The relevance of COPD in World Economic Crisis

World COPD Day

The relevance of COPD in World Economic Crisis

Chronic bronchitis and emphysema take a heavy toll on the economy. In 2010, the US national annual cost of COPD was estimated at $49.9 billion by the National Heart, Lung, and Blood Institute.[1]

Healthcare costs, disability, and lost productivity from chronic obstructive pulmonary disease are of vital relevance to business management. The economic burden of chronic pulmonary disease on employers, and why proper management of employees with this progressive condition can save significant costs to the company, while also improving productivity. [2,3]

The COPD X- Ray and Economy

COPD and Economic Burden

Medical costs alone were 3 times greater for employees with this disease than for others. Absenteeism and presenteeism are particularly prevalent to this patient population. Raising awareness to smoking cessation in the workplace and implementing successful incentives to stop smoking, diagnosis COPD and provide early treatment for COPD employees, can greatly improve productivity and reduce costs to employers. [4]

Usually senior management is less interested in the incidence of disease or minor improvements with medication or with vaccine prevention. That is not convincing in terms of making a business decision. But if they know that the cost for an employee with COPD averaged $20,000, as opposed to $8000 for an employee without COPD – or in other words – That they are losing $12,000 per employee because of COPD, this becomes an incentive to do something to stop unnecessary losts at any time, mainly at this current world credit crunch crisis.[2]
Education Math Formula: SMOKING = COPD + PLUS

The interaction of business and regulatory initiatives can help reduce the economic burden of this diseases from the lost of productivity of companies to the soceity that pay its taxes, but mainly for people that have the disease.
And it starts with education about the disease…

Maybe, this could be a relevant message we need to get out to employers, government officials and also to the industrial stakeholders to fight the nowadays economic crisis.

And Maybe the message through the “didactical Math Smoking formula” could help decrease the unknowledge about the tobacco related diseases as expressed in:
Smoking = COPD + Plus [5]

But the most important is to treat the smoking patients with gentle targeting the decrease of the social and economic burden that generates 52 diseases tobacco related, make popular the COPD term, and also save lives.  More than Math, it is priceless!

(*)References:

1.    Lung Association. Trends in COPD (chronic bronchitis and emphysema): morbidity and mortality. February 2010. http://www.lungusa.org/findingcures/our-research/trend-reports/copd-trend-report.pdf.Accessed May 23, 2011.
2. Bunn W, Pikelny D, Vogenberg FR, et al. Validation of employerfocused actuarial model for measuring the economic burden of chronic obstructive pulmonary disease. J Health Productiv. 2008;3:3-8.
3. Halbert RJ, Isonaka S, George D, Igbal A. Interpreting COPD prevalence estimates: what is the true burden of disease? Chest. 2003;123: 1684-1692.
4. Darkow T, Kadlubek PJ, Shah H, et al. A retrospective analysis of disability and its related costs among employees with chronic obstructive pulmonary disease. J Occup Environ Med. 2007;49:22-30.
5. Nascimento, MHS. The Mathematics of Smoking =COPD + Plus. PulmaoSA Website

With all respect,
Marcos Nascimento, MD.
Professor at PUCPR College of Medicine

World COPD day 2011

World COPD DAY 2011

 

World COPD Day is an annual event organized by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) to improve awareness and care of chronic obstructive pulmonary disease (COPD) around the world. World COPD Day 2011 will take place on November 16 around the theme:

“Are you short of breath? You may have COPD! Ask your doctor about a simple breathing test called spirometry.”

