In support of World Pneumonia Day, 12 November, the Forum of International Respiratory Societies (FIRS), of which Global Initiative for Chronic Obstructive Lung Disease (GOLD) is a member, calls for an end to preventable pneumonia deaths, ensuring equitable access to interventions for prevention and control of pneumonia.

Every minute, two children die from pneumonia, representing 16 percent of childhood deaths globally. Eighty percent of deaths are in children under two years old. Almost all deaths are in low and middle-income countries. Pneumonia is also a common cause of death or illness in the elderly, being the single most common cause of death from infectious disease.

Pneumonia is largely preventable

Good nutrition including exclusive breastfeeding for the first four to six months of life and adequate complementary foods protect against getting pneumonia.

Comprehensive immunisation including vaccines against the common germs that cause pneumonia such as pneumococcus, measles, Haemophilus Influenzae b, pertussis (whooping cough), diphtheria and influenza should be available to all children to prevent pneumonia. Avoiding tobacco smoke exposure and reducing exposure to indoor air pollution reduces the risk of pneumonia in children. Prevention of mother-to-child transmission of HIV, early use of antiretroviral therapy in HIV-infected children, and cotrimoxazole prophylaxis for HIV-infected and exposed children, can reduce the burden of childhood pneumonia.

Pneumonia is largely treatable

To treat pneumonia, timely access to appropriate management including antibiotics, referral to hospital and oxygen when needed, are critical for children who become ill from pneumonia.

Many children continue to die from pneumonia, largely due to lack of comprehensive, holistic implementation of the package of interventions for pneumonia prevention and treatment.

• Only 40 percent of children less than six months are exclusively breastfed.
• Around 170 million children in low and middle-income countries are not vaccinated against pneumonia.
• Globally, only 35 percent of eligible children get the required three doses of pneumococcal vaccine.
• Only two-thirds of children with pneumonia access treatment.

To end the preventable burden of childhood pneumonia and deaths there is a need to:

• Raise awareness about pneumonia, the leading killer of young children.
• Strengthen, accelerate and sustain interventions to prevent and treat pneumonia.
• Focus on equitable access to, and delivery of comprehensive pneumonia prevention and control programs.
• Design specific strategies to reach the “harder-to reach” populations to improve their accessibility to available interventions.
• Conduct research to develop innovative strategies to reduce the burden of pneumonia.

Together, we can end preventable deaths from pneumonia.

FIRS calls upon governments, health care providers, researchers, funders and families to ensure:

• Improved, equitable and sustained access to effective pneumonia prevention and control interventions for all by all.
• Strengthened health systems that promptly and effectively deliver strategies to reduce pneumonia deaths including provision of effective antibiotics and oxygen delivery systems.
• Increased support for strategies to prevent pneumonia including immunisation, prevention of mother-to-child HIV transmission, provision of anti-retroviral therapy for HIV-infected children, reduction of exposure to tobacco and air pollution, and increasing access to safe drinking water and sanitation.
• Support for research towards innovative diagnostic, prevention and treatment strategies.

Click here for the World Pneumonia Day 2019 Factsheet.

About the Forum of International Respiratory Societies (FIRS)

The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

For more information about FIRS please contact Lisa Roscoe lisa.roscoe@firsnet.org.

Cape Town, Glenview, Lausanne, Montevideo, New York, Paris, Tokyo, 25 September 2019

Today, on World Lung Day (WLD), GOLD is united with members of the Forum of International Respiratory Societies (FIRS) and WLD partner organizations to advocate for respiratory health globally and call on policymakers to ensure that everyone has access to the services they need to improve their lung health.

Respiratory diseases impose an immense worldwide health burden. The facts are shocking:

• 384 million people suffer from chronic obstructive pulmonary disease (COPD) and 3 million die from it each year, making it the third leading cause of death worldwide.
• 10 million people develop tuberculosis and 1.6 million die from it each year, making it the most common lethal infectious disease.
• 76 million people die from lung cancer each year, making it the deadliest cancer.
• 334 million people suffer from asthma, making it the most common chronic disease of childhood. It affects 14 percent of children globally − and is rising.
• Pneumonia kills millions of people each year making it a leading cause of death in the very young and very old.
• 91 percent of the world’s population live in places where poor air quality exceeds WHO guidelines.

