Epidemiology of Lung Disease Flashcards
Asthma diagnosis?
Commonest in younger people and in increasing in prevalence
Asthma risk factors?
Family/personal history of atopic disease, e.g: asthma, eczema, allergic rhinitis or allergic conjunctivitis
Co-existence of atopic disease
Male (for pre-pubertal asthma) and female sex (for persistence of asthma from childhood to adulthood)
Bronchiolitis in infancy
Parental smoking, inc. perinatal exposure to tobacco smoke
Low birth weight and/or premature birth
Comparison of genders for lung cancer?
No. 1 diagnosis of cancer for both males and females in Scotland
Women lung cancer diagnosis is increasing, even though smoking prevalence decreased but not matching
Men lung cancer diagnosis is decreasing and male smoking is decreasing
What is lung cancer incidence related to?
Inc. smoking and deprivation
How can the burden of lung disease, in terms of morbidity, be assessed?
Hospital admissions/discharges
Bed occupancy
GP contacts
Limitations of separation of GP and hospital?
Conditions managed in primary care will be missed, e.g: COPD, asthma
GPs operate as independent businesses and even use several different IT systems
However, there is a lot of info on prescribing as there is a central system for this
Conditions associated with smoking?
Lung cancer Emphysema COPD CHD Stroke Oral cancers Circulatory damage - gangrene Breast cancer Cervical cancer Asthma Ulcers ...etc
Changes in smoking prevalence?
In total, is decreasing
What is the dose response relationship?
The more one smokes, the higher their risk of lung cancer
Cigarette smokers have a greater risk than pipe/cigar smokers and ex-smokers still have a greater risk than non-smokers
Lower risk when using filter tips
Lung cancer in non-smokers?
~25% of lung cancer in non-smokers is due to passive smoking
Example of methods used to decrease smoking and passive smoking and effect of this?
Smoking bans causes significant improvements in measured PFTs and significant reduction in self-reported symptoms
Why is not as simple as banning tobacco?
Tobacco often grown in poor areas (warm, wet areas) and is often a sole source of income
Tax revenue
Will not stop addiction, increase in illicit trade
Usefulness of e-cigarettes?
England’s most popular “quitting aid” and could potentially reduce smoking in more deprived groups in society
Dangers of e-cigarettes?
Not risk free
Not clear if everybody will use them to quit and, also, advertising can attract in people who have never smoked
Should be a better regulated market
