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TAP Portugal

 

TAP Portugal will provide additional oxygen and allow the use of portable oxygen concentrators on board their aircraft. You will need to fill out an INCAD (Incapacitated Passengers Handling Advice) form and submit it at least 1 week in advance of your flight.

 

SATA International

SATA International does not allow you to bring your own oxygen on board their aircraft. However, they will provide this at an additional charge of €70 or €100 depending on the length of the journey. This can be administered at a flow rate of 2 or 4 litres per minute and must be ordered at the time of booking. You will require a MEDIF form completed by your doctor.

 

Smaller Airlines

For the latest information on the smaller airlines please use the contact details below.

EuroAtlantic Airways

EuroAtlantic Airways do not provide medical oxygen but will allow you to take your own oxygen provisions on board their aircraft. Medical authorisation is required and can be sorted at the time of booking.

 

Hifly

 

Hifly does not allow you to take your own oxygen on board their aircraft. However, they will provide this service at an additional charge (depending on your destination). You must make a request at least 10 days prior to your flight and complete a medical form, signed by your doctor.

 

Luzair

 

Tel: +351 21 465 87 10

 

Orbest

 

Online Contact Form

All links

The ELF has carefully selected websites on lung health and related issues from around Europe and internationally.

Select a topic below to access a list of top quality websites that are arranged in countries. You will be able to find reliable lung health information in your native language.

All of these links have been read and reviewed by experts in the appropriate field from the ERS.

General links

General lung

Disease links

Asthma

COPD

Lung cancer

Tuberculosis

Cystic fibrosis

Sleep apnoea

Risk factor links

 

Tobacco

Environment

Diet and nutrition

David P. Breen

Update April 2007

So, another month has been completed with plenty of procedures – pleural and endoscopic and ongoing research. As promised, this month I would like to write about my research activities in Marseille. Of course, the primary aim of the fellowship is to obtain training and become expert in the field of Interventional Pulmonology and Thoracoscopy and as can be seen in my previous reports, this aspect of my year is progressing very well.
However, it is essential for me to obtain an academic C.V. to improve my chances of obtaining a good consultants post in Ireland. Therefore I must aim to publish research and articles and with this in mind I have been working on 3 separate areas of research with the various teams in Marseille.
These are as follows:

1. Research in the field of interventional pulmonology (I.P.)
2. Research in the field of pleural diseases and
3. Oncological research.

I would like to present the papers that have been accepted to date. There are a number of other papers that have been submitted and I will highlight these in future reports, if and when they are accepted to journals. To date, I have 2 papers accepted and 1 paper has had the reviewers’ comments addressed and revised and hopefully will be accepted for publication soon. One paper is now indexed on Pubmed. These papers are as follows:

1. Results and impact of routine assessment of co-morbidity in elderly NSCLC patients over 80 years

David Breen1,2, MD, Fabrice Barlési1, MD, PhD, Myriam Zemerli1, MD, Christophe Doddoli3, MD, Jean-Philippe Torre4, MD, Pascal Thomas3, MD, Philippe Astoul1, MD, PhD.
To be published in Clinical Lung Cancer
2. A Rare Cause of an Endobronchial Tumour in Children:
The role of interventional bronchoscopy in the diagnosis and treatment of tumours while preserving anatomy and lung function

David P. Breen, Jean-Christophe Dubusb, Marie-José Payanc, Hervé Dutaua*
To be published in Respiration.

I also have two other papers submitted, one in interventional pulmonology and one in oncology and we are awaiting the reviewers’ comments on these papers. I am also working on a review article and a case report in the area of oncology and I will also be performing basic research in this area.
In addition, I have two ongoing projects in the field of pleural disease and thoracoscopy. I also hope to perform further research and obtain further publications with Dr. H. Dutau in the area of I.P.

As can be seen from the above, Professor P. Astoul and Dr H. Dutau and their respective teams have put in place a very active programme of research that will strengthen my C.V. and greatly assist me in interviews in the near future. This, in conjunction with my ongoing training in I.P. and Thoracoscopy is ensuring that the year is both very busy but fruitful.

Update March 2007

I have decided to postpone the report on my research until next month. In this report, I would like to write about a week I spent in Brescia, Italy learning Pleural Ultrasound.

I believe that procedures should be made as safe as possible. With regards to pleural procedures- for example, pleural puncture, chest drain insertion and Thoracoscopy, these can be made safer and more successful with the use of pleural ultrasound. This is in effect, a technique to examine the pleural space non-invasively prior to performing a pleural intervention. With ultrasound, pleural fluid can be identified with ease and the best site for pleural puncture can be chosen. Therefore, this adds a greater level of safety and success to the procedure and, in turn, reduces the risk of damage to the lung or other neighbouring structures.

I arranged this week in Brescia with Dr GF Tassi whom I met in Marseille when he attended to lecture at the Thoracoscopy course in December 2006. He invited me to attend his unit for training. I received a very warm welcome and spent a very productive week in the unit under the supervision of Dr Tassi and Dr GP Marchetti. During the week, I learned the theory and application of pleural ultrasound in a number of clinical conditions including pleural infection and empyema, malignancy and thoracentesis. I performed ultrasound on cases each day and all this has enabled me to learn the procedure. Dr Tassi and his team provided me with many presentations and articles on topics in pleural medicine which will be invaluable to me. I also had many very interesting discussions on the subject of pleural diseases with Dr Tassi and the history of pleural disease, thoracoscopy and application of Ultrasound with Dr Marchetti.

