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Chronic respiratory diseases

    Overview

    Chronic respiratory diseases (CRDs) affect the airways and other structures of the lungs. Some of the most common are chronic obstructive pulmonary disease (COPD), asthma, occupational lung diseases and pulmonary hypertension. In addition to tobacco smoke, other risk factors include air pollution, occupational chemicals and dusts, and frequent lower respiratory infections during childhood. CRDs are not curable; however, various forms of treatment that help open the air passages and improve shortness of breath can help control symptoms and improve daily  life for people living with these conditions. The WHO Global Alliance against CRDs (GARD) vision is “a world in which all people breathe freely”. GARD focuses on the needs of people with CRDs in low- and middle-income countries.

    The aim of the WHO Chronic Respiratory Diseases Programme is to support Member States in their efforts to reduce the toll of morbidity, disability and premature mortality related to chronic respiratory diseases, specifically asthma and chronic obstructive pulmonary disease.

    Symptoms

    The two most common chronic respiratory diseases are asthma and chronic obstructive pulmonary disease (COPD). These both affect the airways in the lungs.

    Asthma is characterized by recurrent attacks of breathlessness and wheezing due to airway narrowing, which vary in severity and frequency from person to person. Symptoms may occur several times in a day or week in affected individuals, and for some people become worse during physical activity or at night. Asthma is the most common chronic disease among children. 

    In asthma, the airway obstruction is reversible with inhaled medicines, but in COPD it is mostly fixed. COPD only affects adults and usually becomes worse with time. The most common symptoms of COPD are breathlessness or a need for air, sputum production and a chronic cough. 

    Risk factors for chronic respiratory diseases include tobacco smoking (including second-hand smoke), air pollution, allergens and occupational risks. Outdoor air pollution and indoor air pollution (often caused by cooking with solid fuels) are also common causes. 

    Asthma and COPD may be prevented by reducing or avoiding exposure to these risk factors.

    Treatments

    Neither asthma nor chronic obstructive pulmonary disease (COPD) can be cured but treatment can reduce symptoms, prevent deterioration and improve daily life.  

    During attacks of breathlessness caused by airway narrowing, inhaled medicines (bronchodilators) can open the airways and relieve symptoms. If untreated, severe attacks can lead to death.

    Appropriate management of asthma with inhaled corticosteroid medicine can control the progression of the disease and reduce deaths. Long-term treatment is required for people with persistent symptoms and exposures which trigger symptoms (e.g. smoke, fumes, dust, grass and tree pollen, animal fur and feathers) should be avoided.  

    Chronic obstructive pulmonary disease is confirmed by a spirometry test, which measures how much and how quickly a person can blow air out of their lungs. Symptoms can be treated through medical and physical treatments; however, with COPD in people who smoke tobacco, the most effective treatment available is to stop smoking. This can slow down the progression of the disease and decrease COPD-related deaths. In specific cases, people may benefit from using inhaled corticosteroid medicines. 

    Publications

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    Toolkit for developing a multisectoral action plan for noncommunicable diseases: module 2: establishing stakeholder engagement and governance mechanisms

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