and
Diaphragmatic
breathing)
• Therapies

10
3 Cystic fibrosis A multi-system Preventing CF is not • Supportive Antibiotics to
genetic disorder possible care prevent and treat
affecting the (Sodium chloride) chest infections
lungs, pancreas, • Medications(Di
liver and etary
intestine supplement,
Antibiotics and
Cough
medicine)
• Self-
care(Postural
drainage)
• Medical
procedure(Che
st wall
oscillation)
4 Lung cancer occurs • Eat a varied • Surgery • Quitting
primarily in diet high in • radiotherap, smoking
• Chemotherapy
persons fruits and • immunotherap • Need
between the vegetables y. mainten
ages of 45 and low in ance
and 75 years red and chemoth
processed erapy to
meats and keep the
processed cancer
sugar. under
• stop control
smoking.
5 Tuberculosis Can cause • Avoiding close • Isoniazid Tuberculosis
infection in your contact with • Rifampin elimination is the
lungs or other people with • Pyrazinamide effort to reduce
tissues active TB • ethambutol the number of
disease and tuberculosis (TB)
treating latent cases to less
TB infections. than one per 1
• Natural light million
• good hygiene population.

11