WLD, on 25^th September, comes two days after the UN High-Level Meeting on Universal Health Coverage (UHC). UHC calls for all people to receive the health services they need, when they need it, without suffering financial hardship. At least half of the world’s population still do not have full coverage of essential health services.

The global spotlight on UHC represents an opportunity for substantial progress in the fight against lung disease around the world. On WLD this year we are united in our message: ‘Leave no one behind. On World Lung Day, we call for healthy lungs for all.’

“UHC is particularly important to persons with respiratory disease. For example, a break in the supply of medicine for patients with tuberculosis could cause the development of drug resistance, which carries serious consequences. The abrupt unavailability of asthma medicine could cause severe suffering and even death. Lack of health care provider availability usually means delay in diagnosis, which could be fatal for lung cancer patients,” said Dean Schraufnagel, MD, Executive Director of FIRS.

FIRS call for UHC action through:

1. Strengthening health care workers.
2. Prioritising prevention, namely tobacco, as well as air pollution, and vaccinations.
3. Maintaining a continuous supply of essential medicines.
4. Stemming antibiotic resistance

In addition, FIRS call for these essential actions to reduce the burden of respiratory disease and improve global health:

1. Increase awareness among the public and policy makers that respiratory health is a major component of global health.
2. Reduce the use of all tobacco products through universal enforcement of the Framework Convention on Tobacco Control.
3. Adopt and require World Health Organization air quality standards to reduce ambient, indoor, and occupational air pollution for all countries.
4. Promote universal access to quality health care, essential medicines, and immunisations.
5. Improve early diagnosis of respiratory diseases through increasing public awareness of lung health and disease.
6. Increase training of health professionals worldwide in respiratory disease.
7. Standardise the monitoring and management of respiratory diseases with evidence-based national and international strategies.
8. Increase research to prevent and treat respiratory diseases.

“We hope World Lung Day will provide an opportunity for action, conversation, and awareness. A unified voice of all dedicated to respiratory health will be a powerful force,” concludes Dr. Schraufnagel.

To learn more about World Lung Day go to our World Lung Day Toolkit.

About the Forum of International Respiratory Societies (FIRS)

The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

For more information about FIRS please contact Lisa Roscoe lisa.roscoe@firsnet.org.

An article published in the New England Journal of Medicine found associations between short-term exposure to particulate matter (PM10 and PM2.5) and cardiovascular and respiratory mortality risk, from over 600 cities across the globe. [1]

The adverse health effects of short-term exposure to ambient air pollution have been well documented. Particulate matter (PM) raises public health concerns because of its toxicity and the widespread exposure.

This study is an important international effort that evaluates the association of exposure to outdoor fine PM and cardiovascular and respiratory mortality across 652 cities in 24 countries from 6 continents. On average, a 10 mg/m3 increase in two-day moving average of PM10 was associated with increments of 0.44%, 0.36% and 0.47% in total, cardiovascular and respiratory mortality, respectively. The corresponding mortality increments for the same change in PM2.5 were 0.68%, 0.55% and 0.74%.

“This very large data sample allowed researchers to examine the data for obvious confounders while maintaining its statistical power and adjusting for known gaseous pollutants, such as ozone and sulphur dioxide as well as carbon monoxide and nitrogen dioxide.” said Clayton T. Cowl, MD, MS, President of American College of Chest Physicians and member of the Forum of International Respiratory Societies (FIRS) Environmental Committee. [2]

The most notable finding of the study is related to the exposure-response relationship between PM and mortality. “No threshold level of effect emerges from the data, indicating that at any exposure level a health risk for the exposed population still exists. Moreover, paradoxically, the percentage increase in mortality per 10 mg/m3 increase in PM air concentration is stronger at low exposures than at the highest. This result could be explained by several phenomena ranging from development of a biological ‘tolerance’ to the adverse health effects of PM in the long-term highly exposed populations to the adaptation of ‘avoidance’ behaviours (e.g. stay at home on the most polluted days) due to the higher awareness among them of this public health issue,” said Sara De Matteis, MD, MPH, PhD, Adjunct Professor at Humanitas University, Honorary Senior Lecturer at Imperial College London, and member of FIRS Environmental Committee. [3]

“Although the study’s size gives it strength,” warned Teresa To, PhD, Senior Scientist, The Hospital for Sick Children and Professor at the University of Toronto and FIRS Environmental Committee member [4], “the variation across countries may limit its ability to generate a ‘general global estimate.’ The differences between countries could be from varied exposures of concomitant gaseous pollutants, which add to the toxicity of the PM.”