 Source:

 PULMAOSANEWS

The Domino Effect: Exposing COPD and Tobacco Risks

The Domino Effect: Exposing COPD and Tobacco Risks

The Domino Effect: Exposing COPD & Tobacco Risks

Marcos Nascimento,MD

The term “domino effect” has been used since the 1950s to describe the potential for political unrest to become contagious, resulting in a chain reaction. The phrase took on special significance during the Vietnam Era, when it was used to propagate the idea that a communist victory in Vietnam might embolden other communists in the region, prompting them to topple their own governments.
Today, we see the same phrase taking on special significance in the Public Health when The Centers for Disease Control (CDC) and Prevention’s National Center for Health Statistics (NCHS) released a report last week, “Deaths: Preliminary Data for 2008,” confirming that Chronic Obstructive Pulmonary Disease (COPD) became the third leading cause of death in the U.S. for 2008.[ it was the 4th death cause].
With this data above, we are confirming 9 years in advance, the WHO’s prediction that it would happen only in 2020!
In a large field of dominoes, a number of domino paths can topple at the same time, and careful placement of the dominos can set off an entirely new chain reaction elsewhere.
So, the Governments and WHO need careful placement of the dominos in:
1) To popularize the Spirometry! A test to make the COPD diagnosis and stop its worsening course- This simple measure would permit treat the majority of COPD patients who does not have the disgnosis.
2) Point to the need for additional resources to target COPD research and interventions;
3)Approach to smoking Control and therapy for smoking cessation that involves the systematic smokers in well-structured programs in health services, with the use of cognitive-behavioral and pharmacological support with multidisciplinary team.
4)Smoking is responsible for causing 50 other diseases besides COPD. The women Lung cancer curve continues high inclined. So, another carefull atention to these domino piece must be urgent because this presents a spillover risk from one domino to another through a so-called trigger provoked by the marketing strategy of tobacco industry.
5) The UN and WHO need to convince some countries as USA and Argentina not only sign but comply with the determinations of the Tobacco Framework Convention Treaty,for the welfare of their own populations and also for the respect with public money.

By putting these pieces of security, we will have the hope and the chance to preserve the pulmonary atmosphere for the today children and for the tomorrow’s citizens.

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Sources:

The Centers for Disease Control (CDC) and Prevention’s National Center for Health Statistics (NCHS)  Report: “Deaths: Preliminary Data for 2008;

PULMAOSANEWS – PULMAOSA- Lungs, Your Atmosphere, Your Life®

Por que o GOLD deve ser considerado moeda corrente? – Why is GOLD considered as a substitute of currency?

Por que o GOLD deve ser considerado moeda corrente ?

Maratona DPOC - COPD E- Marathon 2010

GOLD é a sigla em inglês para Global Obstructive Lung Disease, estudo que resume as diretrizes e classifica a Doença Pulmonar Obstrutiva Crônica (DPOC), proporcionando o direcionamento tanto para o acompanhamento quanto para o tratamento.¹

O Objetivo deste artigo é mostrar o quanto a classificação GOLD pode ser considerada dinheiro vivo, quando é observado o cumprimento de suas diretrizes, fazendo um comparativo entre a sigla e a palavra GOLD que em inglês significa “Ouro.”

Realidade da DPOC no mundo:

As desordens respiratórias são consideradas causas de alta morbidade e mortalidade em todo o mundo. A DPOC é muito freqüente, constitui a quarta causa de mortalidade em todo o mundo, com potencial a ser a terceira causa em 2020 segundo estimativas da Organização Mundial de Saúde (OMS).²

Entre as 5 causas de mortalidade mundial, o DPOC é a única que cresce exponencialmente, e portanto deveria juntamente com o seu principal causador o Tabagismo, serem objetivos- alvo de programas oficiais de saúde pública e privada no mundo inteiro e enfrentados de uma maneira global, conforme artigo publicado recentemente pela PULMÃO S.A.: “ A Fórmula Matemática do Tabagismo”³

No Brasil, segundo o Estudo Platino, a prevalência total da DPOC foi de 15,8%, sendo 18% nos homens e 14% nas mulheres.⁴ A distribuição dos pacientes de acordo com o estádio de gravidade da DPOC e segundo a classificação do GOLD e da SBPT, mostrou os seguintes resultados de prevalência:

