- + Key points: Respiratory disease
• In 2018 in NSW, 10.5% of adults aged 16 years and over (9.0% of men and 12.9% of women) had asthma currently, as estimated from the 2018 NSW Adult Population Health Survey (self-reported using a Computer Assisted Telephone Interview or CATI). In 2016-2017, 14.5% of boys and 11.1% of girls aged 2-15 years were reported to currently have asthma, with 21.7% of boys and 17.2% of girls reported as ever having asthma, as estimated from the NSW Population Health Survey (self-reported using a Computer Assisted Telephone Interview or CATI). Asthma was responsible for 165 deaths in 2017 and 11,290 hospitalisations in 2018-19.
• Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, was responsible for 2,564 deaths in 2017 in NSW (91% or 2,332 in those aged 65 years and over) and more than 22,378 hospitalisations in 2018-19.
• Asbestosis is a chronic lung dust disease that is associated with occupational exposure to asbestos. Total hospitalisations due to asbestos in NSW have steadily decreased in recent years.
- + 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 7.5% of the total burden of disease and injury in Australia in 2015, with chronic obstructive pulmonary disease and asthma accounting for 51.4% and 33.8% of this burden, respectively (AIHW 2019).
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 2.5% 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 2015, asthma was estimated to account for 2.5% of the disease burden (AIHW 2019).
Chronic obstructive pulmonary disease
Chronic bronchitis and emphysema are the two main conditions comprising chronic obstructive pulmonary disease (COPD). In Australia in 2015, COPD was estimated to account for 3.9% of the disease burden (AIHW 2019).
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 2019. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2015. Australian Burden of Disease Study series no. 19. BOD 22. Canberra: AIHW. Available at: https://www.aihw.gov.au/reports/burden-of-disease/burden-disease-study-illness-death-2015/contents/table-of-contents
- + 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.
Australia is fortunate in having one of the lowest rates of TB in the world. This has been primarily achieved as a result of a continued commitment to provide specialised health services dedicated to the prevention and control of TB in each of the states and territories. The National TB Advisory Committee’s Strategic Plan for the Control of Tuberculosis, 2011-2015 sets out the goals and objectives of TB control in Australia.
Despite Australia’s success in reducing TB, there is no room for complacency. Global connectivity through air travel and migration means that TB will remain a public health concern in Australia until worldwide control of TB is achieved. The NSW TB Program is the provider of specialised services for the prevention and control of TB in NSW and plays a vital role in maintaining Australia’s success in reducing the burden of TB.
Influenza and pnuemonia
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
- + 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