The wide range of the composition of the fine particles (PM2.5) and the different toxins they contain is extremely important and also varies in different regions. Dr. Cowl concludes “Studying anything that involves data across the entire planet is difficult and involves attempting to find common denominators for measurements that span geopolitical, programmatic, or individual variation. Despite this, the study shows extremely compelling data that suggest inhalable and fine particulate matter does not just represent a common annoyance but is associated with human mortality most affecting our most vulnerable populations who suffer from underlying cardiac and respiratory illness. It should prompt not only medical providers, but also policymakers to take notice.”

Notes

[1] The paper can be viewed at: https://www.nejm.org/doi/full/10.1056/NEJMoa1817364

[2] Dr Clayton Cowl is board certified in Pulmonary, Critical Care, Occupational, and Internal Medicine and is the President of CHEST. He chairs the Division of Preventive, Occupational, and Aerospace Medicine at the Mayo Clinic. He is the Immediate Past-President of the Civil Aviation Medical Association. His research interests are in occupational asthma and toxic inhalations.

[3] Dr Sara De Matteis is Occupational and Environmental Health Physician and epidemiologist whose research centers on the effect of the environment and genetics on health, especially with regard to occupational lung diseases ranging from asthma to lung cancer.

[4] Dr. To is a Senior Scientist at The Hospital for Sick Children and a Professor at the Dalla Lana School of Public Health, University of Toronto, whose population-based research focuses on childhood asthma and its environmental influence. She is also at the Institute for Clinical Evaluative Sciences where she works on administrative databases to study healthcare in a variety of medical settings.

About the Forum of International Respiratory Societies (FIRS)
The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

Respiratory groups raise awareness about lung cancer risks, screening, and treatments

Cape Town, Glenview, Lausanne, Montevideo, New York, Paris, Tokyo, 1 August 2019

On World Lung Cancer Day, Global Initiative for Chronic Obstructive Lung Disease (GOLD) alongside members of the Forum of International Respiratory Societies (FIRS) commemorates, celebrates and supports those impacted by lung cancer. FIRS continues to support the grassroots efforts of the lung cancer community to raise awareness about lung cancer and its global impact, creating an educational movement of understanding about lung cancer risks, as well as early treatment around the world.

Lung cancer is one of the most common cancers worldwide, accounting for 2.09 million new cases in 2018. Lung cancer claimed 1.76 million lives in 2018. It is also responsible for nearly 1 in 5 cancer deaths according to the World Health Organization. Lung cancer kills more people yearly than breast, colon and prostate cancers combined.

While most understand that smoking is the single greatest risk factor for lung cancer, other lesser known risk factors include the environment and genetics. Environmental exposure to radon, asbestos, arsenic, beryllium and uranium has been linked to lung cancer. The risk of lung cancer also increases with a history of cancer in another part of the body, age, family history, radiation to the chest area and lung diseases like chronic obstructive pulmonary disease (COPD).

Being aware of key symptoms and screening options is vital for early detection and treatment. Symptoms include change in mucus, chest or back pain, coughing up blood and difficulty swallowing. Tests that may be used to diagnose lung cancer include chest x-rays, CT and PET scans, bronchoscopy and needle biopsies. If you are a current or former smoker and over the age of 55, you may be a candidate for a low-dose CT scan screening that can potentially detect lung cancer in its earliest stages.

“The number of new cases each year has increased from 1.8 million to 2.09 between 2012 and 2018. Treatment options for lung cancer have significantly advanced over the past few years, and survival rates are increasing. World Lung Cancer Day efforts continue to raise awareness of risks and increase early detection for the best possible outcomes.” said Dr. Clayton T. Cowl, President of the American College of Chest Physicians, a FIRS member.

About the Forum of International Respiratory Societies (FIRS)The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

Lung Cancer 2019 Fact Sheet