Estádio GOLD          Prevalência

I                             10,1%

II                            4,6%

III                           0,9%

IV                           0,2%

O diagnóstico de DPOC deve ser considerado em qualquer indivíduo com tosse, expectoração, ou dispnéia e/ou história de exposição a fatores de risco. A espirometria deve ser considerada na definição diagnóstica dos casos de DPOC visto que outras condições podem apresentar quadro clínico bastante semelhante ao desta condição, como é o caso da asma, da bronquiectasia e da insuficiência cardíaca ⁵

GOLD

A DPOC pode ser classificada pelo GOLD em quatro estádios, de acordo com valores do VEF1( Volume Expiratório Forçado no 1º segundo), obtido pela espirometria:

1. Leve;
2. Moderado;
3. Grave e
4. Muito grave.

DPOC e as Exacerbações:

O DPOC pode evoluir para períodos crises respiratórias ou exacerbações da doença pulmonar obstrutiva crônica, e são geralmente causadas por infecções bacterianas (Streptococcus pneumoniae, Haemophilus influenzae e Moraxella catarrhalis), ou por infecções a vírus.

Na exacerbação da DPOC, os pacientes pioram o quadro clínico acentuando a falta de ar, a fadiga, aumenta a frequência da tosse, ocorrem sibilos (chiados no peito) e há aumento da produção de escarro (secreção).

Nas exacerbações, além de ajuste a maior das doses de medicamentos há chance de internação Hospitalar e nas exacerbações graves, há chance de internação na UTI, dado a evolução para insuficiência respiratória. ⁶

Pacientes com DPOC apresentam, em média, duas exacerbações por ano, com um elevado consumo de fármacos e até 10% requerem hospitalização. As exacerbações são a causa observável de morte mais freqüente em estudos prospectivos.⁷

Urge um controle melhor das exacerbações da DPOC, afinal, 60 a 75% dos gastos com a DPOC são uma conseqüência direta das exacerbações.⁵

Outrossim, é preciso lembrar que quanto maior for o número de exacerbações, maior a velocidade da perda da função pulmonar. ⁸ Além disto,existe uma relação inversa ao número de episódios de exacerbações e ao prognóstico dos pacientes ou seja, quanto maior o número de exacerbações menor serão as chances de sobrevida.

O uso de antibióticos de elevado custo (B lactameros e quinolonas respiratórias) na DPOC está indicado nas exacerbações infecciosas da doença que apresentem pelo menos duas das seguintes manifestações. ⁹

• Aumento do volume da expectoração;
• Mudança do aspecto da expectoração purulenta;
• Aumento da intensidade da dispnéia

A utilização de corticosteróides nas exacerbações é precisa, pois se correlaciona a evitar uma menor perda da função respiratória e, portanto a um melhor prognóstico. E também implica em gastos e riscos já que na grande maioria das vezes se faz uso de corticóides venosos, em detrimento de apresentações orais. De acordo com artigos publicados em junho de 2010 no Journal of American Medical Association, não há diferenças estatísticas nos resultados ao comparar o uso IV com o oral, indicando que doses baixas VO deveriam ser consideradas na abordagem inicial da exacerbação.^10,11

CONCLUSÃO:

O documento GOLD é considerado a Bíblia do DPOC, e leva em consideração o VEF1 como classificador da doença. Mas é absolutamente claro no GOLD que é necessário olhar além do VEF1 para o entendimento da DPOC e o seu adequado tratamento.

É preciso que os formuladores de políticas de Saúde tanto Pública quanto os de seguradoras de saúde privada prestem atenção a outros marcadores definidores do status quo da DPOC, como: escala de dispnéia do MRC (Medical Research Council), variação na oximetria e/ou gasometria arterial, a capacidade de exercício inerente a fisioterapia; e a participação mais efusiva do nutricionista em dietoterapia de manutenção do IMC (índice e massa corpórea), uma vez que a perda de peso pode também estar associada à acentuação dos sintomas, piora da qualidade de vida, tolerância ao exercício e maior utilização de recursos de saúde pública e privada.

Proporcionar ao paciente com DPOC um atendimento que atenda as suas necessidades básicas é a meta!  E quais são elas? Melhora no Questionário de avaliação de São George? Melhora em índices como o VEF1, a CVF, IMC ? Diminuir o número de episódios de exacerbações infecciosas? Indicações precisas de oxigenioterapia? Sim para todos estes parâmetros!

