Asthma, chronic obstructive pulmonary disease and other respiratory diseases in Australia May 2010 Australian Institute of Health and Welfare Canberra Cat. no. ACM 20 The Australian Institute of Health and Welfare is Australia’s national health and welfare statistics and information agency. The Institute’s mission is better information and statistics for better health and wellbeing. © Australian Institute of Health and Welfare 2010 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from the Australian Institute of Health and Welfare. Requests and enquiries concerning reproduction and rights should be directed to the Head, Media and Communications Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. ISBN 978-1-74249-028-1 Suggested citation Australian Institute of Health and Welfare 2010. Asthma, chronic obstructive pulmonary disease and other respiratory diseases in Australia. Cat. no. ACM 20. Canberra: AIHW. Australian Institute of Health and Welfare Board Chair Hon. Peter Collins, AM, QC Director Penny Allbon Any enquiries about or comments on this publication should be directed to: Adrian Webster Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Phone: (02) 6244 1144 Email: [email protected] Published by the Australian Institute of Health and Welfare Printed by Bluestar Print Group Please note that there is the potential for minor revisions of data in this report. 2 Please check the online version at <www.aihw.gov.au> for any amendments. Contents Acknowledgments.............................................................................................................................vii Abbreviations................................................................................................................................... viii Summary .............................................................................................................................................. ix 1. Introduction....................................................................................................................................1 1.1 The respiratory system and disease.......................................................................................2 1.2 Diseases covered.......................................................................................................................2 1.3 Relationships between respiratory diseases.........................................................................5 1.4 The monitoring of respiratory diseases in Australia...........................................................6 1.5 Report structure........................................................................................................................6 1.6 Notes on terms used in this analysis .....................................................................................7 2. Respiratory disease risk and trigger factors................................................................................9 2.1 Genetic susceptibility.............................................................................................................10 2.1.1 Asthma...........................................................................................................................10 2.1.2 Hayfever and chronic sinusitis...................................................................................10 2.1.3 COPD.............................................................................................................................10 2.1.4 Cystic fibrosis................................................................................................................10 2.1.5 Pneumoconiosis............................................................................................................10 2.1.6 Sleep apnoea .................................................................................................................11 2.2 Behavioural factors ................................................................................................................11 2.2.1 Tobacco smoke .............................................................................................................11 2.2.2 Alcohol...........................................................................................................................13 2.2.3 Exercise..........................................................................................................................13 2.3 Indoor allergens and air pollutants .....................................................................................14 2.3.1 House dust ....................................................................................................................14 2.3.2 Combustion by-products ............................................................................................15 2.3.3 Volatile organic compounds.......................................................................................15 2.4 Outdoor allergens and air pollutants ..................................................................................15 2.4.1 Pollens............................................................................................................................16 2.4.2 Ambient air pollution..................................................................................................16 2.4.3 The weather ..................................................................................................................17 2.5 Occupational exposures ........................................................................................................17 2.5.1 Asthma...........................................................................................................................17 2.5.2 Hay fever and chronic sinusitis..................................................................................17 2.5.3 COPD.............................................................................................................................18 2.5.4 Pneumoconiosis............................................................................................................18 iii 2.5.5 Bronchiectasis ...............................................................................................................18 2.5.6 Pneumonia ....................................................................................................................18 2.6 Dietary factors.........................................................................................................................18 2.6.1 Asthma...........................................................................................................................18 2.7 Excess body weight................................................................................................................19 2.7.1 Asthma...........................................................................................................................19 2.7.2 COPD.............................................................................................................................19 2.7.3 Sleep apnoea .................................................................................................................19 2.8 Medication...............................................................................................................................19 2.8.1 Asthma and hayfever ..................................................................................................19 2.9 Infectious diseases..................................................................................................................19 2.9.1 Asthma and COPD ......................................................................................................20 2.9.2 Bronchiectasis and pneumoconiosis..........................................................................20 2.9.3 Sinusitis and hayfever .................................................................................................20 2.9.4 Cystic fibrosis................................................................................................................21 3. Asthma..............................................................................................................................................22 3.1 General epidemiology ...........................................................................................................22 3.1.1 Prevalence .....................................................................................................................22 3.1.2 Mortality........................................................................................................................24 3.2 Health service impacts...........................................................................................................25 3.2.1 GP encounters...............................................................................................................25 3.2.2 Hospitalisations............................................................................................................26 3.3 Comorbidities and complicating factors.............................................................................27 3.3.1 Side effects of asthma medications............................................................................27