Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet

May 2014

Mortality

  • COPD is the third leading cause of death in America, claiming the lives of 134,676 Americans in 2010.1

Prevalence

  • In 2011, 12.7 million U.S. adults (aged 18 and over) were estimated to have COPD.2 However, close to 24 million U.S. adults have evidence of impaired lung function, indicating an under diagnosis of COPD.3
  • In 2011, an estimated 10.1 million Americans reported a physician diagnosis of chronic bronchitis. Chronic bronchitis affects people of all ages, although people aged 65 years or more have the highest rate at 64.2 per 1,000 persons.4
  • Of the estimated 4.7 million Americans ever diagnosed with emphysema, 92 percent are 45 or older.5
  • In 2011, COPD prevalence ranged from less than 4 percent in Washington and Minnesota to more than 9 percent in Alabama and Kentucky.6

Gender Differences

  • This is the eleventh consecutive year in which women have exceeded men in the number of deaths attributable to COPD. In 2010, more than 70,000 females died compared to more than 64,000 males.7
  • Women are about twice as likely to be diagnosed with chronic bronchitis as men. In 2011, 3.3 million men (29.6 per 1,000 population) had a diagnosis of chronic bronchitis compared to 6.8 million women (56.7 per 1,000 population).8
  • Historically, men have been more likely than women to receive a diagnosis of emphysema. However, in 2011 more women reported a diagnosis of emphysema than men; 2.6 million (21.4 per 1,000 population) compared to 2.1 million (19.0 per 1,000 population), respectively.9

Causes

  • Smoking is the primary risk factor for COPD. Approximately 80 percent of COPD deaths are caused by smoking. Female smokers are nearly 13 times as likely to die from COPD as women who have never smoked. Male smokers are nearly 12 times as likely to die from COPD as men who have never smoked.10
  • Other risk factors of COPD include exposure to air pollution, secondhand smoke and occupational dusts and chemicals, heredity, a history of childhood respiratory infections and socioeconomic status.11
  • Occupational exposure to certain industrial pollutants also increases the risk for COPD. One study found that the fraction of COPD attributed to work was estimated as 19.2% overall and 31.1% among never smokers.12
  • Alpha1 antitrypsin deficiency-related (AAT) emphysema is caused by the inherited deficiency of a protein called alpha1-antitrypsin (AAT) or alpha1-protease inhibitor. AAT, produced by the liver, is a "lung protector." In the absence of AAT, emphysema is almost inevitable. It is responsible for only 2-3% of the emphysema in the United States.13
  • An estimated 100,000 Americans, primarily of northern European descent, have AAT deficiency emphysema. Another 20 million Americans carry a single deficient gene that causes Alpha-1 and may pass the gene onto their children.14
  • One study suggested that there are at least 116 million carriers among all racial groups, worldwide.15
  • Symptoms of AAT deficiency include shortness of breath and decreased exercise capacity. They rarely appear before 25 years of age and sometimes never develop, mostly in nonsmokers. In those who smoke, symptoms occur between 32 and 41 years of age on average. Smoking significantly increases the severity of emphysema in AAT-deficient individuals.16

Burden

  • An estimated 715,000 hospital discharges were reported in 2010; a discharge rate of 23.2 per 100,000 population. COPD is an important cause of hospitalization in our aged population. Approximately 65% of discharges were in the 65 years and older population in 2010.17
  • A Lung Association survey revealed that half of all COPD patients (51%) say their condition limits their ability to work. It also limits them in normal physical exertion (70%), household chores (56%), social activities (53%), sleeping (50%) and family activities (46%).18
  • In 2010, the cost to the nation for COPD was projected to be approximately $49.9 billion, including $29.5 billion in direct health care expenditures, $8.0 billion in indirect morbidity costs and $12.4 billion in indirect mortality costs.18

For more information on COPD, please review the COPD Morbidity and Mortality Trend Report in the Data and Statistics section of our website at www.lung.org or call the American Lung Association at 1-800-LUNG-USA (1-800-586-4872).

Sources:


1. Centers for Disease Control and Prevention. National Center for Health Statistics. National Vital Statistics Report. Deaths: Final Data for 2010. May 2013; 61(04).
2. Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey Raw Data, 2011. Analysis performed by the American Lung Association Research and Health Education Division using SPSS and SUDAAN software.
3. Centers for Disease Control and Prevention. Chronic Obstructive Pulmonary Disease Surveillance – United States, 1971-2000. Morbidity and Mortality Weekly Report. August 2, 2002; 51(SS06):1-16.
4. Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey Raw Data, 2011. Analysis performed by the American Lung Association Research and Health Education Division using SPSS and SUDAAN software.
5. Ibid.
6. Centers for Disease Control and Prevention. National Center for Health Statistics. Behavioral Risk Factor Surveillance System raw data, 2011. Analysis performed by the American Lung Association Research and Health Education Division using SPSS and SUDAAN software.
7. Centers for Disease Control and Prevention. National Center for Health Statistics. National Vital Statistics Report. Deaths: Final Data for 2010. May 2013; 61(04).
8. Centers for Disease Control and Prevention. National Center for Health Statistics: National Health Interview Survey Raw Data, 2011. Analysis performed by the American Lung Association Research and Health Education Division using SPSS and SUDAAN software.
9. Ibid.
10. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014.
11. Global Initiative for Chronic Obstructive Pulmonary Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease, Updated 2011.
12. Hnizdo E, Sullivan, PA, Bang KM and Wagner G. Association between COPD and Employment by Industry and Occupation in the US Population: A Study of Data from the Third National Health and Nutrition Examination Survey. American Journal of Epidemiology. 2002; 156:738-45.
13. American Thoracic Society. Standards for the Diagnosis and Management of Individuals with Alpha-1 Antitrypsin Deficiency. American Journal of Respiratory and Critical Care Medicine. 2003; 168:818-900.
14. Alpha-1 Foundation. What is Alpha-1? 2012.
15. de Serres FJ. Worldwide Racial and Ethnic Distribution of 1-Antitrypsin Deficiency: Summary of an Analysis of Published Genetic Epidemiologic Surveys. Chest. 2002; 122:1818-29.
16. American Thoracic Society. Standards for the Diagnosis and Management of Individuals with Alpha-1 Antitrypsin Deficiency. American Journal of Respiratory and Critical Care Medicine. 2003; 168:818-900.
17. Centers for Disease Control and Prevention. National Center for Health Statistics. National Hospital Discharge Survey raw data, 2010. Analysis performed by the American Lung Association Research and Health Education Division using SPSS software.
18. Confronting COPD in America, 2000. Schulman, Ronca and Bucuvalas, Inc. (SRBI) Funded by Glaxo Smith Kline.
19. U.S. Department of Health and Human Services. National Institutes of Health. National Heart Lung and Blood Institute. Morbidity and Mortality: 2009 Chartbook on Cardiovascular, Lung and Blood Diseases.