Of course, this week in Brescia would not have been possible without the prior meeting with Dr Tassi in Marseille and therefore it is thanks to the ERS/ELF fellowship that I could go to Italy for this training. I would again like to extend my thanks to the ERS/ELF both for the opportunity to meet European leaders in the field of pleural disease and interventional bronchoscopy and for the ongoing funding that covers my training in Marseille and the cost of the trip to Brescia.

One of the hidden gains of the fellowship is the interaction with doctors from around the globe who attend Marseille for training and to lecture at the various courses. This provides a great opportunity to learn from the leaders in the field and to share ideas with them. The fellowship is not just about learning and training but provides to a physician in the early stages of his/her career an amazing chance to meet the experts in a relatively informal environment and to build up a personal network of friends in the speciality.

I would like to thank all the staff in Brescia especially Drs Tassi and Marchetti for their great welcome, hospitality and teaching during my week in their unit. I have learned a new procedure that will be invaluable to me in my future work and it will make pleural procedures safer for my patients.

Finally, I will lecture at the ERS Thoracoscopy course in Marseille which is running from the 3rd to the 6th of April. I am looking forward to these lectures as I believe that providing training and knowledge to others is an essential component of medicine. It also is rewarding to me as it shows to me that I have learned a huge amount during the first 6 months of my fellowship here.

Next month, I will return to the schedule of these reports and write about my research projects in Marseille.

Update: February 2007

I am now in the fifth month of a combined clinical and research fellowship in Marseille. I believe that my training is proceeding very well. This month I would like to provide some more details of the clinical work that I am performing and in my report next month I will concentrate on the research component of my fellowship.

There is a daily list of procedures in the endoscopy unit of the hospital. These range from pleural procedures such as pleural aspiration and thoracoscopy to bronchoscopic procedures. These include flexible bronchoscopy, autofluorescence, endobronchial ultrasound and rigid bronchoscopy, mechanical debulking, laser and stent placement. All these procedures have different roles in benign and malignant diseases.

In Ireland, I have trained and become proficient in flexible bronchoscopy and related procedures. Therefore, the aim of the fellowship from a clinical viewpoint was to gain experience and knowledge in rigid bronchoscopic procedures and techniques. I have learnt the necessary theory through various sources. As I stated in my last report, I attended the interventional bronchoscopy course in Marseille in October 2006 when I commenced my fellowship. This provided me with a lot of essential background knowledge of interventional bronchoscopy. Secondly, I have gained experience through discussion with the staff in the unit (both doctors and nurses) and by watching the medical staff perform the various procedures. It is an essential component of training in interventional bronchoscopy to observe the staff during procedures. This is for a number of reasons: it is necessary to learn how to hold the scope, what hand movements are necessary for various manoeuvres and how to use and effectively work a number of instruments at the one time. I have now watched a large number of procedures and I have learned a vast amount from this. Interventional bronchoscopy has a major role to play in both benign and malignant disease and I now have an understanding of its role in these settings.

I feel I have become part of the endoscopy team and I have performed procedures under the supervision of Dr Hervé Dutau. These procedures include, to date, rigid intubation (I have performed approximately 50 intubations) – the ERS/ATS guidelines state that 20 supervised intubations are necessary before attempting the procedure alone. I have also placed and removed stents, dilated with the rigid scope and performed laser. I feel that I am becoming proficient in performing these procedures and I still have 7 months of training left!

With regard to thoracoscopy, I have performed approximately 20 procedures to date. In some of these cases, I have been assisting and in the remainder I have been the primary operator. These procedures have been under the supervision of Professor P. Astoul and Dr. A. Fraticelli. As with interventional bronchoscopy, I have obtained the background theory and knowledge from the medical thoracoscopy course held in Marseille in December 2006. I attended and lectured at this course and there is another course scheduled for April which I will also lecture and demonstrate at. I have an understanding of the indications, contra-indications and complications associated with this procedure. During these procedures, I have induced pneumothorax, examined the pleural space, performed biopsies and talc pleurodesis.

In addition, I have performed pleural punctures for therapeutic and diagnostic purposes and I have observed the placement of Denver PleurX catheters, which have a small but important role in the management of malignant pleural disease that has not been controlled by talc pleurodesis.
I feel that the clinical component of my fellowship is proceeding very well and indeed, it is better than my expectations. I have learned both the theory and practice of multiple new procedures that will assist me in my clinical practice in Ireland and will benefit the lives of my patients.
Next month, I will discuss the research component of my fellowship and provide details of forthcoming publications. I will also discuss in future reports the precise role of these procedures in a variety of benign and malignant diseases.

 

 

 

 

 

 

 

 

 

 

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First report

Firstly, I would like to thank the ERS/ELF for selecting my project for receipt of a fellowship. It is a great honour and has provided me with a wonderful opportunity to advance my knowledge and to learn new procedures for the diagnosis and treatment of respiratory diseases.

I have been training in respiratory medicine in Ireland for the last 5 years. Prior to coming to France, I was working in the Department of Respiratory Medicine, CResT Directorate, St. James’s Hospital, Dublin, Ireland. It was in this post that I have developed a particular interest in lung cancer.

I became aware that there was a huge need for Interventional Pulmonology services in Ireland as at present the majority of bronchoscopy is diagnostic with minimal therapeutic procedures been performed. I researched centres in Europe that could provide training in this field and I came to the conclusion that the service in Marseille was both a pioneer and a continuing leader in interventional bronchoscopy and Thoracoscopy. My supervisor, Dr. Finbarr O’Connell and I made contact with Professor Astoul and with their support I applied for the fellowship.

I commenced my fellowship on the 1st October 2006 and I will spend one year in Marseille. The principal aim of my year in the Hôpital St Marguerite is to become proficient in interventional bronchoscopy and Thoracoscopy and to perform research in these fields.

