GGARD

Nan Shan ZhongNan Shan ZhongCChina

The first ten leading causes of death in urban China (2003)

Rank Disease Mortality(per 105)1 Malignant tumor 134.52 Cerebrovascular diseases 105.43 Respiratory diseasesRespiratory diseases 77.377.34 Heart diseases 76.25 Trauma/Poisoning 32.66 Digestive diseases 19.37 Endocrinal, Nutritional &

Metabolic Disorders14.1

8 Genitourinary diseases 7.19 Neurological diseases 4.8

10 Perinatal diseases 162.1

The first ten leading causes of death in rural China (2003)

Rank Disease Mortality (per 105)1 Malignant tumor 95.72 Cerebrovascular diseases 89.93 Respiratory diseasesRespiratory diseases 70.970.94 Heart diseases 45.55 Trauma/Poisoning 21.56 Endocrinal, Nutritional & Metabolic

Disorders14.5

7 Digestive diseases 10.58 Genitourinary diseases 7.29 Perinatal diseases 372.2

10 Pulmonary TB 4.2

2,000 ~ 2,500

1,500 ~ 2,000100 ~ 500

1 ~ 100

11 ~ 50

BeijingBeijing

GuangdongGuangdong

ShanxiShanxi

Survey cities: 14 sites from 7 cities (Beijing, Shanghai, Tianjin, Shenyang, Xi’an, Chongqing, Guangzhou)

Shanghai

Tianjin

Chongqing

Shenyang

Xi’an

Beijing

Guangzhou

Ren PX et al 2005

Overall prevalence of COPD in China

12. 1

4. 9

7. 8

12. 7

5. 4

8. 8

12. 4

5. 1

8. 2

02468

101214

Male Female Total

prev

alen

ce o

f CO

PD(%

)

Urban Rural Total

*

#

* Male VS Female: P<0.01; # Urban VS Rural: P<0.01

COPD mortality rates per 100,000 population

0

10

20

30

40

50

60

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Chi na(M) Chi na(F) HongKong(M) HongKong(F) Aus(M) Aus(F)

Exacerbationsdays in last 6 months

None20%

Up to 512%06-10

18%

26+25%

11-1511%

16-2011%

21-253%

Base: 752 patients

Number of Times Hospitalised for COPD

in the last year

0%

20%

40%

60%

80%

100%Five+ times

Four times

Three times

Twice

Once

None

Base: 752 patients

0. 0

5. 0

10. 0

15. 0

20. 0

25. 0

0-15 15-30 30-45 45+ packs*years

preval ence % mal e femal e toatal

Association Between Prevalence of COPD And Smoke-index

# tests for trend : P<0.000

#

##

Prevalence of Smoking in China

(Chinese Academy of Preventive Medicine 1996)

Population (15yrs) 130,657

Current smoker 35.3%

Male 63.0%

Female 3.8%

Shaoguan

Guangzhou

Shaoguan rural (northern part of Guangdong province) and Guangzhou city (the capital city of Guangdong province) of China was selected to be studied. Total 3449 subjects investigated, response rate 81.3% .

Comparison of COPD prevalence in smoker and non-smoker in Guangdong province

△ P<0.01, compared with Guangzhou; * P<0.01, compared with Non-smoke; ▲ P<0.05, compared with Non-smoke.; ** P<0.01, compared with Non-smoke; OR=2.723(2.145-3.456).

Guangzhou ShaoguanShaoguan Total

Male female total male female totalmale female total male female total

Non-smoker

smoker

10.7 2.7 4.9 13.8 7.213.8 7.2 △ △ 7.87.8△△ 11.3 4.9 6.16.1

16.4▲ 4.2 11.9* 18.9 0 18.818.9 0 18.8**△△ 17.9* 4.1 15.115.1****

+:with biomass or cigarette exposure; – ： without biomass or cigarette exposure ▼ compared with (4) p ＝ 0.017, ▲ compared with (4) p ＝ 0.000 ， ** compared with (3) p＝ 0.003, * compared with (4) p＝ 0.000 ，◆ compared with (3) P＝ 0.000, ★ compared with (2) P＝ 0.001

Exposure factor （ biomass/ cigarette smoking ） Prevalence in corresponding

exposure factor （％）(1) Biomass(+)/cigarette smoking(+) 19.3*◆★

(2) Biomass(-)/cigarette smoking(+) 12.3▲**

(3) Biomass(+)/cigarette smoking(-) 7.7▼

(4) Biomass(-)/cigarette smoking(-) 5.1

Association between COPD prevalence and exposure to biomass and cigarette smoking

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

1990 2000(432500 population in 31 cities)

National Cooperative Group of Children Asthma

Current Asthma Prevalence of Children (0-

14yrs) in China

1GINA Treatment GuidelineNo (or minimal) need foremergency hospital visit/hospitalization

China Survey Findings 33% had visited the emergency room at hospital in the past year 16% of these patients had been hospitalized during the previous year

30%

19%

15%

26%

33%

16%

0% 10% 20% 30%

UnscheduledEmergency Visits

Hospital EmergencyRoom

Hospitalized in PastYear

Chi naAIRIAP Total

Summary of Hospital and Emergency Visits for Asthma in Past Year

Have Lost Work/School Days in the Past Year Due to Asthma

20%

25%

0%

5%

10%

15%

20%

25%

30%

35%

40%

China

Adults Children

GINA Treatment GuidelinesNo missed school or work

China Survey FindingsUp to 25%(20%) missed work (school) because of asthma inthe past year

CRD in China

Current patientsCOPD 32.8 millionsAsthma 39.0 millionsDeaths 1.6 millions

Chronic Respiratory Diseases (CRD) Are a Major

Burden in China

Distribution of economic status areas depending on the global country income

LuxembourgLuxembourg($69056/($69056/1)1)

U.S.U.S.($42076/7)($42076/7)

Japan Japan ($36486/10)($36486/10)

KoreaKorea($14649/($14649/34)34)

BrazilBrazil($3311/77)($3311/77)

TurkeyTurkey($4437/66)($4437/66)

ThailandThailand($2807/84)($2807/84)

ChinaChina($1352/112)($1352/112)

BurundiBurundi($123/179)($123/179)

BurmaBurma($135/176)($135/176)

RussiaRussia($4750/63)($4750/63)

IndiaIndia($652/133)($652/133)

The International Monetary Fund， IMF(2005)

Country(GDP per capita/rank)