The number of women dying from chronic obstructive pulmonary disease (COPD) is increasing and, for the first time, might soon exceed mortality from the disease in men, according to researchers.
Dr Joan Soriano (department of worldwide epidemiology, Glaxo Wellcome research and development, Greenford, UK) and colleagues studied trends in prevalence and mortality from COPD in patients in the UK General Practice Research Database between 1990 and 1997.
They identified 50,714 COPD cases, of whom 23,277 were women. By 1997, the annual prevalence rate of diagnosed COPD in women had risen from 0.8 per cent to 1.36 per cent (the rate observed in men in 1990). Over the study period, the rate of increase in women was 68 per cent compared with 25 per cent in men.
"On the basis of current trends, the annual number of [COPD] deaths attributable to smoking in women should exceed that for men shortly after the year 2000 in both the UK and US," the authors say.
Dr Soriano and colleagues say that additional education about the effects of smoking is needed to promote cessation, especially in younger women.
While COPD prevalence rates in men reached a plateau in the mid 1990s, the rates for women aged 45-65 years began to approach those for men. In young adults (aged 20 to 44 years), there were low rates of COPD but, by 1997, the prevalence in women had already overtaken that for men in the mid 1990s.
The researchers found that patients with severe COPD died, on average, three years before those with mild disease and four years before people without COPD. Women with COPD had the same pattern of disease as men but were more likely to survive, whatever the severity of the disease (Thorax 2000;55:189).
In addition to the COPD study described above, a new survey reported this week has found that patients suffering from COPD are often confined to their homes because they do not have access to ambulatory oxygen.
The survey was conducted by the British Lung Foundation.
The charity surveyed nearly 2,500 COPD sufferers from its "Breathe Easy" patient support group to assess which aspects of the disease were most troublesome to sufferers. Nearly a quarter of respondents said that they needed to use oxygen at home every day but only 13 per cent of the total number of respondents used ambulatory oxygen.
Commenting on this finding, Dr Mike Morgan, consultant physician, Glenfield hospital, Leicester and chairman of Breathe Easy said: "This means that patients suffering from COPD are stuck at home unable to undertake everyday tasks because they cannot leave their oxygen cylinder."
The survey results also showed that 80 per cent of COPD patients use a "reliever" (bronchodilator) inhaler. When asked how often they used their reliever inhaler, 32 per cent said between two and three times a day, 36 per cent between four and six times a day and 16 per cent said that they used it more than six times a day. Only the frequency of use of inhalers was specified in the survey, doses were not given.
Mr Bengie Walden, chief executive of the British Lung Foundation, said that the World Health Organisation rated COPD as the fifth biggest killer in the world and that it would soon be the third biggest.