Original Article

Mortality from Chronic Obstructive Pulmonary Disease Among Adults Aged 25 Years or Older in North Carolina

Authors: David W. Brown, DSc, MScPH, MSc, Roy A. Pleasants, PharmD

Abstract

Objectives: Recent reports highlight variation in the burden of chronic obstructive pulmonary disease (COPD) mortality across the United States. This report describes COPD mortality in North Carolina (NC).


Methods: Data on COPD deaths were obtained from the National Vital Statistics System. COPD deaths were identified using International Classification of Diseases (ICD)-9 codes 490, 491, 492, and 496 for 1980–1998, and ICD-10 codes J40, J41, J42, J43, and J44 for 1999–2006. Death rates (per 100,000 population) were computed by dividing the number of COPD deaths by midyear population estimates, using the 2000 US standard population aged ≥25 years for direct age standardization.


Results: During 2000–2006, COPD was the underlying cause of death for more than 25,000 persons aged ≥25 years in NC (12,478 women, 12,991 men). Death rates per 100,000 population increased with age, and age-adjusted mortality rates were greater among men (91.7; 95% confidence interval, 90.1–93.4) than women (56.2; 55.2–57.1), and among whites (75.0; 74.1–76.0) than blacks (42.5; 40.8–44.2). From 1980–2006, the COPD death rate among women increased from 12.9 to 59.1 per 100,000 population, while the rate for men increased from 72.9 to 83.7 per 100,000 population.


Conclusion: The findings in this report indicate an increased burden of COPD among persons aged ≥25 years in NC from 1980–2006, with differences in mortality patterns for men and women. Continued attention is needed to improve public recognition of COPD as a public health problem and to increase awareness of COPD symptoms. In addition, routine collection of state-based COPD prevalence data over time is needed to further understand the burden of COPD.

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References

1. Centers for Disease Control and Prevention (CDC). Death from chronic obstructive pulmonary disease—United States, 2000–2005. MMWR Morb Mortal Wkly Rep 2008;57:1229–1232.
 
2. Centers for Disease Control and Prevention (CDC). State-specific prevalence and trends in adult cigarette smoking—United States, 1998–2007. MMWR 2009;58:221–226.
 
3. Centers for Disease Control and Prevention (CDC). State-specific smoking-attributable mortality and years of potential life lost—United States, 2000–2004. MMWR Morb Mortal Wkly Rep 2009;58:29–33.
 
4. Mannino DM, Homa DM, Akinbami LJ, et al. Chronic obstructive pulmonary disease surveillance—United States, 1971–2000. MMWR Surveill Summ 2002;51:1–16.
 
5. Shopland DR. Tobacco use and its contribution to early cancer mortality with a special emphasis on cigarette smoking. Environ Health Perspect 1995;103(suppl 8):131–142.
 
6. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for diagnosis, management, and prevention of COPD. Available at: http://www.goldcopd.org. Accessed March 30, 2010.
 
7. Matheson MC, Benke G, Raven J, et al. Biological dust exposure in the workplace is a risk factor for chronic obstructive pulmonary disease. Thorax 2005;60:645–651.
 
8. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Data. Atlanta, US Department of Health and Human Services, Centers for Disease Control and Prevention, 2000–2009.
 
9. Blanc PD, Eisner MD, Earnest G, et al. Further exploration of the links between occupational exposure and chronic obstructive pulmonary disease. J Occup Environ Med 2009;51:804–810.
 
10. Balmes J, Becklake M, Blanc P, et al; Environmental and Occupational Health Assembly, American Thoracic Society. American Thoracic Society statement: occupational contribution to the burden of airway disease. Am J Respir Crit Care Med 2003;167:787–797.
 
11. Drummond Wise RA, John M, et al. Accuracy of death certificates in COPD: analysis from the TORCH Trial. COPD 2010;7:179–185.
 
12. Pleasants R, Donohue J, Liao W, et al. A survey of the prevalence and impact of COPD in NC [abstract]. Am J Respir Crit Care Med 2009;179:A4528.
 
13. Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006;27:397–412.
 
14. O'Donnell DE, Aaron S, Bourbeau J, et al. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease—2007 update. Can Respir J 2007;14(suppl B):5B–32B.