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China: Dramatic increase in lung diseases

China: Dramatic increase in lung diseases

China has seen a massive increase in chronic lung diseases

In China, health authorities have been seeing a massive increase in lung diseases for years. The causes are above all the high tobacco consumption, the increased concentration of air pollutants and the inhalation of "impure air while working in factories, on large-scale companies or while cooking on stoves", according to a statement in an overview article by the science magazine "Nature".

The growing problem of lung diseases in China is exacerbated by outdated diagnosis and treatment options, writes the author Virginia Hughes in the current article. Overall, experts expect the number of deaths from lung disease in China to increase to three million a year over the next twenty years. Around two million people die in the world's most populous country from this disease every year.

300 million smokers in China More and more Chinese suffer from chronic obstructive pulmonary disease (COPD), also known as smoker's cough. The disease is usually caused by regularly high levels of pollutants in the respiratory tract. For example, COPD can be caused by smoking or high concentrations of air pollutants at work. In China, several unfavorably complementary factors play a role in the significant increase in lung diseases. For example, almost half of adult Chinese men smoke (around 300 million). Tobacco consumption is widespread, cigarettes are cheap, and there were no smoking bans until 2011. In addition, many Chinese still ignore the bans on smoking in public places and restaurants.

Smoking is also used in medical practices "In rural areas, cigarette smoke permeates buses, shops and even medical practices", reports the specialist magazine "Nature". Critical voices are relatively rare. Hardly surprising, since a 2007 study in six major Chinese cities showed that even among doctors, 41 percent smoke - 15 percent even smoked in front of their patients. Experts estimate that 1,700 billion cigarettes are smoked in China every year. "Since the late 1970s, disposable income in China has increased significantly and the Chinese tobacco industry, production and advertising has ramped up," the author writes. While more than half of the men smoke, this applies to only one in 50 Chinese women, reports Don Sin, respiratory medicine specialist at the University of British Columbia in Vancouver in the current article. However, Chinese women also often suffer from COPD. This is due on the one hand to passive smoking and on the other hand to increased levels of air pollutants.

Passive smoking as the cause of COPD? The author of the “Nature” article reports on two studies that examined the possible connections between passive smoking in women and chronic obstructive pulmonary diseases. “The first of these studies, published in 2007, was based on the Guangzhou Biobank cohort study, a collection of blood samples and extensive medical data from more than 20,000 people over the age of 50 from the southern Chinese city of Guangzhou. According to the results of the study, the longer the subjects were passively exposed to tobacco smoke, the higher the likelihood of chronic obstructive pulmonary disease. The second long-term study with only 910 study participants, all of whom did not smoke, came to the conclusion that the probability of COPD was more than twice as high with regular passive smoking. However, the results of the two studies are still extremely controversial. Especially since other studies have found no connection between passive smoking and COPD.

Cooking Pollutants Cause Chronic Lung Disease "There is no question that secondhand smoke is bad, but how much COPD causes it in China is not yet known," said David Christiani of Harvard School of Public Health in Nature magazine. According to the expert, other risk factors also play a role in the relatively high number of Chinese diseases. For example, indoor air pollution should be mentioned here. Because over 70 percent of Chinese households and 90 percent of households in rural areas use stoves for cooking and heating, which are powered by wood, crop residues, coal or manure. The released fine dust and the smoke enriched with carbon monoxide, formaldehyde and free radicals, according to the experts, lead to a significant increase in the COPD risk. Women, who mostly cook for families, are increasingly exposed to these pollutants, which could also result in the high proportion of chronic obstructive pulmonary diseases among non-smokers, said Don Sin.

Air pollutants from industrial production Another major factor in the increase in lung disease in China is the economic boom and the associated increased release of pollutants from industrial production. This also affects the stress at work, the experts report in the specialist magazine "Nature". There are currently particularly high pressures, for example in the cotton industry, silk production, grain processing and construction. Here, workers would regularly be exposed to high concentrations of pollutants despite the limits that have now been introduced. In addition to the damage to the lungs due to inadequate protective measures at work, the smog in the cities as well as the high number of tuberculosis diseases (1.5 million Chinese suffer from tuberculosis), the spread of pneumonia among Chinese children and malnutrition are loud Don Sin's statement on the increase in chronic obstructive pulmonary disease.

Inadequate diagnosis and treatment of COPD in China According to the experts, the consequences of the increased lung diseases in China could be less dramatic if an appropriate diagnosis and treatment were carried out. However, the symptoms such as cough, shortness of breath and tiredness are all too often confused by Chinese doctors with other diseases such as asthma. The late diagnosis of COPD usually makes treatment significantly more difficult, especially since irreversible damage to the lungs is often already present in the later stage of the disease. In addition, the therapy offerings in China are not up to the most modern medical standards. According to David Christiani, the whole of China needs a wake-up call "to realize the considerable human and economic burdens caused by COPD." As soon as China realizes that this problem "needs to be addressed, there can be some significant progress", the expert hopes . However, it would already be too late for millions of elderly Chinese and their hope of avoiding COPD would have gone up in smoke. (fp)

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