Reparação de Créditos - Credit Repair

E como proporcionar isto?

Inter-relacionando a prevenção e o tratamento do tabagismo, o diagnóstico espirométrico e o tratamento do DPOC, com broncodilatadores de curta e de longa ação anticolinérgicos de curta e o uso precoce dos de longa ação como o Tiotrópio e o ainda não lançado Indacaterol, segundo o GOLD, e ainda  oferecendo vacinas antiinfluenza e anti pneumocócica para os portadores de bronquite crônica e enfisema pulmonar, as interfaces da DPOC, protegendo-os das exacerbações e possibilitando acesso ao nutricionista e ao fisioterapeuta respiratório (que inclusive poderia ajudar no diagnóstico espirométrico).

Com esta logística educacional sendo incorporada ao binômio Saúde-Administração ter-se-ía um melhor entendimento da DPOC.E com isto, um menor número de internações e despesas público-privadas, o que conduziria a um menor gasto associado a ganhos inquestionáveis na qualidade de vida dos pacientes.Em outras palavras, a abordagem adequada do DPOC proporciona uma reparação de créditos quantitativos e qualitativos respectivamente à administração e ao paciente.

O que leva a concluir que a observação do GOLD, como artigo de necessidade primária para o diagnóstico e tratamento da DPOC, deva ser encarada, de fato, como moeda corrente, pelos administradores de recursos de saúde.

Mas é possível que o paciente com DPOC em sua sábia maneira de expressar, queira apenas não estar internado no dia da formatura do seu neto. Muito embora este sentimento queira dizer na linguagem médica exatamente a mesma coisa.

Respeitosamente,

Dr. Marcos Nascimento, MD.

Editor Médico da PULMÃO S.A.- Sua Atmosfera, Sua Vida!

Professor de Pneumologia PUCPR

FONTES:

1.The Global Initiative for Chronic Obstructive Lung Disease (GOLD)

2. Organização Mundial de Saúde (OMS);

3.Nascimento M. A Matemática do tabagismo.Pulmaosa Respiratory Site,2010: Acessado em 20 de junho de 2010.

4. Prevalence of chronic obstructive pulmonary disease and associated factors: the PLATINO Study in São Paulo, Brazil. Cad. Saúde Pública, Rio de Janeiro, 2005; 21(5):1565-1573.

5- Jardim J, Oliveira J, Nascimento O. II Consenso Brasileiro de Doença Pulmonar Obstrutiva Crônica (DPOC). J Bras Pneumol 2004; 30: S1-S42.

6. Rodriguez-Roisin R. Toward a consensus definition for COPD exacerbations. Chest 2000;117:398S-401S.

7. Celli B, Barnes P. Exacerbations of chronic obstructive pulmonary disease. Eur Respir J 2007;29:1224-38.

8. Donaldson GC, Seemungal TA, Bhowmik A, et al. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002;57:847-52.

9– Anthonisen NR, Manfreda J, Warren CPW. Antibiotic therapy in acute exarcebations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106:196-204.

10-Lindenauer PK, et al “Association of corticosteroid dose and route of administration with risk of treatment failure in acute exacerbation of chronic obstructive pulmonary disease” JAMA 2010; 303(23): 2359-67.

11-Krishnan JA, Mularski RA “Acting on comparative effectiveness research in COPD” JAMA 2010; 303(23): 2409-10.

ENGLISH

Why is GOLD considered as a substitute of currency?

 

GOLD is the English acronym for Global Obstructive Lung Disease, a study that summarizes the guidelines and classifies Chronic Obstructive Pulmonary Disease (COPD), providing guidance for both the monitoring and for the treatment.¹
The goal of this paper is to show how the GOLD classification can be considered cash, when we see the fulfillment of its guidelines, making a comparison between the symbol and the word GOLD which in English means “gold.”