I have been given a very warm welcome by all the staff in the departments of Pulmonary Disease and Thoracic Oncology (the service of Professor Astoul) and the Thoracic Endoscopy Unit (the service of Dr. Hervé Dutau) at Hôpital St Marguerite. My timetable is very structured involving both clinical work and research. During the morning, I have an active role in the endoscopy unit where I am learning rigid bronchoscopy and Thoracoscopy. I have performed both of these procedures under the guidance of my supervisors and I am becoming more comfortable with these techniques. Importantly, I am also learning the associated theory, in particular indications, risks and benefits etc.

Over the last four months I have been involved in many very interesting cases and have seen the benefit interventional bronchoscopy procedures can provide patients both with benign and malignant disease.  With regard to thoracoscopy, I have learned the crucial role that this procedure has in the work up of undiagnosed pleural effusions. I am obtaining experience in mesothelioma, a disease that I had minimal experience of in Ireland.

I have attended an Interventional Bronchoscopy Course shortly after my arrival in October. I have also attended and lectured at the Medical Thoracoscopy Course,(European School Of Respiratory Medicine Course under the auspices of the ERS), in December.

In the afternoons, I have an active research programme both in lung cancer and pleural diseases (Dr. Fabrice Barlési, Dr Anne Fraticelli and Professor Astoul) and Interventional Bronchoscopy (Dr. Hervé Dutau) and this component of my fellowship is proceeding very well.

Next month, I will discuss further aspects of my clinical work and in particular I will provide more details of this ongoing research.

EU action

Our health is influenced by a variety of factors, but environment pollutants influence around 25 to 33% of these problems.

The 6th Environmental Action Plan (EAP)

The EU adopted, in 2002, the 6th Environmental Action Plan (EAP), a new environmental strategy that outlines the priorities for action on the environment in the coming years.  ‘Environment 2010: Our future, our choices’ sets up four main priority areas for action:

  • climate change
  • nature and bio-diversity
  • environment and health
  • sustainable use of natural resources and waste

It also seeks ways to involve citizens and relevant stakeholders in the process of policy making and to make decisions on the basis of sound science.

Seven thematic EU strategies

To tackle more specific environmental problems in the most cost-effective way, the EU will also adopt seven thematic strategies:

  1. Air Pollution
  2. Prevention and Recycling of Waste
  3. Protection and Conservation of the Marine Environment
  4. Soil
  5. Sustainable Use of Pesticides
  6. Sustainable Use of Resources
  7. Urban Environment

Each strategy will be founded on thorough research and science, and will set clear environmental objectives to be achieved by 2020.

Children’s Environment and Health Action Plan for Europe (CEHAPE)

The World Health Organisation (WHO) adopted in May 2004, at the fourth Ministerial Conference on Environment and Health, the Children’s Environment and Health Action Plan for Europe (CEHAPE). This plan sets concrete measures to reduce the impact on children’s health of air pollution, water, chemicals and injuries. CEHAPE will be implemented through National Children’s Environment and Health Action Plans.
As a response to this conference, the European Commission published its Environment and Health Action Plan 2004-2010. The EU plan was received with some disappointment as no concrete actions were proposed. It was also criticised for its lack of positive actions in the face of scientific evidence. Progress on implementation is being reported to a Consultative Forum set up by the Commission.

5th Framework Programme for Research

Research to establish the effects of environmental pollution and health has also been encouraged by the EU. Under its 5th Framework Programme for Research, the European Community funded projects to study the links between air pollution and ill-health.

Directorate General for the Environment website

The European Commission – Directorate General for the Environment, started a new service to improve the dissemination of research results and to reinforce the links between science and policy.  Policy makers and general public can now learn more about the environment and research by visiting the new website.

Outdoor air pollution

Outdoor air pollution has been related to adverse respiratory effects since the 1930s.
The project “Air Pollution and Health: a European Approach” (APHEA 1996) has confirmed that air pollution increases daily cardiorespiratory mortality.

Particulate matter

Increases in the concentration of particulate matter in the air are linked to an increase in the risk of death from respiratory diseases. Increases in the concentration of particulate matter, black smoke and sulphur dioxide in the air are associated with emergency hospital admissions.

Deaths from outdoor pollution

A study published in 2000 and carried out in three countries (Austria, France and Switzerland) concluded that outdoor pollution was the cause of 6% of the total number of deaths in these countries.

Environment links

The links on this page will take you to recommended sites that have useful information on all aspects of the environment.

EEN – EPHA Environment Network

EPHA Environment Network is an international non-governmental organisation advocating greater protection of the environment as a means to improving the health and well being of European citizens.

 

EPHA – European Public Health Alliance

The European Public Health Alliance (EPHA) represents over 100 non-governmental and other not-for-profit organisations working on public health in Europe.

 

 

WHO – World Health Organization

WHO Regional Office

 

British swine flu advice service to go live

British Health Secretary Andy Burnham has outlined plans for a swine flu advice service, which will available by the end of the week in the UK.

According to Burnham, the flu service will be able to diagnose people with swine flu quickly and give them the opportunity to get anti-viral drugs from local centres, freeing up doctors’ time. The government says this new flu service will include a hotline and internet advice.

Meanwhile, the British government has been trying to clear up confusion about its advice to pregnant women.The National Health Service website has for the past 11 days been advising pregnant women that they can reduce their risk of infection by avoiding unnecessary travel and staying away from crowds where possible. This guidance was backed by the Royal College of Midwives (RCM) at the weekend.

