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      Spirometric testing on World COPD Day

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          To determine the importance of spirometric testing for early detection of chronic obstructive pulmonary disease (COPD).


          Spirometric testing has been performed annually on World COPD Day in Sezana from 2003. Sezana is in a semiurban region of Slovenia, with 12,000 inhabitants. The investigation was performed between January 2003 and December 2008. In total, 770 persons were enrolled (414 females and 356 males). The participants were recruited by mass media appeals. Smokers aged ≥40 years with a smoking history of ≥10 pack-years were invited to visit the local chest clinic. The participants completed a questionnaire and had spirometry performed. Subjects with a postbronchodilator forced expiratory volume in one second/forced vital capacity <0.70 were defined as having COPD, according to the Global Initiative for Chronic Obstructive Lung Disease guidelines.


          We identified that 16.2% of subjects had impaired lung function. Of these, 10.2% had an obstructive pattern of ventilatory impairment and 6% had a restrictive pattern. We identified 79 individuals with COPD. Subjects with COPD were >70 years in 40.5% in cases. The majority of individuals with COPD were men (74.6%), and 90% were smokers. COPD was mild in 52% of subjects, moderate in 34%, and severe in 14%. The majority of subjects had a milder stage of the disease, and 92% of those with COPD (72/79) had not been recognized to have COPD previously.


          These results suggest that spirometry testing could detect patients with COPD in the earlier stages of the disease.

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          Most cited references 36

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          Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study

          Plausible projections of future mortality and disability are a useful aid in decisions on priorities for health research, capital investment, and training. Rates and patterns of ill health are determined by factors such as socioeconomic development, educational attainment, technological developments, and their dispersion among populations, as well as exposure to hazards such as tobacco. As part of the Global Burden of Disease Study (GBD), we developed three scenarios of future mortality and disability for different age-sex groups, causes, and regions. We used the most important disease and injury trends since 1950 in nine cause-of-death clusters. Regression equations for mortality rates for each cluster by region were developed from gross domestic product per person (in international dollars), average number of years of education, time (in years, as a surrogate for technological change), and smoking intensity, which shows the cumulative effects based on data for 47 countries in 1950-90. Optimistic, pessimistic, and baseline projections of the independent variables were made. We related mortality from detailed causes to mortality from a cause cluster to project more detailed causes. Based on projected numbers of deaths by cause, years of life lived with disability (YLDs) were projected from different relation models of YLDs to years of life lost (YLLs). Population projections were prepared from World Bank projections of fertility and the projected mortality rates. Life expectancy at birth for women was projected to increase in all three scenarios; in established market economies to about 90 years by 2020. Far smaller gains in male life expectancy were projected than in females; in formerly socialist economies of Europe, male life expectancy may not increase at all. Worldwide mortality from communicable maternal, perinatal, and nutritional disorders was expected to decline in the baseline scenario from 17.2 million deaths in 1990 to 10.3 million in 2020. We projected that non-communicable disease mortality will increase from 28.1 million deaths in 1990 to 49.7 million in 2020. Deaths from injury may increase from 5.1 million to 8.4 million. Leading causes of disability-adjusted life years (DALYs) predicted by the baseline model were (in descending order): ischaemic heart disease, unipolar major depression, road-traffic accidents, cerebrovascular disease, chronic obstructive pulmonary disease, lower respiratory infections, tuberculosis, war injuries, diarrhoeal diseases, and HIV. Tobacco-attributable mortality is projected to increase from 3.0 million deaths in 1990 to 8.4 million deaths in 2020. Health trends in the next 25 years will be determined mainly by the ageing of the world's population, the decline in age-specific mortality rates from communicable, maternal, perinatal, and nutritional disorders, the spread of HIV, and the increase in tobacco-related mortality and disability. Projections, by their nature, are highly uncertain, but we found some robust results with implications for health policy.
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                Author and article information

                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                10 February 2011
                : 6
                : 141-146
                [1 ]Department of Pneumonology, Hospital Sezana, Sezana, Slovenia;
                [2 ]Clinical Department of Respiratory Diseases and Allergy, University Clinical Center, Ljubljana, Slovenia
                Author notes
                Correspondence: Tanja Grzetic-Romcevic, Department of Pneumonology, Hospital Sezana, Cankarjeva 4, 6210 Sezana, Slovenia, Tel +386 4023 0105, Fax +386 5707 4019, Email dr.romcevic@
                © 2011 Grzetic-Romcevic et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.


                Respiratory medicine

                spirometry, chronic obstructive pulmonary disease, epidemiology, smoking


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