Reality of COPD in the world:

Respiratory disorders are considered causes of morbidity and mortality worldwide. COPD is very common, is the fourth leading cause of mortality worldwide, with the potential to be the third leading cause in 2020 according to estimates by the World Health Organization (WHO) .²
Among the five big causes of mortality worldwide, COPD is the only one that grows exponentially, and thus should along with its main cause Tobacco, are the target goals of public programs for public and private health worldwide and tackled in a comprehensive way as recently published article by PULMAOSA: “A Mathematical Formula for Smoking” ³

COPD in Brazil
In Brazil, according to the Platino study, the overall prevalence of COPD was 15.8% and 18% in men and 14% in mulheres.⁴ Patient distribution according to the stage and severity of COPD according to the classification of GOLD and BTS, showed the following results of prevalence:
GOLD stage Prevalence
I 10.1%
II 4.6%
III 0.9%
IV 0.2%

The diagnosis of COPD should be considered in anyone with cough, expectoration, or dyspnea and / or history of exposure to risk factors. Spirometry should be considered in the diagnosis of COPD cases since other conditions can present quite similar to the clinical picture of this condition, such as asthma, bronchiectasis and heart failure. ⁵
COPD can be classified by GOLD in four stages, according to values of FEV1 (Forced Expiratory Volume in 1^st second), obtained by spirometry:
1. Mild;
2. Moderate;
3. Severe and
4. Very severe.

COPD & exacerbations:

The COPD can progress to respiratory crisis periods, or exacerbations of chronic obstructive pulmonary disease, and are usually caused by bacterial infections (Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis), or by viral infections.
COPD exacerbation’s patients worsen the clinical and stressing the shortness of breath, fatigue, increases the frequency of coughing, wheezing occur, and there is increased production of sputum (secretions).

Exacerbation, in addition to setting the highest doses of drugs increase chance of hospitalization and in severe exacerbations, there’s a high chance in ICU hospitalization, since progression to respiratory failure. ⁶
COPD patients, on average, present two exacerbations per year, with a high consumption of drugs, in which 10% require hospitalization. Exacerbations are the greatest cause of death more frequently observed in prospective studies.⁷
So, it claims a better control of  COPD’s exacerbations , after all, 60-75% of spending on COPD are a direct consequence of this condition.⁵

Moreover, we must remember that the greater the number of exacerbations, the greater the speed of loss of lung function. ⁸ Because, there is an inverse relationship to the number of episodes of exacerbation and the prognosis of patients that is, the greater the number of exacerbations lower the chances of survival.

The use of antibiotics in high-cost (B lactamers and respiratory quinolones) in COPD is indicated in infectious exacerbations of their disease at least two of the following events. ⁹
• Increased volume of sputum;
• Change the appearance of purulent sputum;
• Increased intensity of dyspnea.

The use of corticosteroids in exacerbations is accurate, it is correlated with a lower loss of respiratory function and thus a better prognosis. It also entails costs and risks because in most cases it makes use of intravenous steroids, rather than presentations. And that according to articles published in June 2010 in the Journal of American Medical Association, there are no statistical differences in results when comparing the use of IV to oral, indicating that low oral doses should be considered in the initial exacerbation approach.^{10 11}

CONCLUSION

The GOLD document is considered the bible of COPD, and takes into account the FEV1 as a classifier of the disease. But it is absolutely clear in GOLD which is necessary to look beyond the FEV1 to the understanding of COPD and its appropriate treatment.
We need policy makers of both public and private health pay attention to other indicators that define the status quo of COPD, as the MRC dyspnea scale (Medical Research Council), variation in pulse oximetry and /or arterial blood gases, the ability to performance inherent in physical therapy, participation more effusive nutritionist in diet therapy for maintenance of BMI (body mass index and), since weight loss can also be associated with stress symptoms, worse quality of life, exercise tolerance and greater use of public health resources and facilities.

We must provide the patient with COPD, a service that meets their basic needs. And what are they?  An improvement in St. George Questionnaire? An  Improvement in indices such as FEV1, FVC, BMI? Decrease the number of episodes of infectious exacerbations? Precise indications for oxygen?
Yes to all these parameters.