However, the Department of Health did not support this advice on its own website over the weekend, as had been expected. A department source later confirms: “Our advice has not changed. For the majority of pregnant women, good hand hygiene will be enough.”

For the full story please go to:

For the latest information and advice on swine flu in your country please visit our swine flu links section.

Swine flu hotline could leave children at risk

Britain’s national pandemic flu service hotline will be going live this afternoon, but could it leave children at risk from other potentially fatal infections?

The new pandemic flu service came to light as Ministers decided that the NHS was under too much pressure. NHS Direct has been receiving nearly four times the number of calls that are usually experienced during the winter.

 

The new swine flu hotline will be manned by 1,500 operators who are not medically trained. These operators will work through a computerised questionnaire to help determine whether the caller has swine flu, and if so, they will provide vouchers for antiviral medication.

However, the Meningitis Research Foundation (MRF) has stated that the decision to rely solely on the call centre could lead to cases of meningitis and septicaemia being missed. It is known that flu can cause viral meningitis, which is deadly if diagnosed too late. With the increase in flu cases, there is a high possibility that this could lead to more cases of meningitis and septicaemia.

In reply to the MRF statement, Peter Holden, the lead expert on swine flu for the British Medical Association said “The questionnaire is designed to weed out the 999 threats, like meningitis, right at the start. But this is mass medicine. It is inevitable that one or two will fall through the cracks.”

Christopher Head, chief executive of MRF said that if people use the hotline, then it is important to spot warning symptoms of meningitis early: cold hands and feet, severe pain in the limbs and joints, pale or mottled skin, stiff neck and a dislike of bright lights.

Pneumonic plague seals off remote town

A second man has died of pneumonic plague in a remote town of more than 10,000 people in north-west China.

To prevent further spread, the town of Ziketan has been sealed off and about 10 other people inside the town have also contracted the disease.

Pneumonic plague attacks the lungs and can spread from person to person or from animals to people. The first signs are fever, headache, weakness, and rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery sputum. This eventually progresses for 2 – 4 days into respiratory failure and shock.

The local health bureau has warned anyone with a cough or fever who has visited the town since mid-July to seek medical treatment.

A spokeswoman for the World Health Organization, Vivian Tan, praised the Chinese for reacting quickly and for getting the situation under control. For the full story please go to:

Respiratory doctors call for EU action on climate change

A new study shows that the risk of premature death due to temperature increases associated with global warming is six times higher for Europeans who are already suffering from respiratory problems.

The European Respiratory Society (ERS) and the Health and Environment Alliance (HEAL) want to ensure that the respiratory health effects and costs of climate change are considered in all discussions and recommended actions at the EU level.

 

A one degree increase in temperature produces a 1-3% increase in deaths in the general population, but this same temperature increase results in a 6% increase in deaths among people with respiratory conditions.

The ERS encourages its doctors to speak out and to educate healthcare professionals on the impact of hotter temperatures on their patients.

HEAL, who represents more than 60 health and environment organisations, are encouraging other medical bodies to produce similar papers to increase awareness of the effect of climate change on health.

GPS system tracks asthma hotspots

Dr. David Van Sickle, a researcher from the University of Wisconsin, USA, is currently using global positioning system (GPS) technology to help pinpoint geographic areas where asthmatics suffer most.

The research funded by the Centers for Disease Control and Prevention (CDC), attaches GPS locators to emergency inhalers to allow the mapping of the areas where asthmatics suffer most. This should allow doctors to determine the main triggers of asthma attacks in that area.

This may help to accurately pinpoint asthmatic hot spots and will eventually allow researchers to create an “asthmap,” which could allow them to “see” exactly what is making asthma symptoms worse.

Caterpillar causes asthma

Toxic caterpillars, which can trigger an asthma attack or anaphylaxis, have infested People’s Park in St Helier on the Channel Island of Jersey.

The oak processionary caterpillar causes respiratory problems via its 60,000 barbed setae (hairs), which contain a harmful toxin. People visiting the park have been taken to hospital with skin rashes as a result of contact with the setae.

The infested trees have been cut down to prevent further risk to the public. Before being cut down, the trees were coated with biodegradable vegetable oil to prevent the toxic hairs being blown into the air. Furthermore the grass surrounding the trees were also coated with vegetable oil and burnt.

Oak processionary caterpillars can be found inhabiting oak trees across Europe, feeding on leaves and making nests on the trunk or branches of oak trees.

Fears rise over Tamiflu side effects

Researchers at Oxford University have urged the UK’s Department of Health to urgently rethink its policy on giving Tamiflu (also known as oseltamivir) to children.

Their study, recently published in the British Medical Journal (BMJ), warned that Tamiflu can lead to vomiting and dehydration in some children; resulting in the need for hospital treatment.

Co-author, Dr Carl Heneghan says the current policy of giving Tamiflu for mild illness is an “inappropriate strategy”. The research concluded that children could suffer more harm than benefit from taking Tamiflu and that widespread use of the anti-viral could result in the flu virus becoming resistant to the drug.

Another study on children has shown that the drug can cause nausea, insomnia and nightmares. UK government chief medical officer Sir Liam Donaldson says: “All drugs do have side-effects. It is always a case of deciding the balance between benefiting a patient from a treatment and the side-effects. Most of the side-effects are relatively minor – a degree of nausea, a bit of a tummy upset, the sort of thing you get quite often with antibiotics.”

Global warning over drug-resistant TB

New study suggests that drug resistant tuberculosis (TB) may become a more common problem in the future.

In 2007 the World Health Organization (WHO), estimated that there was over 9.27 million cases of TB worldwide. It is estimated that 1 in 3 carry the TB bacteria, most without showing any symptoms.

