49 - Chronic Obstructive Pulmonary Disease

Lack of agreement among definitions of COPD, combined with delayed diagnosis in many patients, makes estimates of prevalence difficult. In 2008, 13.1 million U.S. adults (aged 18 and older) were estimated to have COPD, but close to 24 million U.S. adults have evidence of impaired lung function, thus indicating underdiagnosis of COPD. COPD accounted for 1.5 million emergency department (ED) visits and 726,000 hospitalizations in 2000. In 2010, the cost to the nation for COPD was projected to be approximately $49.9 billion, including $29.5 billion in direct health care expenditures, $8.0 billion in indirect morbidity costs, and $12.4 billion in indirect mortality costs. COPD was the third leading cause of death in the United States in 2007 with 124,477 victims, more than half of whom were female. Of note, the prevalence of COPD in women has doubled in the past few decades but has remained stable in men. In industrialized countries, 80% to 90% of the risk for COPD is from cigarette smoking. Tobacco smoke is the major risk factor for the development of COPD, but only 15% of smokers experience COPD. Other factors associated with the development of COPD, in addition to smoking, are occupational dust, chemical exposure, and air pollution.