And how to provide this?

Interrelating the prevention and treatment of smoking, the spirometric diagnosis and treatment of COPD; Furnish bronchodilators of short and long-acting; Furnish anticholinergic short and the early use of long acting as Tiotropium and unreleased Indacaterol, according to GOLD, and still offering pneumococcal vaccines and anti antiinfluenza for patients with chronic bronchitis and emphysema, the interfaces of COPD exacerbations, to protect them against infections. Allowing access to nutritionists and respiratory therapy (which physic therapy Professionals could also help in the spirometric diagnosis).
With this logistics education being incorporated into the binomial Health-Administration would have a better understanding of COPD.
And with that, fewer hospitalizations and expenditures public-private partnerships, leading to a lower cost associated with unquestionable gains in quality of life of patients.
This leads one to conclude that the observation of GOLD, as an article of primary necessity for the diagnosis and treatment of COPD. Thereafter, GOLD parameters should be viewed in fact as currency by the administrators of health care resources. In other words, a best approach of COPD provides a credit repair both quantitative and qualitative respectively for the health administration and for the patient.

But it is possible that the COPD  patient in his(her) wise way to express, just say:- “Please I just do not be admitted on the day of graduation of my grandson. And this feeling may mean exactly the same thing,  in medical language.

Respectfully,

Dr. Marcos Nascimento,MD.

Chief Editor of Respiratory Site PULMAOSA- Lungs, Your Atmosphere, your Life! ®

Pulmonology Professor at COM of PUCPR- Curitiba, Brazil

SOURCES:

1.The Global Initiative for Chronic Obstructive Lung Disease (GOLD)

2. Organização Mundial de Saúde (OMS);

3.Nascimento M. A Matemática do tabagismo.Pulmaosa Respiratory Site,2010: Acessado em 20 de junho de 2010.

4. Prevalence of chronic obstructive pulmonary disease and associated factors: the PLATINO Study in São Paulo, Brazil. Cad. Saúde Pública, Rio de Janeiro, 2005; 21(5):1565-1573.

5- Jardim J, Oliveira J, Nascimento O. II Consenso Brasileiro de Doença Pulmonar Obstrutiva Crônica (DPOC). J Bras Pneumol 2004; 30: S1-S42.

6. Rodriguez-Roisin R. Toward a consensus definition for COPD exacerbations. Chest 2000;117:398S-401S.

7. Celli B, Barnes P. Exacerbations of chronic obstructive pulmonary disease. Eur Respir J 2007;29:1224-38.

8. Donaldson GC, Seemungal TA, Bhowmik A, et al. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002;57:847-52.

9– Anthonisen NR, Manfreda J, Warren CPW. Antibiotic therapy in acute exarcebations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106:196-204.

10-Lindenauer PK, et al “Association of corticosteroid dose and route of administration with risk of treatment failure in acute exacerbation of chronic obstructive pulmonary disease” JAMA 2010; 303(23): 2359-67.

11-Krishnan JA, Mularski RA “Acting on comparative effectiveness research in COPD” JAMA 2010; 303(23): 2409-10.

How can I keep my lungs healthy?

LUNGS

How can I keep my lungs healthy?

Your lungs perform an amazing job every day. Function as a large hydroelectric power supplier (read oxygen), for a country (for the whole body).
Healthy lungs provide large amounts of oxygen to the blood and this is what allows you to work, walk, run, play and live well. They also remove carbon dioxide and other gases that your body needs. There are many things you can do to keep your lungs healthy and free of disease:

