EPID 624 - Epidemiology of Chronic Diseases- Spring 2018


Asthma and COPD

Review Chapter 15 in the required Text and as usual review figure 15.1 and look at the causes and risks and consider how they relate to similar diagrams in the other topics. Look at the definitions for predecessors and their role in COPD, look at figure 15.2. Review the section on descriptive epidemiology. Where are patients with asthma found, consider whether and where translational research might be appropriate. When doing this think about the difference of individual disease from that seen in the hospital, and the populations with the disease is usually seen in the community. Which of the various environmental factors you think are most important in development of asthma, and whether these factors more important for children or adults. Look at examples of evidence-based intervention and suggestions for future research. Remember that we discussed COPD in the session on tobacco. Look at the information that has been gleaned from the NHANES studies and consider the modifiable risk factors. Then consider cystic fibrosis and wether you see a role for adding intervention for this condition pre or perinatally   When considering occupational lung disease, ( mainly pneumoconiosis) we discuss asbestosis, byssinosis, or silicosis, and consider how occupational asthma relates to asthma generally. Read this editorial in the August 2012 issue of the Lancet. When you get to the end of the readings on this week's topic, take another look at this editorial and consider whether it would change your thinking from the first reading. This seminar on Asthma from the Lancet, in fall 2013, provides current thinking about epidemiology and treatment of asthma. It is also worth thinking about the occurrence of COPD and asthma in the same person at the same time.

Student PowerPoint Slides

Skeleton of the lung Published by the BMJ


British Medical Journal Publishing Group BMJ 2015;351:bmj.h6335


In Asthma Fast Stats look at the More Data section, consider the issues of asthma in both children and adults. Also look at the CDCs webpage on asthma.
CDC's National Asthma Control Program, also look at 'Triggers' link in the Basic information on "what causes asthma". Look at each of the links under this title "2010 At A Glance", particularly future directions, and note that there are no funded projects in Virginia. also look at the interventions particularly the ones labeled potentially effective.also look at the link on air pollution respiratory health and consider the environmental hazards for asthmatics. look at the web page on helping those with asthma. Have been a number of observations over the years that both acute and chronic disease are reduced when one is less hygienic. Look at the possible role of growing up on a farm where hygiene is not always great, in this report on food allergy.

Then look at  COPD and determine what the commonalities are between the two (Be sure to visit each of the links on the upper left side of the page). look at the data for COPD in Virginia by clicking on VA on the map.  Can Asthma and COPD exist together? Look at the links on prevention & cause for both conditions.  Look at incidence of COPD and consider how it contributes to morbidity, especially in older ages, Look at this paper on integration of care. Look at the Data on asthma Surveillance. In particular look at the slidce set on prevalence data (slides5-15). What does this tell you about asthma? Examine the data and surveillance activities conducted and consider why we need to know about these and how they can relieve the burden of the problem. How about the cost of care? Limitation of function among those with COPD
How effective do you think the intervention programs will be? Are they primary or secondary prevention?  Do they focus on individuals or populations?
Examine the NIH Lung diseases site. Look at all the information available on asthma and on COPD, including the Guidelines documents, then focus on research issues (Unfortunate that data from an NIH is almost 10 years old, this is a problem with much of government data which is not kept current, but is all we have.).
What does recent research (click on the what's new link) from CDC add to our knowledge of prevention?

Have you thought of the relation of diet to COPD? See this interesting article (the summary), Couldn't this conclusion be applied to any disease, that a better diet is associated with better health?

How would you expect the current research foci of the NIH to assist in prevention or diminution of Asthma?
What additional information can learn about preventive interventions, primary & secondary  from the American Asthma  Foundation? (see links at left)

It may be of more interest in preventing asthma to consider the idea of the hygiene hypothesis, where people are so scared of getting sick they don't like to be involved with animals or environment outside the city, in case they harm, look at article 1 and article 2 on farming and asthma prevention.

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