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Column Why is lung disease so prevalent in Ireland?

Ireland has one of the highest death rates from lung disease in Western Europe – only Belgium, Moldova, Hungary and Kyrgyzstan have higher mortality levels. Dr Edward McKone examines why.

A NUMBER OF stark facts about lung disease in Ireland were recently published in an independent report released by the European Respiratory Society. This report, looking at lung health across all countries in Europe, found that Ireland has one of the highest death rates from lung disease in Western Europe.

The report noted that the prevalence of diseases such as asthma and cystic fibrosis is particularly high in Ireland, as are hospital admission rates for chronic obstructive pulmonary disease (COPD) and respiratory infection. The report also found that Ireland has one of the lowest number of respiratory specialists and trainees per capita in Europe, almost four times lower than the European average.

To understand why lung health is so poor in Ireland, we must first look at what  lung disease is and how it currently affects the health of Irish people. ‘Lung disease’ refers to any medical condition that affects the lungs, the organs we use to breathe. Lung disease includes lung cancer, conditions affecting the airways such as COPD and asthma, infections such as pneumonia and TB, lung inflammatory conditions such as lung fibrosis and sarcoidosis and inherited conditions such as cystic fibrosis and alpha-1-antitrypsin deficiency.

Lung disease is extremely common in Ireland with 1 in 5 people dying as a result of lung disease. It is the second most common reason for admission to acute general hospitals and lung problems are the most common reason for people to attend their GPs. Undiagnosed lung disease is also very common in Ireland with a recent study showing that 1 in 7 Irish people, with no history of lung disease, have evidence of airflow obstruction on breathing tests indicating possible COPD or asthma.

Why is lung disease so prevalent in Ireland?

The reason for Ireland’s increased death rate and high prevalence of lung disease is unclear and is most likely a combination of genetic, climate, social and public health factors. One common misconception is that respiratory disease is all smoking related. Other than COPD and lung cancer, most other lung diseases are seen in people that have never smoked. Likewise, smoking is not a reason for the poor lung health seen in Ireland as smoking rates here are similar to other European countries that have significantly better lung health in their population.

One contributing factor to reduced lung health in Ireland is poor awareness of lung disease. People who develop early symptoms of lung disease, particularly breathlessness, rarely associate this with possible lung problems and often attribute it to being age-related, or due to a lack of fitness or a recent weight gain. This results in many people with lung disease attending their GP only after their condition has become quite advanced.

While lung disease is generally very treatable, the earlier you treat it the better. Often, if lung disease is diagnosed late, lung damage may be impossible to reverse. For this reason, if a person has symptoms of increasing breathlessness, especially if associated with cough or wheeze, and regardless of whether they smoke or not, they should get it checked out by their GP.

Putting lung disease prevention on the health agenda

Recently, the Irish Lung Health Alliance (ILHA) was formed ( which includes 14 charities and professional organisations with an interest in lung health. It is the vision of the ILHA to firmly place lung disease prevention and reduction on the health agenda and in the public consciousness, in line with the scale and burden of the disease and the importance of lungs to quality of life and population longevity.

To do this, a cohesive public health policy on lung health in Ireland encompassing primary, secondary and community care and health promotion is required. We also need more information regarding lung disease in Ireland such as the true prevalence of diseases such as COPD, asthma and interstitial lung disease; why Ireland has such high rates of mortality and morbidity for these diseases; and how we can do a better job to both prevent and reduce lung disease.

Find out more about lung health, as part of a public lecture series, lectures will take place in Galway and Limerick over the coming days:

Galway – Thursday, 7th November (6.30pm to 8pm) – Croi House, Galway
Limerick - Monday, 11th November(6.30pm to 8pm) – Clarion Hotel, Limerick

The Irish Lung Health Alliance comprises the Alpha One Foundation, the Irish Thoracic Society, Cystic Fibrosis Ireland, the Asthma Society of Ireland, the Irish Sleep Apnoea Trust, COPD Support Ireland, Irish Sarcoidosis Network, Irish Lung Fibrosis Association, Pulmonary Hypertension Ireland, the Irish Cancer Society and ASH Ireland.

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