Chronic Obstructive Pulmonary Disease in Middle East and UAE: An Unrecognized Underestimated Epidemic

Abstract

Abbreviations: COPD, chronic obstructive pulmonary disease; GOLD, global initiative for chronic obstructive lung disease; α1-AT, αlpha1-antitrypsin deficiency; CAT, COPD assessment test IntroductionChronic Obstructive Pulmonary Disease (COPD) is defined by the Global initiative for chronic Obstructive Lung Disease (GOLD) as "a common preventable and treatable disease characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases". 1COPD is a leading cause of morbidity and mortality worldwide. In 2001, the Global Burden of Disease project identified COPD as the sixth leading cause of mortality in middle-or low income countries accounting for 4.9% of total deaths. 2 According to the latest WHO estimates (2004), currently 64million people have COPD and 3million people died of COPD 3 WHO predicts that COPD will become the third leading cause of death worldwide by 2030.Another study in USA, identified COPD as the fourth leading cause of chronic morbidity and mortality 4 and continue to rise steadily, Although around 90% of deaths due to COPD occur in low-or middleincome countries, scarce data are available in these countries on the prevalence of COPD .Although COPD is not a curable disease, elimination or reduction of risk factors can prevent the development or slow down the progression of the disease. The main risk factors for the development of COPD are cigarette smoking, exposure to air pollutants resulting from the burning of wood or other biomass fuels, tuberculosis, occupational exposures and increasing age. 5 The increase in prevalence of COPD is directly related to the increase in prevalence of smoking worldwide, particularly among women and adolescents.Purpose of this review article is to present the current status of smoking and prevalence of COPD and its consequences in UAE along with comparison with GCC countries. Discussion Tobacco smokingA global pandemic: Smoking is a major risk factor for development of COPD than other types of tobacco, and may be predictive of COPD morbidity and mortality with all the adverse consequences.As per WHO (2008) tobacco caused one in ten deaths in adults worldwide, corresponding to a total of fivemillion deaths per year. 6In 2000, the estimated rate of mortality attributable to smoking in the adult population (aged >30years) was 19% in industrialized countries and 9% in developing countries. 7 Moreover, it has been estimated that the tobacco epidemic may kill one in six adults corresponding to 10million people annually in the next 20-30years, with 70-80% of these deaths occurring in developing countries. primarily focus on cigarettes, many people in developing regions smoke tobacco using water-pipes 9 which also increases the risk of COPD, lung cancer & other respiratory problems.10 The nicotine exposure from daily water-pipe use was estimated to be equivalent to smoking 20 cigarettes/day 11 and water pipe smokers report features of depe...