Respiratory health

Facts, figures and trends

National picture

  • An estimated 3 million people have COPD in the UK and, of those, 2 million remain undiagnosed - mainly those with milder symptoms (1)
  • COPD is the fifth largest cause of death in the UK.  It causes 30,000 deaths per year and accounts for one-fifth of respiratory mortality (2)
  • COPD is the second most common cause of emergency admissions to hospital, is one of the most costly in-patient conditions treated by the National Health Service (NHS)(3) and is a major cause of morbidity within Primary Care
  • With effective services and treatment, exacerbations of COPD can be shortened so reducing the need for hospital admission and improving the outcomes and quality of life for patients (4)
  • COPD is often associated with other long-term conditions; 40% of people with COPD also have heart disease and significant numbers have depression and/or an anxiety disorder17
  • Smoking (5) is the main cause of COPD and is thought to be responsible for around 90% of cases.  The lining of the airways becomes inflamed and permanently damaged by smoking and this damage cannot be reversed.  Up to 25% of smokers develop COPD
  • Fumes and dust- exposure to certain types of dust and chemicals at work, including grains, isocyanates, cadmium and coal, has been linked to the development of COPD, even in people who do not smoke.  The risk of COPD is even higher if you breathe in dust or fumes in the workplace and you smoke
  • Air pollution- according to some research, air pollution may be an additional risk factor for COPD.  However, at the moment it is not conclusive and research is continuing

Local picture

The prevalence of COPD in Central Bedfordshire was 4,476 (1.6%) in 2013/14 (6), an increase since 2009 (Figure 1).  This is mainly due to the population ageing as COPD is strongly associated with age.  The prevalence of COPD over the next 3-5 years in Central Bedfordshire and nationally are forecast to show a slow increase of about 0.05% per year.

A model estimates that the true prevalence of COPD in Central Bedfordshire was 4,860. (7) This means that there may be 1,170 undiagnosed in 2011.

Figure 1: Percentage of Practice Populations on register for COPD, trend 2009-2014

Figure 1: Percentage of Practice Populations on register for COPD, trend 2009-2014 Source: QOF, 2014

Figure 2 shows the prevalence by locality in Central Bedfordshire.  Chiltern Vale has the highest prevalence.  The higher prevalence for COPD at Chiltern Vale could be due to pollution, partly from the A5 and the M1 becoming trapped in the valley where Dunstable is situated.  In addition, it is thought that Chiltern Vale has a high prevalence for smoking compared with Bedfordshire CCG.

Figure 2: Percentage of Practice Populations on register for COPD by locality, trend 2008-2011

Figure 2: Percentage of Practice Populations on register for COPD by locality, trend 2008-2011 Source: QOF, 2009-14

Harm caused by COPD and projected future position if no action taken

Figure 3 shows the directly age-standardised mortality rate (DSR) for COPD in Central Bedfordshire.  The mortality rate for males was higher than females, though the gap was generally reducing over time as the smoking prevalence decreases.  Mortality for males in Central Bedfordshire was slightly higher than the England over the time period.  Women’s rates were lower compared to England.

Figure 3: Directly standardised mortality rate for Bronchitis, Emphysema and Chronic Obstructive Pulmonary Disease in Central Bedfordshire by sex and year

Figure 3: Directly standardised mortality rate for Bronchitis, Emphysema and Chronic Obstructive Pulmonary Disease in Central Bedfordshire by sex and year Source: Health & Social Care Information Centre, 2014

Figure 4 shows COPD premature deaths (up to age 75 years) in males and females.  Premature deaths among females in Central Bedfordshire were significantly lower for women compared with England but similar for men.  About 4% of all premature deaths were caused by COPD.

Figure 4: Premature death from bronchitis, emphysema and other COPD (DSR, pooled data), 2010-12

Figure 4: Premature death from bronchitis, emphysema and other COPD (DSR, pooled data), 2010-12 Source: Health & Social Care Information Centre, 2014

Figure 5 shows mortality rates of COPD by age and sex.  The majority of deaths were in the over 75 year age group; few were recorded in the 0-34 year age group.

Figure 5: Age specific death rates from bronchitis, emphysema and other COPD (pooled 2010-12)

Figure 5: Age specific death rates from bronchitis, emphysema and other COPD (pooled 2010-12) Source: Health & Social Care Information Centre, 2014

Figure 6 shows years of life lost due to COPD premature death.  Central Bedfordshire was significantly lower than England for males and females.

Figure 6: Years of life lost due to mortality from bronchitis, emphysema and other COPD, 2010-12 (pooled) to the age of 75y

Figure 6: Years of life lost due to mortality from bronchitis, emphysema and other COPD, 2010-12 (pooled) to the age of 75y Source: Health & Social Care Information Centre, 2014

The proportion of COPD patients that are registered and the mortality rates at Central Bedfordshire appear favourable compared to England.  However, premature mortality rates for lung disease are worse than average when compared with similar local authorities (10th out of 14).

References

(1) Healthcare Commission (2006) Clearing the air: a national study of chronic obstructive pulmonary disease.  London: Healthcare Commission

(2) British Thoracic Society (2006).  The Burden of Lung disease 2nd Edition

(3) British Lung Foundation (2007).  Invisible lives: Chronic Obstructive Pulmonary Disease (COPD) finding the missing millions

(4) Royal College of Physicians of London, British Thoracic Society and British Lung Foundation (2008).  Report of The National Chronic Obstructive Pulmonary.  Disease Audit 2008, UK Primary Care Organisations: Resources and Organisation of Care)

(5) NHS Choices

(6) QOF March 2013/14

(7)  Disease and risk factor prevalence - Public Health Profiles


Last updated Tuesday, 21st November 2017