- + Key points: Respiratory disease
• In 2014 in NSW, 9.9% of adults aged 16 years and over (8.1% of men and 11.6% of women) had asthma, as estimated from the 2014 NSW Adult Population Health Survey (self-reported using a Computer Assisted Telephone Interview or CATI), and in 2011-2012, around 26% of boys and around 21% of girls aged 2-15 years were reported to ever had asthma as estimated from the 2012 NSW Population Health Survey (self-reported using a Computer Assisted Telephone Interview or CATI). Asthma was responsible for 130 deaths in 2012 and around 12,993 hospitalisations in 2013-14.
• Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, was responsible for around 2,000 deaths in 2013 in NSW and more than 22,000 hospitalisations in 2014-15.
• Asbestosis is a chronic lung disease that is associated with occupational exposure to asbestos. Total hospitalisations due to asbestos in NSW have remained stable in recent years.
• The rate of new cases of malignant mesothelioma (a cancer that is associated with past exposure to asbestos) more than doubled in NSW between 1987 and 2003. It has been very slowly decreasing since then.
- + Background: Respiratory disease
Respiratory diseases include acute diseases such as influenza and pneumonia, and chronic respiratory diseases (specifically asthma, chronic obstructive pulmonary disease, asbestosis, and respiratory tuberculosis), where preventive measures and better management of conditions can reduce the burden of disease and reduce associated healthcare costs.
Chronic respiratory diseases were responsible for 8.3% of the total burden of disease and injury in Australia in 2011, with chronic obstructive pulmonary disease and asthma accounting for 43% and 29% of this burden, respectively (AIHW 2016).
Influenza and pneumonia
Influenza and pneumonia are acute respiratory diseases that can be very severe and, in persons at high risk, can lead to death. Influenza and pneumonia cause around 1.8% of all deaths and around 0.9% of hospital separations and are an important cause of hospitalisations in the very young, and of death and hospitalisations among older age groups.
Asthma is a significant public health problem in Australia and it is estimated that Australian prevalence rates are among the highest in the world. Fortunately, recent studies in children show no further increase in prevalence. In Australia in 2011, asthma was estimated to account for 2.4% of the disease burden (AIHW 2016).
Chronic obstructive pulmonary disease
Chronic bronchitis and emphysema are the two main conditions comprising chronic obstructive pulmonary disease (COPD). In Australia in 2011, COPD was estimated to account for 3.6% of the disease burden (AIHW 2016).
Tuberculosis (TB) is caused by the bacterial organism Mycobacterium tuberculosis. Despite the increasing burden from respiratory tuberculosis globally, it is not a major public health problem in NSW. In fact the mortality and morbidity from all types of tuberculosis in NSW is one of the lowest in the world.
Lung cancer is usually excluded from analyses of respiratory diseases as it is classified with cancers in the International Classification of Diseases (the coding system used for health data in NSW). It has been included with respiratory diseases here to provide a more appropriate measure of the burden of respiratory disease from a clinical and health services planning perspective.
Cigarette smoking is the main risk factor for both COPD and lung cancer and the current incidence rates of these conditions reflect smoking rates 20 years and more in the past. Lung cancer is one of the leading causes of death in Australia.
Australian Institute of Health and Welfare 2016. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2011. Australian Burden of Disease Study series no. 3. BOD 4. Canberra: AIHW. Available at: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129555176
- + Interventions: Respiratory disease
Written asthma management plans are recommended as part of the national guidelines for the management of asthma: Australian Asthma Handbook (NACA 2015). They enable people with asthma to recognise a deterioration in their condition and initiate appropriate treatment, thereby reducing the severity of acute episodes.
The Australian Asthma Handbook promotes preventive care activities, proper inhaler technique and adherence and stepped medical management where the use of medicines can be increased or decreased depending on circumstances and the therapy combinations.
The NSW Tuberculosis Program is successful as the incidence of tuberculosis in NSW has remained stable over the last decade despite large-scale migration from high-prevalence countries and the treatment success rates have been high, with the absence of treatment failures and low rates of relapse of cases initially treated in Australia.
The main challenges to the NSW Tuberculosis Program are similar to those that face tuberculosis control globally. They include control of multi-drug resistant and extreme drug-resistant tuberculosis and identification and management of tuberculosis-HIV coinfection (O'Connor et al. 2009).
Influenza and pneumonia
Influenza and pneumococcal disease are covered by the National Immunisation Programs in NSW.
Influenza has been a notifiable disease by all laboratories under the Public Health Act in NSW since 2001. Surveillance is enhanced in winter months when the NSW Ministry of Health collects and reports weekly on influenza-like illness presentations to Emergency Departments, through the Public Health Rapid, Emergency, Disease and Syndromic Surveillance System (PHREDSS), and laboratory-confirmed diagnoses of influenza virus infections.
Emergency Departments in NSW are prepared for influenza epidemics with peak visit plans and similar measures in winter months.
National Asthma Council Australia. Australian Asthma Handbook. NACA, 2015. Available at: https://www.nationalasthma.org.au/health-professionals/australian-asthma-handbook
O'Connor B, Fritsche L, Christensen A, McAnulty J. EpiReview: Tuberculosis in New South Wales, 2003-2007. NSW Public Health Bulletin, 2009. Available at: www.publish.csiro.au/index.cfm?act=view_file&file_id=NB09001.pdf
- + For more information: Respiratory disease
Useful websites include:
Australian Centre for Asthma Monitoring at http://www.asthmamonitoring.org
National Asthma Council Australia at http://www.nationalasthma.org.au
Australian Bureau of Statistics at http://www.abs.gov.au
Australian Institute of Health and Welfare at http://www.aihw.gov.au
healthdirect at http://www.healthdirect.gov.au