The new research has shown that drug resistant TB is very persistent and can spread as easily as normal versions of the virus. These new findings contradict previous studies and imply that drug-resistant strains of TB are likely to become highly prevalent.

TB bacteria can become resistant to antibiotics if a patient is given the wrong treatment, a patient takes the wrong dose or if a patient does not complete the full course of drugs.

Climate change worsens air quality

New research has shown that climate change is making forest fires more common, resulting in particulate matter, which reduces air quality and irritates the lungs.

The study published in the Journal of Geophysical Research is the first to look at how bad the air is going to get as forest fires increase in the future. The scientists compared information on forest fires over the past 25 years. Once this information was combined with a standard climate model they estimated that, by the 2050s, forest fires will become as much as three times more common.

It is already well documented that particulate matter produced by forest fires can cause serious respiratory problems and irritate the lungs. The researchers took this into consideration and created another computer model to show the effect of forest fires on the amount of carbon emissions they produced.

In order to work out the emissions many variables had to be taken into account including: the types of wood involved, how hot the air was, how much fuel was lying around on the ground and more. Their findings estimated a 40 per cent rise in lung-irritating particles as a result of forest fires by the 2050s.

Quicker way to diagnose asbestos cancer

Scientists say they have developed a quicker way of diagnosing the asbestos-related cancer mesothelioma.

Mesothelioma is a type of tumour that is found on the surface of the lung and is very hard to treat, when it can be treated at all. It is caused by exposure to asbestos and develops decades after exposure. It has particularly affected tradesmen such as joiners, plumbers and electricians around Europe.

The team of researchers from Oxford University looked at the build-up of fluid in the cavity surrounding the lungs, measuring the levels of a substance called meothelin. This new method could provide a way for doctors to quickly diagnose the mesothelioma and minimise the number of invasive procedures needed. This would reduce the time a patient would need to spend in the hospital for diagnosis and provide more time for possible interventions such as chemotherapy.

Dr Paul Beckett of the British Thoracic Society says this method may “improve the outlook for this disease, as well as avoiding unnecessary tests in those who don’t have mesothelioma.”

Lung-on-a-chip could be used to predict the effects of toxins or drugs

Scientists at Harvard Medical School and the Children’s Hospital in Boston, USA, have created a device that mimics a human lung, by incorporating lung and blood vessel cells into a microchip.

This means that human lung and living tissue can be studied without opening up people or animals.

The lung-on-a-chip could predict how human lungs absorb airborne nanoparticles and mimic the inflammatory response.

The device was able to replicate many of the natural responses of lung tissue, such as detecting pathogens and speeding up blood flow so that immune cells can deal with the invaders.

Several more years of research using stem cells are required before a fully functioning organ may be created, which could one day be a way to replace diseased or damaged human lungs.

Ultrafine particles in air pollution may heighten allergic inflammation in asthma

American researchers have discovered that even a brief exposure to very small particles of air pollution near a motorway can trigger asthma symptoms.

The researchers found that tiny particles of air pollution, about one-thousandth the width of a human hair, caused inflammation deep inside the lungs.

 

 

These particles are most often released in car exhaust fumes and so levels are high near motorways and other high-traffic areas.

In addition to new considerations for asthma treatment, the study findings may also help epidemiologists further establish the link between surges of pollutants near motorways and worsening asthma symptoms and to pinpoint the amount of ultrafine particle concentrations involved.

Homeowners ‘ignorant on asbestos’

A survey carried out in the UK suggests that almost two-thirds of people would not be confident of identifying asbestos in their home.

The British Lung Foundation (BLF) surveyed 2,000 homeowners and found that 45% did not realise that asbestos had been used as a building material.

The ultra-resistant substance was used extensively in the 20th Century in many aspects of building, and can be found in floor tiles, textured ceiling coatings and in the lining of boiler cupboards.

Those who had been employed in jobs in which they regularly worked with asbestos, such as plumbers or shipyard workers, were most at risk of developing lung problems such as mesothelioma and asbestosis.

However, asbestos is no longer used for these purposes and so the greatest risk lies among those involved in demolition, building repair and maintenance. If asbestos is disturbed, it releases dangerous fibres into the air, which are harmful to the lungs.

If you find asbestos in your home, you should seek advice from your local authority before removing and disposing of the material.

Home care equivalent to hospital care for some patients with cystic fibrosis

People with cystic fibrosis (CF) recover from exacerbations equally well if they are treated at home or in a hospital, according to researchers from Johns Hopkins University, Baltimore, MD, USA.

CF patients are regularly required to clear the airway of mucus from their airways and take antibiotics in an attempt to sustain a normal lifestyle; however, their lung function rarely returns to normal. It is vital to find out the best way to treat worsening symptoms.

Outpatient intravenous antibiotic therapy is becoming increasingly popular because of its advantages over hospitalisation including; fewer absences from school or work, less disruption of family life, decreased costs per treatment course and high patient satisfaction.

American researchers studied 1,535 individuals with CF, from 755 families, to find out how lung function altered with antibiotic treatment.

The researchers found that periods of worsening symptoms were followed by long-term declines in lung function, regardless of whether antibiotics were administered in the hospital or at home, and the optimal duration of antibiotic therapy was 7–10 days, compared with the current practice of 10–21 days.

European caterpillar causes asthma in Britain

Toxic caterpillars, which can trigger an asthma attack or anaphylaxis, are invading Britain, experts warn.

The oak processionary caterpillar causes respiratory problems because of its 60,000 barbed hairs, which contain a harmful toxin. As well as causing severe breathing difficulties and lethal asthma attacks, contact with these hairs can also result in painful rashes and eye/ear irritation.

