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Control of allergic and chronic respiratory diseases in children to improve healthy ageing
1. Control of allergic and chronic
respiratory diseases in children to
improve healthy ageing:
The Polish Priority of the Council
of the EU
Boleslaw Samolinski
Past Chairman of the Sub-Committee on Priorities of Ministry of Health during Polish
Presidency of the EU Council
Public Health National Consultant in Poland
Radoslaw Gawlik
Member of the Sub-Committee on Priorities of Ministry of Health during Polish
Presidency of the EU Council
Past Secretary General of Polish Allergy Society
2. Life expectancy in newborns
85
Life expectancy at birth, in years
Belarus
Czech Republic
Germany
Lithuania
Poland
Russian Federation
Slovakia
Ukraine
80
Poland
75
70
65
60
1980
1990
2000
Małgorzata Kacprzak
3. NCD are responsible for 86% of premature
deaths in EU populations
Main Statistical Office
4. Three major death causes in Europe
1
Vascular Diseases
2
Cancer
3
Respiratory Diseases
ERS/ELF. European Lung White Book 2003
5. Critical risk factors include :
Smoking
Imbalanced diet
Lack of physical activity
Alcohol abuse
Mental and social stress
Bad conditions at home and work
Enviromental factors
6. Ragweed is the most common allergen, to which 70 % of the United States
population had sensitivity ( 60% increase in last 10 yr).
Incidence of moulds and ragweed are related with climate changes
Wayne P, i wsp. Production of allergenic pollen by ragweed ( Ambrosia artemisiifolia L.) is
increased in CO 2 -enriched atmospheres. Ann Allergy Asthma Immunol. 2002.
Singer BD,i wsp. Increasing Amb a 1 content in common ragweed (Ambrosia artemisiifolia)
pollen as a function of rising atmospheric CO2 concentration. Funct Plant Biol. 2005.
8. Since 1950 mean annual temp rose + 0,7 °C
The IPCC report concluded that there was“good evidence” that the
impact on temperatures and greenhouse gases has affected the timing
of the onset of allergenic pollen production, which may influence pollen
abundance and/or potency. These factors in turn are likely to increase
the frequency of allergies and related respiratory disorders such as
asthma.
Solomon S, Qin D, Manning M et al. Climate Change 2007:The Physical Science Basis. Contribution of Working Group I to the
Fourth Assessment Report of the Intergovernmental Panel on Climate Change. In: Solomon S, Qin D, Manning M et al., editors.
Intergovernmental Panel on Climate Change; 2007.
9.
10. Incidence of chronic Non Communicable Diseases in Poland per 1000 population.
According to Polish National Statistical Office.
Sources: G. Juszczyk, GUS, Evaluation of polish population health statuts 2004 r. Warsaw,
2006
450
Choroby kręgosłupa lub dyskopatia
Nadciśnienie tętnicze
400
Przew lekłe zapalenie staw ów
Chorobowość na 1000 os.
350
300
Migrena i bóle głow y
Nerw ica lub depresja, lęki
Allergy without asthma
Inne choroby serca
250
Choroba w rzodow a żołądka i dw unastnicy
Choroba w ieńcow a bez przebytego zaw ału
200
Inne choroby zw yrodnieniow e staw ów
150
Choroby tarczycy
Alergia (bez astmy alergicznej)
100
Miażdżyca
50
Cukrzyca
Kamica żółciow a
0
15-19
20-29
30-39
40-49
50-59
Grupa w iekow a
60-69
70 i w ięcej
Choroba w ieńcow a z przebytym zaw ałem
11. Struktura ogólna chorobowości w populacji Polski według częstości występowania
mierzonej wskaźnikiem chorobowości na 1000 mieszkańców.
Źródło: Oprac. G. Juszczyk na podst. GUS, Stan zdrowia ludności Polski w 2004 r. Warszawa, 2006.
140
Osteoporoza
Kamica nerkow a
120
Allergic asthma
Przew lekłe zapalenie oskrzeli
Zaćma
Chorobowość na 1000 os.
