3.2 Million COPD Deaths Worldwide in 2015

Chronic obstructive pulmonary disease (COPD) and asthma resulted in the deaths of 3.2 million across the globe in 2015, increasing from 2.8 million in 1990, according to a recent study.

The study used the GBD Cause of Death Ensemble modeling tool (CODEm) to estimate deaths from 188 countries from 1990 to 2015.

Although asthma remains the leading respiratory disease, the study, done by the Global Burden of Disease (GBD) collaborators and led by Theo Vos, MD, PhD, professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington (pictured), found that the number who died due to COPD increased 11.6% since 1990 (95% uncertainty interval, 3.1 million to 3.3 million).

COPD cases also increased from 121 million to 174.5 million from 1990 to 2015, for a total of 44.2% (95% UI, 3.1 million to 3.3 million).

In terms of the total global disability-adjusted life years (DALYs), the measurement of a disease’s burden based on the number of years lost due to poor health, COPD accounted for 2.6%.

“Deaths from COPD were eight times more common than deaths from asthma,” Vos and GBD collaborators wrote. “Although there are laudable international collaborative efforts to make surveys of asthma and COPD more comparable, no consensus exists on case definitions and how to measure disease severity for population health measurements like GBD. Comparisons between countries and over time are important, as much of the chronic respiratory burden is either preventable or treatable with affordable interventions.”

Vos and the authors noted that smoking and ambient particulate matter were the highest risk factors for COPD, followed by occupational particulates, household air pollution, ozone, and secondhand smoke. They stated that “these risks explained 73·3% (95% UI 65·8 to 80·1) of DALYs due to COPD. Smoking and occupational asthmagens were the only risks quantified for asthma in GBD, accounting for 16·5% (14·6 to 18·7) of DALYs due to asthma.”

Interestingly, asthma prevalence increased 12.6%, now at 358.2 million compared to 318.2 million in 1990, but asthma-related deaths decreased from 550,000 to 400,000 (26.2% decrease). Asthma caused 1.1% of DALYs.

The United States landed mid-range with COPD burden, as DALY rates in the US were 601 to 1000, while the asthma DALY rates came in between 201 and 300 per 100,000.

These data were found despite a 41.9% decrease in the age-standardized death rate (37.7 to 45.1) for COPD, as the population growth “outweighed the downward trend in age-[standardized] death rates.”

Age-standardized prevalence of COPD decreased 14.7% (13.5 to 15.9), a significantly smaller decrease than the age-standardized death rates.

"More, and updated, population measurements of COPD and asthma are needed to better quantify the size of the problem, to benchmark with other chronic conditions associated with smoking and [aging], and with any other environmental and air pollution,” Vos and colleagues wrote.

The study, Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990—2015: a systematic analysis for the Global Burden of Disease Study 2015, was published online in the Lancet Respiratory Medicine.

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