The caterpillars arrived in Britain in 2006, on a shipment of oak trees from the Netherlands, quickly becoming established in the South East. Experts believe that, within 5 years, these caterpillers will affect everyone within the M25.

With a preference for isolated trees, these insects pose a particular human risk, as they are more commonly found on trees in towns, cities and parks where they could easily come into contact with people.

Diabetes drugs may slow lung cancer

American researchers have found that certain diabetes medications, including metformin, may slow the progression of lung cancer and lengthen survival.

The researchers studied more than 600 people with diabetes and lung cancer to see how they reacted to metformin and thiazolidedione.

Overall, people who took these drugs were less likely to get lung cancer. Those with lung cancer were less likely to have it spread and had longer survival if they were on one of the diabetes drugs before their diagnosis.

The reason why diabetes drugs reduce the risk of lung cancer is not known for sure but it has also been confirmed in many other studies, some with larger groups of patients.

Some research has shown metformin to act on the pathway which regulates cell growth and survival in lung tumours.

Tuberculosis cases highest for nearly 30 years in UK

According to the Health Protection Agency, the number of tuberculosis cases in the UK topped 9,000 last year, the highest for nearly 30 years.

Diagnoses have been rising almost continuously since the 1980s, with many of the new cases thought to be among people who caught the disease abroad.The number of drug-resistant TB cases has also dramatically increased to 389, nearly double that recorded in 2000

As symptoms can take up to two years to appear, health experts believe many people may have caught the disease before moving to the UK or caught it on trips back to the countries of their birth.

The HPA said it was important that local health managers put steps in place to diagnose and treat the condition in the worst affected areas.

About 300 people a year die as a result of TB, even though it is treatable if caught early enough.

Lung research ‘needs more money’

Millions of lives could be saved if more money was spent on studying and tackling common lung infections, say experts.

Pneumonia kills more women than breast, ovarian and cervical cancer combined, however it only receives a fraction of the funding compared to cancer research.

The World Lung Foundation has released a global “atlas” which, it says, details “hotspots” for respiratory infections.

Pneumonia is one of the biggest killers, with the death rate 215 times higher in low-income countries compared with high-income countries.

Children are particularly vulnerable, with an estimated 1.6 million deaths each year in the under five-year-old group

According to the report, approximately £19.4m is spent per year on research into new drugs, compared with £68m on HIV and related illnesses.

Levels of tobacco-related carcinogens are high in children living with smokers

A new study has found that tobacco-related carcinogens are found in the urine of 90 per cent of children who lived in a home where at least one parent smoked.

The researchers took urine samples from 79 children aged one month to 10 years and found that the average level of tobacco metabolites was about 8 per cent of the level found in smokers.

Although the researchers expected some level of exposure to carcinogens in children, the average levels were far higher than anticipated.

The researchers also found a direct correlation between the numbers of cigarettes smoked by one or more adults in a house each day and tobacco metabolites in the children who lived there.

Canadian researchers have discovered an infectious superbug that can be deadly to people with cystic fibrosis

The drug-resistant strain of Pseudomonas aeruginosa was first detected a decade ago in the British city of Liverpool. But since the superbug migrated to Canada, physicians have discovered just how deadly it can be to people with cystic fibrosis.

In healthy people, the bacterium causes little more than a rash but in people with cystic fibrosis (CF), it can lead to chronic lung infections as the bacterium lodges deep in the lungs.

The researchers have discovered that drug-resistant Pseudomonas aeruginosa can triple the risk of death in CF patients, which suggests that hospitals must screen CF patients for the bacterium and implement stringent infection control.

According to a 3-year study carried out in CF clinics in Ontario, Canada, the superbug attacks 7 out of every 1,000 CF patients each year. This equates to 25 Canadian CF patients per year and of these, 10 per cent could die.

Powder antibiotic effective against tuberculosis

Researchers at the University of Colorado, USA, have developed a dry powder that appears to be effective in treating tuberculosis (TB) and multi-drug resistant tuberculosis (MDR-TB).

Tuberculosis is a disease caused by infection with Mycobacterium tuberculosis. This bacterium can attack any part of the body, but the disease usually affects the lungs.

The new powder is composed of fine particles of antibiotics. These are inhaled deep into the lungs, where tuberculosis is often located in its early stages.

Tuberculosis remains a significant health concern. The disease killed an estimated 1.7 million people worldwide in 2009 and generated 9.4 million new cases, according to the World Health Organization.

The researchers have also found that when the powder is used alone or in combination with current treatments, it may significantly reduce treatment for tuberculosis (TB) and multi-drug resistant TB.

Britons have highest deaths from breathing conditions in Europe

Data from the national office of statistics have shown that deaths from lung conditions and asthma are higher in Britain than any other European country due to high smoking rates.

Experts said that some Eastern European countries may now have higher smoking rates than in Britain but this is relatively recent and that the consequences are not yet apparent.

In the UK, 88 men per 100,000 die from respiratory conditions such as flu, pneumonia, chronic obstructive pulmonary disease (COPD) and asthma. This compares to an average of 63 deaths per 100,000 men in Europe.

UK rates for women were 64 deaths per 100,000 people, compared with 33 per 100,000 people in Europe.

Professor Stephen Spiro, spokesperson for the British Lung Foundation, said: “The results in this report about respiratory disease are unsurprising as unfortunately deaths due to lung diseases including COPD, lung cancer, and respiratory infection such as pneumonia, are extremely high in the UK.”

The data reflect the extremely high smoking rate in the UK and the length of time that people have smoked. The statistics are very worrying and highlight the need to reduce the number of smokers and improve respiratory outcomes.