100
Inne choroby nerek
Nonallergic asthma
Astma o podłożu alergicznym
80
Inne przew lekłe choroby w ątroby
60
Przew lekłe choroby skóry
Astma niealergiczna
40
Jaskra
Przebyty udar
20
Now otw ory złośliw e
Padaczka
0
15-19
20-29
30-39
40-49
50-59
Grupa w iekow a
60-69
70 i w ięcej
Choroba Parkinsona
12. Public health priorities
Closing the gaps in health status of the European Union’s population
– Prevention, early detection and treatement of chronic respiratory
diseases in children
Chronic respiratory diseases prevalence
in Europe and worldwide
600,000,000 people suffer from allergic rhinitis worldwide
over 130,000,000 people in the EU suffer from allergies
30,000,000 Europeans have asthma
by 2015, 1 in every 2 Europeans will suffer from some
form of allergy
13. ISAAC, tendency
of
asthma
prevalence,
6-7-year- olds
Public health priorities Lancet 2006;368:733Closing the gaps in health status of the European Union’s
43
population – Prevention, early detection and treatement of
chronic respiratory diseases in children
10
10
Asthma and allergic rhinitis are the most common non 7
11
communicable chronic respiratory diseases in children
12
21
14
7
12
Asthma is the most common reason for emergency room
visits and hospital admissions among children
7
7
13
8
9
5
15. ECAP expressed in numbers
estimation of the whole Polish population
Allergy: 40% of 36mln Poles
> 13 mln
AR: 25% of 36 mln Poles
> 8 mln
Asthma: 5% of 36 mln Poles
>1.5 mln
Wheezing : 12% of 36 mln Poles > 4 mln
AD : 7% of 36 mln Poles
> 2.5 mln
16. Public health programme
There is important influence of respiratory
diseases in childhood on healthy aging
Healthy aging
depends on
children health
EAACI,
ERS, IPCRG, GARD, EFAADP
17. Public health priorities
Closing the gaps in health status of the European Union’s
population – Prevention, early detection and treatement of
chronic respiratory diseases in children
COMORBIDITIES
Allergic rhinitis is the highest risk factor for asthma
development (OR=8)
Early prevention of allergic rhinitis prevents asthma
development
Chronic respiratory diseases in early life are risk
factors for COPD (OR>2.3)
Asthma is a risk factor for COPD (OR>12)
COPD affects 44 million people in Europe, and is
the fourth leading cause of death and it will
become the third leading cause of death by 2030
18. Warsaw-Ossa, 21-22 September 2011
Polish Presidency 2011
CRD as risk factor
Allergic rhinitis, asthma and rhinosinusitis in childhood
are responsible for cardiovascular diseases in older age:
• Asthmatics are 1.4 times more likely to have heart
diseases , and 1.3 times more likely to have high
blood pressure than nonasthmatics
• Seasonal and chronic rhinitis have on average by 3.5
mm Hg higher systolic blood pressure than those
without allergic rhinitis
19. Adam
Fronczak
Jean
Bousquet
Ewa
Kopacz
Marek
Krawczyk
The experts and all stakeholders who supported Polish Presidency
in EU Council on CRD conference Warsaw-Ossa 21-22.09.2011
Cezmi
Akdis
Torsten
Zuberier
Breda
Flood
Susan
Palkonen
Dorota
Sienkiewicz
Micheal
Hubel
Jose
Anto
Peter
Burney
Andrew
Bush
Marek
Jutel
Marek
Kowalski
Piotr
Kuna
Erica von
Mutius
Nikos
Papadopoulos
Juray
Sykora
20.
21. Agnieszka
Czupryniak
Working Party of Public Health of European Union Council
Brussels 3.10.2011
Polish Presidency in EU Council
Marcin
Rynkowski
Michael
Hubel
Liliana
Michalik
Radoslaw
Gawlik
Bolesaw
Samoliński
Torsten
Zuberbier
Piotr
Kuna
Juray
Sykora
23. Invites the member states to:
Strenghten knowledge and public awareness in the
prevention and treatment of asthma
Take national action on childhood asthma
Strengthen cooperation and exchange of best practices
Health education of children , parents and teachers
Exchange best practices and data/statistics
Implement common action at the EU level on respiratory
diseases :
By creation of networks, preferably employing already
existing infrastructure
24. Invites the member states
and the commission to:
Encourage and support research into prevention, early
diagnosis, treatment and defining causative factors
Strenghten efforts to reduce the disability and premature
death related to asthma
Develop better understanding of the reasons for the
increase in the prevalence of CRD and disparities between
countries
Promote multisectoral approach and innovative
partnerships , especially e-health
25. Invites the European Commission to:
include childhood asthma and allergy in the research
and health community programmes and activities
support Member States and stakeholders
26.
27. Council of the European Union conclusions on chronic respiratory diseases in c
Samoliński B, Fronczak A, Włodarczyk A, Bousquet J.
Lancet. 2012 Mar 31;379(9822):e45-6.
28. Public Perceptions of Climate Change as a Human Health Risk: Surveys of the United States, Canada and Malta. Int J Environ Res Public Health. 2010
increasing by as much as 60 %, ragweed was the most common allergen, to which 70 % of the United Stated population had sensitivity
Intergovernmental Panel on Climate Change (IPCC), a collaboration of more than 2000 scientists from 100 countries
Abundance- obfitość, rozpowszechnienie
At least half expressed high or very high confidence that climate change would increase levels of pollen (50%), particulate matter (PM2.5) (55%), and ozone (70%).
The following slide presents changes in incidence of allergy and asthma in CEE.
There is the growing trend in differrent age groups
So we have millions of allergic patients in our country
Thats why the Polish Presidency of the Council made a priority for the EU ‘s public health policy.
But the most interesting in this problem is that CRD leads to cardiovascular diseases
– the most important factor among NCD responsible for early health loss and mortality in older ages.
CRD are responsible for : heart diseases and hypertension.
Asthmatics are 1.4 times more likely to have heart diseases ,
and 1.3 times more to have high blood pressure than nonasthmatics.
Michael Hübel European Commission, Health and Consumers Directorate General