The global burden and impact of chronic obstructive pulmonary disease worldwide.

A prerequisite for fighting chronic obstructive pulmonary disease (COPD) world-wide is accurate data on death and illness. Such data are not available in many countries and surveys with spirometry of forced expiratory volumes should be performed world-wide. Severe COPD, with one second FEV1 below 40% of predicted value, has been estimated to be below 1% in the general population. Mild to moderate COPD can be 10 times more frequent. The prevalence of COPD increases heavily with age. The Global Burden of Disease study, undertaken by the World Bank and World Health Organisation, concluded that COPD worldwide will increase from 1990 to 2020 its rank number of death from rank 6 to rank 3, and its rank number of disability-adjusted life years lost from rank 12 to rank 5. Reduction of total personal exposure to tobacco smoke and occupational and other indoor or outdoor dusts are important goals to prevent the onset and progression of COPD.