Infection control ‘needs update’

How should the authorities treat people with infectious diseases who might put others at risk?

This tricky question is being considered by health officials in England. Their consultation about new laws on the control of disease and other hazards closes this week.

Experts agree that a new approach is needed – but some people are worried that the government’s proposals for change are too vague.

It is easy to think of tuberculosis (TB), for example, as a disease of the past.

TB is still with us. A drug-resistant form of the disease recently reared its head in the US, forcing officials to issue their first quarantine order in 44 years.

The infected man remains in hospital, ahead of lung surgery next month.

EPA Ozone Pollution Standards “Unhealthy for America”

21/06/2007

David H. Ingbar MD, president of the American Thoracic Society, today called the proposed standards issued by the Environmental Protection Agency for ozone pollution–commonly known as smog-“unhealthy for America’s kids, unhealthy for America’s seniors, and unhealthy for America.”

“The science is clear,” Dr. Ingbar said, “ozone pollution is causing unnecessary, illnesses and death in America. The proposed EPA standards fall short of providing the protection needed to keep Americans safe from ozone air pollution.”

In announcing the proposed standard today, EPA is calling for a modest tightening of the current standard of 0.08 ppm/8-hours. EPA is proposing a revised standard in the range of 0.075 ppm/8-hours to 0.070 ppm/8-hours. While suggesting a stricter standard, EPA is still considering retaining the current standard.

The range proposed by the EPA falls far short of the standard of 0.060 ppm/8-hours supported by the American Thoracic Society and others in the scientific community.

Tobacco

At a conservative estimate, tobacco kills more than 650,000 people every year in the European Union alone. Many of these deaths are due to respiratory disease. Action needs to be taken in many forms to reduce this preventable morbidity and mortality.
Tobacco smoking

Tobacco smoking is a chronic disease. It is the single biggest cause of death and disease within the European Union (EU), despite the progress that has been made in tobacco control….Quitting and smoking reduction

Quitting has immediate and long term benefits. It’s never too late to stop smoking. It has even been proven that lung cancer patients who quit smoking have better treatment outcomes than those who continue to smoke…. Burden in Europe

More than 650,000 Europeans are killed every year because they smoke, which equates to one in seven deaths across the EU. In fact, half of all smokers will die from their habit, and will lose on average 14 years of their life-span…. Different forms of tobacco smoking

Most of data presented on smoking comes from cigarette smoking; however, other forms of tobacco smoking can be just as damaging….
Environmental tobacco smoke

Environmental tobacco smoke (ETS) is also known as “second-hand smoke”, “passive smoking” or “involuntary smoking” (breathing in the smoke from nearby smokers).

Environment

The environment that we live in can have a dramatic effect on our health. Poor environment quality, both inside our own homes, and in the work place and open air, contributes to many diseases, respiratory diseases in particular.

Outdoor air pollution

WEB_CHEMIN_51_1134486389Outdoor air pollution has been related to adverse respiratory effects since the 1930s.
The project “Air Pollution and Health: a European Approach” (APHEA 1996) has confirmed that air pollution increases daily cardiorespiratory .

Indoor air pollution

WEB_CHEMIN_52_1134487273Indoor air pollution (exposure in the home) is much lower in Europe than in developing countries, such as India and China.

Diet and nutrition

In recent years, the link between diet and health has become increasingly clear. The role of a bad diet has been well reported in many diseases. But the role that the diet plays in lung diseases is poorly understood.
Protective foods

WEB_CHEMIN_44_1134398237There is evidence that certain vitamins and nutrients should be included in our diet on a regular basis to keep our lungs as healthy as possible.

Harmful foods

There is not much information available on foods that have a bad effect on the lungs. However, there are a range of foods that cause other diseases and these may also be harmful for respiratory health.

How does air get into the body?

Air is breathed in through the nose, mouth or both.

Nose or mouth

The nose is the best route for air to get into the lungs, as it is a better filter than the mouth. The nose decreases the amount of irritants that reach the lungs, whilst also heating and adding moisture to the air.
Mouth breathing is usually needed when exercising or when more air is needed, because the nose is not the most efficient way of getting large amounts of air into the lungs.
Journey down the windpipe

After entering the nose or mouth, air travels down the trachea or “windpipe”. The trachea is the tube lying closest to the neck.
Behind the trachea is the oesophagus or “food tube”. Air moves down the trachea when we inhale and food moves down the oesophagus when we eat.
The path air and food take is controlled by the epiglottis, a gate that prevents food from entering the trachea. Occasionally, food or liquid may enter the trachea, resulting in choking and coughing spasms.
Route into the lungs

The trachea divides into one left and one right breathing tube, termed bronchi. The left bronchus leads to the left lung and the right bronchus leads to the right lung. These breathing tubes continue to divide into smaller tubes called bronchioles.
The end of the trip

The bronchioles end in tiny air sacs called alveoli. Alveoli, which means “bunch of grapes” in Italian, look like clusters of grapes attached to tiny breathing tubes. There are over 300 million alveoli in normal lungs. If the alveoli were opened and laid out flat, they would cover the area of a doubles tennis court. Not all alveoli are in use at one time, so the lung has many to spare in the event of damage from disease, infection or surgery.

European Respiratory Society

Founded in 1990, the European Respiratory Society (ERS) is a nonprofit making, international medical organisation with over 7,000 members from 100 countries. It is the biggest society in Europe in its field.

The aim of the ERS is to promote and improve lung health in Europe through research, education and advocacy.

