Figures
- Fig. 1—
The World Health Organization mortality subregions used in the Global Burden of Disease 2000 Study. A: very low child and adult mortality; B: low child and adult mortality; C: low child mortality and high adult mortality; D: high child and adult mortality; E: high child mortality and very high adult mortality; AFR: Africa; AMR: Americas; EMR: Eastern Mediterranean; EUR: Europe; SEAR: South-East Asia; WPR: Western Pacific.
- Fig. 2—
Comparison of relative risks of chronic obstructive pulmonary disease-related mortality by age and sex for a) males and b) females. ▴: USA burden of disease study; •: Global Burden of Disease Study; ▪: model estimates.
- Fig. 3—
Estimated age-specific incidence for a) males and b) females, and age-specific prevalence for c) males and d) females of chronic obstructive pulmonary disease (COPD) by region, 2000. ▴: industrialised regions with very low child and adult mortality; ♦: Americas, combining the regions with low child and adult mortality, and high child and adult mortality; ▪: Europe, combining the regions with low child and adult mortality, and low child mortality and high adult mortality; ○: Eastern Mediterranean; □: South-East Asia; •: Western Pacific regions with low child and adult mortality; ⋄: Africa.
- Fig. 4—
Comparison of yrs lived with disability (YLD) per 1,000 for a) males and b) females in Global Burden of Disease (GBD) Study 1990 (□) and GBD 2000 (░) estimates. This figure compares results for 2000, using subregions, with results for 1990, where a different categorisation of subregions was used. EMR BD: Eastern Mediterranean, combining low child and adult mortality, and high child and adult mortality; AMR BD: Americas, combining the regions with low child and adult mortality, and high child and adult mortality, which corresponds to the 1990 categorisation of Latin America and the Caribbean; AFR: Africa; SEAR B + WPR B: this category comprises some of the South-East Asia region with low child and adult mortality, and two-thirds of the Western Pacific region with low child and adult mortality, which allows comparison with the 2000 estimates; SEAR D: South-East Asia region with high child and adult mortality, which corresponds to India; EUR BC: Europe, combining low child and adult mortality, and low child mortality and high adult mortality; A: industrialised regions.
- Fig. 5—
Chronic obstructive pulmonary disease mortality during the period of 1945–1999 in a) males and b) females aged ≥45 yrs in England and Wales (UK), unadjusted for International Classification of Disease (ICD) coding version changes (----: ICD change years). ▾: aged 45–54 yrs; ▴: aged 55–64 yrs; ▪: aged 65–74 yrs; ♦: aged 75–84 yrs; •: aged ≥85 yrs.
- Fig. 6—
Modelled and actual chronic obstructive pulmonary disease mortality rates per 1,000 for males (a–i) and females (j–r) in England and Wales for 1945–1999 and projected rates for 2000–2009 (----: cut-off line) for the following age groups: 45–49 yrs (a, j); 50–54 yrs (b, k); 55–59 yrs (c, l); 60–64 yrs (d, m); 65–69 yrs (e, n); 70–74 yrs (f, o); 75–79 yrs (g, p); 80–84 yrs (h, q); 85–89 yrs (i–r). Lines represent 5%, 25%, 50%, 75% and 95% centiles of modelled rates. Actual rates are represented by X.
Tables
- Table 1—
Estimated chronic obstructive pulmonary disease deaths and disability-adjusted life yrs (DALYs) by World Health Organization (WHO) region, 2002
Region Deaths thousands DALYs thousands % of regional total DALYs AFR A 52 514 0.3 AFR E 65 668 0.3 AMR A 141 1743 3.7 AMR B 90 1419 1.7 AMR D 10 195 1.1 SEAR B 100 1420 2.3 SEAR D 556 6740 1.9 EUR A 140 1744 3.4 EUR B 45 673 1.8 EUR C 76 1036 1.7 EMR B 15 349 1.5 EMR D 80 989 0.9 WPR A 21 415 2.5 WPR B 1354 9820 4.0 World 2748 27756 1.9 A: very low child and adult mortality; B: low child and adult mortality; C: low child mortality and high adult mortality; D: high child and adult mortality; E: high child mortality and very high adult mortality; AFR: Africa; AMR: Americas; SEAR: South-East Asia; EUR: Europe; EMR: Eastern Mediterranean; WPR: Western Pacific. The mortality strata (A–E) were used to distinguish groupings of countries likely to be at a similar level of health development among the member states of the WHO regions. Adapted from 7.
- Table 2—
Estimated differences in chronic obstructive pulmonary disease regional prevalence according to definition used for age groups≥30 yrs
Region Prevalence % Symptoms Physician diagnosis Spirometry AFR D 1–3 AMR A 5–15 1–3 2–5 AMR B 5–13 EMR B 2–10 1–2 EUR A 10–20 2–5 3–7 EUR B 10–20 SEAR D 2–7 WPR A 10–15 2–5 WPR B 2–8 1–3 Regions without prevalence studies have been omitted. A: very low child and adult mortality; B: low child and adult mortality; D: high child and adult mortality; AFR: Africa; AMR: Americas; EMR: Eastern Mediterranean; EUR: Europe; SEAR: South-East Asia; WPR: Western Pacific. See Supplementary material on website for information regarding the source of these data.