1. If you smoke, seek help to stop. Today there are several forms of treatments available that will certainly help in this goal. See your doctor and he will be able to guide you.
But if you are a non-smoker, do not start! Smoking is theà       leading cause of serious lung diseases such as lung cancer and chronic obstructive pulmonary disease (COPD). The smoke from cigarettes, cigars and pipes contains over 4,000 harmful chemicals – and about 60 are known to known to cause cancer. The PULMAOSA points out that even if you have smoked for many years, it is never too late to stop and break free. Stop smoking, as well as possible, provides an immense sense of freedom as well as providing you reap the benefits for your health, to be smoke-free. Quitting smoking is not easy because smoking is an addiction. But it is a disease whose main difference is that there are resources available to deal with. A well directed, right drug, right, you can stop smoking in the 1st attempt.
But remember: Seek medical attention! Because without orientation greatly increases the chance of relapse.
2. Avoid smoke:
Secondhand smoke is a complex mixture of chemicals produced by burning tobacco. As active smoking, passive smoking can also cause disease and death. Two thirds of the smoke of a cigarette is not inhaled by the smoker, but spreads through the air around the smoker.
Here are some suggestions you can do to avoid secondhand smoke:

* Do not allow smoking in your home, car or at work.
* Support the restaurants, businesses, and places that are smoke-free.
* Make sure your children are not exposed to passive smoke in schools, nurseries or even with friends or relatives homes.

3.Secondhand smoking is deadly to you and also to your Pets:

If you are a smoker and love your dog, there is one VERY important thing you can do to save your animal’s life and yours too: quit smoking. A growing body of research – including the Surgeon General’s Report – shows there are no safe levels of exposure to secondhand smoke – for humans and for animals.

An estimated 50,000 Americans lose their lives to secondhand smoke (“SHS”) annually and 4 million youth (16 percent) are exposed to secondhand smoke in their homes. A number of studies have indicated that animals, too, face health risks when exposed to the toxins in secondhand smoke, from respiratory problems to allergies and even cancer.

Toxins in secondhand smoke can cause lung and nasal cancer in dogs and malignant lymphoma in cats, along with allergy and respiratory problems in other pets. One recent study shows that nearly 30 percent of pet owners live with at least one smoker – a number far too high given the consequences of exposure to SHS.

So, if you love your annimals and would like to protect them and yourself, look for Medical help and quit smoking!

4. Wash hands properly with soap and water regularly:
It is estimated that the hands are capable of commanding various germs (viruses such as  influenza H1N1, seasonal influenza, adenovirus, bacterias …) can be held responsible for a large percentage of common infectious respiratory diseases such as colds and flu. You can reduce the risk of getting sick, just practicing the act of washing hands. Therefore:

* Always wash your hands before meals, after going to the bathroom, before greeting people, especially children;
* Look to disclose this information at school and at work;
* Use alcohol hand sanitizer when you do not have access to soap and water.

5. Be aware of air pollution and do your part to keep the air clean:
Air pollution can cause health problems, especially for people who have lung diseases. Air pollution can irritate, inflame or destroy lung tissue. Even low levels of air pollution can cause health problems.
There are many things you can do to keep the air clean and healthy:

* Do not let your car engine on while standing and avoid the burning of fuel in enclosed areas, such as garages, or even open.
* Do not use unnecessary pesticides and other chemicals on your lawn and garden.
* Use, where possible, public transportation.
* Seek support laws and initiatives to improve air quality.
* Control moisture in your home: For example, use exhaust fans in bathrooms and kitchens to reduce the excess moisture from these sites, or just the windows abertas.Por other hand, in places whose relative to low, look no a wet towel inside the rooms to sleep. Ideally, try to maintain the relative humidity indoors between 40% and 50%.

* Control dust (especially if you are allergic to animal dander and dust mites) mites grow in mattresses, sofas and chairs with cushions. When possible, try to wash bedding in hot water (at least 54.5 ° C or 130 ° F) to kill dust mites. Keep carpets clean and dry.
* Make sure you are getting lots of fresh air and clean in your home. Open windows when cleaning or when performing painting.

6. Protect yourself from the danger to lung health at work:
People working in certain jobs such as construction and mining have a higher risk of lung diseases, including lung cancer, asthma and COPD. If you work in a place with much dust, asbestos, chemicals, please use Personal Protective Equipment (PPE).

SOURCES:
PULMÃO S. A. Lungs: Your atmosphere, Your Life! ®

Adapted from PHA-Canada

American Legacy Foudation