Why Is Europe Neglecting Chronic Respiratory Disease?
The magnitude of chronic respiratory diseases (CRDs) across Europe has been overlooked, leading to under- and misdiagnosis, poor management, and inadequate funding, according to a new report.
Published by the World Health Organization (WHO) Europe and the European Respiratory Society, the report found that 81.7 million people in the region are living with a CRD — including chronic obstructive pulmonary disease (COPD), asthma, and other lung diseases — and 6.8 million are newly diagnosed each year.
CRDs are the sixth leading cause of death in the WHO European region, with almost 400,000 dying from a CRD every year, nearly 80% of which are caused by COPD. However, most of these deaths are driven by preventable risk factors, primarily tobacco use and indoor and outdoor air pollution. The region has one of the highest rates of tobacco use, with one fourth of its adults being smokers, and more than 90% breathing air that is polluted with dangerous levels of particulate matter.
Answering the Whys
So why are CRDs so vastly underdiagnosed in Europe? Why do healthcare professionals not have the skills and expertise to identify them, as stated in the report? And what resources are required to bridge this gap?
On a policy level, the report noted an important paradox: Earlier progress led to a decline in CRD mortality, but this consequently led to reduced research funding and weakened surveillance. Without understanding the true burden of disease, it is difficult to advocate for increased policy focus and additional funding.
'Unfortunately, due to complexity with their definitions and absence of unanimously agreed targets, CRD surveillance and monitoring systems are not well designed,' the report said. 'Determining the real magnitude of the CRD burden is fundamental to identifying unmet needs at population level.'
'There has been a reduction in investment for CRD research compared with other noncommunicable diseases, where epidemiological studies have defined their global burden and priority actions; there are only a handful of population-based studies on CRDs,' the report continued.
Numerous health system and health worker challenges prevent the timely and correct diagnosis of CRDs. These include overlapping symptoms with other respiratory conditions and frequent comorbidities; limited healthcare provider knowledge and skills, especially at the primary healthcare level; inadequate access to diagnostic tools; lack of respiratory health specialists; and lack of awareness among patients, all of which can contribute to under- and misdiagnosis and thus delays in accessing treatment.
Respiratory Diseases Not so Glamorous
Philip Bardin, FRACP, PhD, professor and director of Lung and Sleep Medicine at Monash University and Medical Centre, Melbourne, Australia, and an international authority in the field of asthma and COPD, told Medscape Medical News that the impact of CRDs in the community has long been underappreciated.
Philip Bardin, FRACP, PhD
'We compete in the health space with other chronic diseases that use shock and awe tactics such as: 'You will have a stroke, a heart attack, or your foot will fall off' to gain public attention and funding,' he said. 'Historically, [there has been] poor advocacy by craft groups.'
Peter Burney, MD, professor of respiratory epidemiology and public health at the National Heart and Lung Institute at Imperial College London and honorary consultant physician at Royal Brompton Hospital, London, England, echoed Bardin's thoughts.
Peter Burney, MD
'Respiratory diseases are not glamourous; there is little sympathy for the old and the poor, and even less if they have been smokers. Asthma research has always been better funded with publicity that focuses on childhood [exposure to] smoking. Governments ought to be spurred on by the high costs of COPD in [terms of] direct costs of hospitalization.'
He cited a 2015 study published in the journal Chest that reviewed population-based prevalence studies that measured lung function and looked for undiagnosed COPD.
Undiagnosed COPD was high in almost all locations studied, he said.
'London (UK) had a high prevalence of disease, but approximately 80% [of detected COPD cases were] undiagnosed. The why is complicated,' he said. 'Firstly, COPD is a very recent invention, and chronic obstructive pulmonary disease may mean more to average Americans than others. We used to call it bronchitis or chronic obstructive bronchitis.'
The Primary Care Challenge
With a shortage of respiratory specialists, some countries are expanding the role of primary healthcare to include the identification of CRDs, joining many other countries that have for decades put primary providers on the front line of respiratory medicine.
But while spirometry is one of the essential tools for diagnosing and monitoring CRDs, it remains limited as it requires well-trained staff, reliable equipment, and standardized procedures.
'Spirometry is not commonly done in general practice, and it was more or less stopped during COVID. It is difficult to do well, and quality assurance is a problem,' Burney said. 'If a practitioner is not using skills learned in medical school and in early training, the skill in interpreting spirometry results soon atrophies. In addition, primary care is feeling a bit put upon, and it is difficult in these circumstances to launch a whole new initiative.'
Promise in Education
Expanding education and using innovative technology appear to hold some promise in overcoming such challenges.
The report cited Spain, which has a new e-learning program, Spirometry Simplified, for primary healthcare providers to expand their knowledge. Also, Italy and Spain are testing tele-spirometry. Here, a technician remotely controls from within a hospital a computer with spirometer software that is connected to a primary care patient. The aim is to help overcome the issue of poor-quality spirometry use in primary care.
'Solutions need to come via patient participation and teamwork by doctors, nurses, and others to improve care. Waiting for governments and bureaucrats to solve problems will take us nowhere,' Bardin said. 'Doing better what we've always done will get us what we've always had.'