- Table 3—
Comparison of chronic obstructive pulmonary disease prevalence for those aged≥30 yrs by region, 1990 and 2000
Region Current 2000 estimates % Estimates based on GBD 1990 data % Published prevalence based on spirometry % Males Females Males Females Males Females AFR D 1.1 0.5 2.4 1.4 <1.0 AFR E 0.6 0.2 2.1 1.3 AMR A 4.0 3.2 1.4 0.7 3.0–5.0 2.0–4.0 AMR B 3.4 2.5 1.5 0.8 2.0–4.0 AMR D 0.7 0.3 1.4 0.7 EMR B 2.3 0.5 0.9 0.9 1.0–2.0 1.0 EMR D 1.8 1.0 0.9 0.9 EUR A 3.1 2.2 1.7 0.9 3.0–7.0 2.0–6.0 EUR B 1.7 1.2 1.7 0.9 3.0–8.0 2.0–5.0 EUR C 2.0 1.5 ¶ ¶ SEAR B 1.6 0.9 1.2 0.6 SEAR D 2.5 1.4 1.7 1.3 <2.0 <1.0 WPR A 2.9 2.0 1.9 1.0 2.0–4.0 2.0–3.0 WPR B 2.8# 1.5# 4.8# 4.5# >3.0# <3.0# GBD: Global Burden of Disease Study; A: very low child and adult mortality; B: low child and adult mortality; C: low child mortality and high adult mortality; D: high child and adult mortality; E: high child mortality and very high adult mortality; AFR: Africa; AMR: Americas; EMR: Eastern Mediterranean; EUR: Europe; SEAR: South-East Asia; WPR: Western Pacific. #: aged ≥15 yrs; ¶: included with EUR B.
- Table 4—
Estimates of yrs lived with disability(YLDs), yrs of life lost (YLLs) and disability-adjusted life yrs (DALYs) due to chronic obstructive pulmonary disease by region, 2000
YLD·100000 males−1 YLD·100000 females−1 YLL·100000 males−1 YLL·100000 females−1 Total YLD thousands Total YLL thousands Total DALYs thousands AFR D 49.8 11.2 152.9 136.1 102 482 584 AFR E 47.1 11.5 167.5 131.9 99 505 603 AMR A 340.7 270.3 216.7 202.2 944 648 1592 AMR B 179.0 209.5 134.5 92.9 860 502 1362 AMR D 159.4 95.4 73.6 90.2 91 58 149 EMR B 283.6 57.4 60.2 44.1 244 73 317 EMR D 123.1 58.6 105.9 100.3 126 142 268 EUR A 265.0 298.9 198.6 104.7 1160 619 1779 EUR B 140.9 175.3 40.9 27.8 343 74 418 EUR C 197.2 265.6 390.4 132.3 574 622 1196 SEAR B 209.8 171.3 185.4 118.6 752 600 1351 SEAR D 123.3 123.0 397.3 353.7 1660 5073 6733 WPR A 113.5 92.5 77.9 34.1 154 83 237 WPR B 236.2 95.4 407.8 493.8 2524 6777 9628 Total 188.9 140.1 286.2 260.9 9954 16543 26497 A: very low child and adult mortality; B: low child and adult mortality; C: low child mortality and high adult mortality; D: high child and adult mortality; E: high child mortality and very high adult mortality; AFR: Africa; AMR: Americas; EMR: Eastern Mediterranean; EUR: Europe; SEAR: South-East Asia; WPR: Western Pacific.
- Table 5—
Comparison of predictions with actual total number of chronic obstructive pulmonary disease(COPD) plus asthma deaths for 1990–1999 in England and Wales in those aged ≥45 yrs
Smoothing constraint Data bridge-coded adjusted? % difference of sum of posterior median predictions from actual total number of deaths % of age-group categories where actual numbers lie within 25–75% centiles of predictions# % of age-group categories where actual numbers lie within 5–95% centiles of predictions# Square root of sum of posterior median predictive deviances COPD males RW1 No +10.8 62.2 93.3 36.39 RW1 Yes +9.0 57.8 94.4 35.10 RW2 No +76.9 91.1 100.0 217.77 RW2 Yes +50.0 91.1 100.0 194.21 COPD females RW1 No +4.9 80.0 93.3 34.96 RW1 Yes +5.6 80.0 93.3 36.01 RW2 No +72.6 96.7 100 238.55 RW2 Yes +69.7 96.7 100 244.52 RW: random walk smoothing constraint. #: represents 90 cells, nine age-group categories over 10 yrs.
Supplementary material
Files in this Data Supplement:
- Adobe PDF - Final_Q_and_A_Global_Burden_of_COPD.pdf - This document summarizes the question and answer discussions related to the proceedings of a scientific workshop entitled The Global Burden of COPD, held in Vancouver, Canada, October 21-22, 2004.
- Adobe PDF - Appendix1.pdf - Review of recent studies on COPD prevalence by WHO region.
- Adobe PDF - Appendix2.pdf - Includes ICD codes used to define COPD and lung cancer and further information about Bayesian age-period-cohort statistical model.
