Burden of lung diseases in India likely much higher than Lancet study's projection: Doctors

Indian doctors have expressed concerns that the burden of lung-related disorders in the country may be higher than projected by a recent Lancet study, due to high levels of air pollution and tobacco consumption. According to the study published in May, ischaemic heart disease will continue to be the leading cause of death around the world, followed by stroke, diabetes and chronic obstructive pulmonary disease (COPD). In ischaemic heart disease, narrowing of vessels in the organ reduces blood flow.

The study projected that men and women around the world could live longer by up to five and four years, respectively.

“It is going to remain the number one killer and disabling disease with continued bad lifestyle and increasing stress. Yet, there is a lack of understanding of the exact mechanism of formation of these blockages (in the heart’s blood vessels). Till we understand the mechanism, the solutions cannot be found,” said Dr Atul Mathur, Executive Director, Interventional Cardiology and Chief of Cath Lab, Fortis Escorts Heart Institute, New Delhi.

However, the doctors also cautioned that the overall chest disease burden in India will be much higher than what the study predicts, owing to continuing earlier challenges of infectious diseases, along with air pollution and smoking.

“This is because we continue to struggle with the earlier problems of infectious diseases, including tuberculosis. On the other hand, we have started seeing a massive increase in new age diseases like lung cancer,” said Dr Arvind Kumar, Chairman, Institute of Chest Surgery, Chest Onco Surgery and Lung Transplantation, Medanta Hospital, Gurugram.

High levels of air pollution and tobacco consumption could be reasons why COPD would be one of the top leading causes of mortality, according to Dr. Lancelot Pinto, Consultant Pulmonologist and Epidemiologist, P. D. Hinduja Hospital and Medical Research Centre, Mumbai.

“Air pollution, use of indoor biomass fuels and poor lung development in childhood are all significant risk factors for the disease, and unless we take preventive health more seriously, our health systems will not be able to cope with the huge burden of the disease,” said Pinto.

“As life expectancy (is expected to) increase, our overall exposure to various agents causing COPD, will also increase. Smoking, despite all efforts, still continues to be rampant and it is the number one contributor to COPD,” said Kumar.

“We need to remember that the (current) median age of the Indian population is under 30. COPD, which is related to smoking, usually manifests later in life, and so what we experience (presently) is likely to be the tip of the iceberg,” said Pinto.