2.4. Respiratory diseases
After cardiovascular diseases and cancer, respiratory diseases represent the third cause of death in Italy and it is estimated that, due to the presence of an ageing population, the prevalence of these diseases is set to rise.
Respiratory diseases are fought primarily through projects aimed at both primary (by reducing smoking and the pollutants present in living and work places) and secondary prevention. Another important role is played by the information provided to patients and their families, who need to be informed about the characteristics of the disease, compliance with the therapy prescribed and how to react swiftly in the event of an exacerbation and the continuity of management.
One very recent cross-sectional epidemiological study on COPD and asthma, using data published by the Italian Society of General Medicine (SIMG), showed that at the end of 2009, the prevalence of asthma and COPD was equal to 6.10% and 2.83%, respectively, with an asthma/COPD ratio of 2.16. The prevalence of asthma appears to be higher amongst women in all age ranges, with the exception of that between 15 and 34 years. In COPD, the prevalence was higher in men of all ages, with a significant difference between the sexes after 64 years of age. The high percentage of obstructive respiratory diseases is a significant health problem, not least because, as age increases, COPD and asthma are frequently associated with concomitant conditions, which causes a deterioration in the patient’s conditions, complicates therapy and requires a greater use of healthcare resources, including a greater need for hospitalisation and an increased risk of death.
As regards occupational lung diseases, there has been a numerical reduction in the number of reports in occupational lung diseases (4,583 in 2009 compared to 4,793 in 2005) and, above all, in the percentage (13.2% of all reports in 2009 compared to 17.9% in 2005). This trend also suggests an improvement in the conditions of workplaces in Italy, possibly connected to improvements in preventative measures, although it is also important to note that occupational or occupation-related diseases are extensively underestimated.
Interstitial lung disease, a heterogeneous group of over 150 different conditions with common clinical, radiological, physiological and pathological characteristics, but different aetiology and molecular pathophysiology, underwent a slight increase in their relative frequency, associated with a more accurate diagnostic approach and better implementation of guidelines.
The Global Alliance against Chronic Respiratory Diseases (GARD) was established in 2004 to provide an efficacious solution to the problems caused by chronic respiratory diseases. This voluntary national and international alliance including various institutional and non-institutional partners working towards the common aim of improving overall respiratory health, allows each participating country the change to create national alliances. This led to the founding of GARD-Italy (GARD-I), a national voluntary alliance, including Institutions, Scientific Societies, Patient Associations and tendentiously, any other player working in the pneumology field, that strives to meet the common goal of developing a strategy for the prevention and care of respiratory diseases suited to the Italian context and whose technical leadership lies with the Ministry of Health. The directions of the projects implemented concern: respiratory prevention in schools; smoking and the domestic environment; training for early diagnosis; predictive medicine and continuity of care.