Bardin and Burney reported having no relevant financial relationships.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Fox News
38 minutes ago
- Fox News
One Whistleblower's Fight Against Big Pharma
About one million Americans live with Multiple Sclerosis, and nearly 10,000 new cases are diagnosed every year. While scientific advances have aimed to slow MS's progression, whistleblower Lisa Pratta argues the real threat may lie within the pharmaceutical industry itself. A former drug sales rep turned U.S. Department of Justice informant, Lisa Pratta, exposed widespread corruption, including bribing doctors to prescribe drugs for profit. Now an outspoken activist, Lisa describes how she believes Big Pharma exploits the vulnerable in pursuit of revenue. Learn more about your ad choices. Visit
Yahoo
2 hours ago
- Yahoo
Scientists Working to Decode Signal From Earliest Years of Universe
As mysterious as the Big Bang that gave birth to the universe is the brief but tumultuous period that immediately followed it. How did the cosmos transform from a uniform sea of darkness into a chaotic swirl brimming with radiant stars? What were these first stars like, and how were they born? So far, we have very strong suspicions, but no hard answers. One reason is that the light from this period, called the cosmic dawn, is extremely faint, making it nearly impossible to infer the traits of these first cosmic objects, let alone directly observe them. But that's about to change, according to a team of international astronomers. In a new study published in the journal Nature Astronomy, the astronomers argue that we're on the verge of finally decoding a radio signal that was emitted just one hundred millions years after the Big Bang. Known as the 21 centimeter signal, which refers to its distinct wavelength, this burst of radiation was unleashed as the inchoate cosmos spawned the earliest stars and black holes. "This is a unique opportunity to learn how the universe's first light emerged from the darkness," said study co-author Anastasia Fialkov, an astronomer from the University of Cambridge in a statement about the work. "The transition from a cold, dark universe to one filled with stars is a story we're only beginning to understand." After several hundred thousand years of cooling following the Big Bang, the first atoms to form in the universe were overwhelmingly neutral hydrogen atoms made of one positively charged proton and one negatively charged electron. But the formation of the first stars unbalanced that. As these cosmic reactors came online, they radiated light energetic enough to reionize this preponderance of neutral hydrogen atoms. In the process, they emitted photons that produced light in the telltale 21 centimeter wavelength, making it an unmistakeable marker of when the first cosmic structures formed. Deciphering these emissions would be tantamount to obtaining a skeleton key to the dawn of the universe. And drum roll, please: employing the Radio Experiment for the Analysis of Cosmic Hydrogen telescope, which is currently undergoing calibration, and the enormous Square Kilometer Array, which is under construction Australia, the researchers say they've developed a model that can tease out the masses of the first stars, sometimes dubbed Population III stars, that are locked inside the 21 centimeter signal. While developing the model, their key revelation was that, until now, astronomers weren't properly accounting for the impact of star systems called x-ray binaries among these first stars. These are systems where a black hole or neutron star is stripping material off a more ordinary star that's orbiting it, producing light in the x-ray spectrum. In short, it appears that x-ray binaries are both brighter and more numerous than what was previously thought. "We are the first group to consistently model the dependence of the 21-centimeter signal of the masses of the first stars, including the impact of ultraviolet starlight and X-ray emissions from X-ray binaries produced when the first stars die," said Fialkov. "These insights are derived from simulations that integrate the primordial conditions of the universe, such as the hydrogen-helium composition produced by the Big Bang." All told, it's another promising leap forward in the field of radio astronomy, where recent advances have begun to reveal an entire "low surface brightness" universe — and a potentially profound one as well, with the promise to illuminate our understanding of the cosmic dawn as never never before. "The predictions we are reporting have huge implications for our understanding of the nature of the very first stars in the universe," said co-author Eloy de Lera Acedo, a Cambridge astronomer and a principal investigator of the REACH telescope. "We show evidence that our radio telescopes can tell us details about the mass of those first stars and how these early lights may have been very different from today's stars." More on astronomy: Scientists Investigating Small Orange Objects Coating Surface of the Moon
Yahoo
2 hours ago
- Yahoo
Scientists Just Found Something Unbelievably Grim About Pollution Generated by AI
Tech companies are hellbent on pushing out ever more advanced artificial intelligence models — but there appears to be a grim cost to that progress. In a new study in the science journal Frontiers in Communication, German researchers found that large language models (LLM) that provide more accurate answers use exponentially more energy — and hence produce more carbon — than their simpler and lower-performing peers. In other words, the findings are a grim sign of things to come for the environmental impacts of the AI industry: the more accurate a model is, the higher its toll on the climate. "Everyone knows that as you increase model size, typically models become more capable, use more electricity and have more emissions," Allen Institute for AI researcher Jesse Dodge, who didn't work on the German research but has conducted similar analysis of his own, told the New York Times. The team examined 14 open source LLMs — they were unable to access the inner workings of commercial offerings like OpenAI's ChatGPT or Anthropic's Claude — of various sizes and fed them 500 multiple choice questions plus 500 "free-response questions." Crunching the numbers, the researchers found that big, more accurate models such as DeepSeek produce the most carbon compared to chatbots with smaller digital brains. So-called "reasoning" chatbots, which break problems down into steps in their attempts to solve them, also produced markedly more emissions than their simpler brethren. There were occasional LLMs that bucked the trend — Cogito 70B achieved slightly higher accuracy than DeepSeek, but with a modestly smaller carbon footprint, for instance — but the overall pattern was stark: the more reliable an AI's outputs, the greater its environmental harm. "We don't always need the biggest, most heavily trained model, to answer simple questions," Maximilian Dauner, a German doctoral student and lead author of the paper, told the NYT. "Smaller models are also capable of doing specific things well. The goal should be to pick the right model for the right task." That brings up an interesting point: do we really need AI in everything? When you go on Google, those annoying AI summaries pop up, no doubt generating pollution for a result that you never asked for in the first place. Each individual query might not count for much, but when you add them all up, the effects on the climate could be immense. OpenAI CEO Sam Altman, for example, recently enthused that a "significant fraction" of the Earth's total power production should eventually go to AI. More on AI: CEOs Using AI to Terrorize Their Employees