ERS Congress

The ERS Congress is Europe’s biggest annual scientific gathering in respiratory medicine, with an attendance of over 16,000 delegates. This event provides a platform for important improvements in the treatment of lung diseases. In 2007, the ERS will meet in Stockholm, Sweden from September 15-19, 2007.

Publications

The ERS produces a number of publications for scientists, doctors and health providers in Europe to keep them up to date on the latest research and developments in lung health and disease treatments:

  • European Respiratory Journal
  • European Respiratory Monograph
  • European Respiratory Review
  • Breathe
  • Buyers’ Guide
  • ERS Newsletter

ERS School

The ERS School is involved in educating doctors across Europe on the best treatment strategies for lung disease and also provides financial assistance for scientists researching new treatments for lung diseases

  • Encouraging new initiatives
  • Producing guidelines
  • Organising numerous postgraduate courses
  • Developing joint documents with international societies
  • Showing a genuine commitment to continuing medical education
  • Actively developing e-learning programmes
  • Sponsoring task forces and seminars

Breathe is the official educational journal of the ERS school.

Fellowships

The ERS offers training and research fellowships. These fellowships provide money for those involved in research related to lung health.

Collaboration with Central & Eastern Europe

The ERS supports the further development of lung health in Central and Eastern European Countries. More than 200 physicians and scientists from these countries are given support to attend the annual congress.

Advocacy

The ERS is actively involved in lobbying governments, grant agencies and political bodies to provide better lung health in Europe. A recent success was the launch of the:

  • European Lung White Book

This publication was officially launched on November 25, 2003 at the European Parliament in Brussels and was produced in conjunction with the European Lung Foundation (ELF). It provides the first comprehensive survey on respiratory health in Europe. It is also available in an abbreviated version:

  • Lung Health in Europe – Facts and figures

The abbreviated version is also available in French, Dutch, Russian, German, Polish, Spanish and Italian.

Thank you

Thank you to all the people who have donated to the ELF and helped Europe to breathe.

Ghussan Alothman, Kuwait
Matt Broadhead, UK

Dorotea Buffa, Italy

“In loving memory of Lorenzo Lugli”

Neil Bullen, UK
Istuan Bittera, Hungary
Domingez Del Valle, Spain
Lee Dodd, UK
Raja Dhar, UK
Jean-Luc Eisele, Switzerland
Jeroni Ferres, Spain
Bernard Fierens, Switzerland
Rainer Gebhardt, Germany
K.P. Hui, USA
Mark Livingston, UK
Raileamu Marimela, Romania
Laurent Nicod, Switzerland
Domenico Osella, Italy
Roldolfo Posadas-Valay, Mexico
Paul-Martin Putora, Germany
Elin Reeves, UK
A.D. Vellore, UK
Ingrid Wagenbreth, Germany
Thomas Weisinger, Austria
Rachel White, UK

Donations >10,000 euro

Deutsche Atemwegsliga, Germany

Environment in the news

Climate change impacts on human health 13/07/2007

An American researcher recently reviewed the available scientific evidence of the effect of climate on diseases affecting humans. He notes that the potential for outbreaks of certain diseases will be increased with climate change. Nevertheless, he suggests that, by changing our sensitivity and even adaptive capacity, the impacts of climate mediated diseases could be mitigated….
Scientific committee suggests further research into possible indoor air pollutants 18/06/2007

Available data on indoor air risk assessment are limited, according to an EU scientific committee, which highlights the need for further research into possible indoor air pollutants as chemicals for intended use or unintentional emissions, radon, particles, microbes, pets, pests etc.

Health fears as ozone levels double 21/05/2007

Levels of a gas known to cause respiratory illness and exacerbate allergies and asthma have more than doubled in Scotland’s towns and cities in 15 years.

Policies “must link” air quality and climate 12/04/2007

Climate experts that advise the British government suggest that environment policies at European, national and local levels must observe the complex interactions between air pollution and climate change more frequently.
Urban air pollution ‘more dangerous than Chernobyl’ 03/04/2007

Air pollution in major cities may be more damaging to health than the radiation exposure suffered by survivors of the 1986 Chernobyl disaster, according to a report published today.

New technology fights diesel pollution 02/04/2007

Every year cancers, lung disease and heart conditions stemming from exposure to vehicle pollution cost the Australian economy between three and five billion dollars.

EPA tells 20 states cut air pollution by ’08 29/03/2007

The U.S. Environmental Protection Agency on Thursday finalised rules directing 20 U.S. states to slash levels of tiny particles spewed by power plants, cars and other sources by 2010.

Reducing carbon dioxide emissions in the transport sector 29/03/2007

The transport sector is responsible for 21% of total greenhouse gas (GHG) emissions in the EU-15 (excluding international aviation and maritime transport).

Parliament to set up climate committee 26/03/2007

The European parliament is to set up a temporary committee on climate change and its consequences

Mutagenic effects of urban air pollutants 08/03/2007

Air pollution seriously damages health and the environment because it is known to cause respiratory problems and ecosystem damage.

General lung links

he links on this page will take you to sites that have useful information on all aspects of the lungs and your health in general.

Europe
Austria
Denmark
Finland
France
Germany
Norway
UK
International

Europe

 

DG SANCO: is the Health & Consumer Protection Directorate General of the EU. DG SANCO helps make Europe’s citizens healthier, safer and more confident.

EU Health Portal: a single point of reference from the European Commission for reliable and easily accessible information on a wide range of health-related topics for citizens, patients, health professionals, stakeholders and policy-makers.

 

The cost of healthcare abroad: provides information on how to get treatment when you are abroad.

Austria

 

Österreichischen Lungenunion: Austrian Lung Foundation.

Read reviewers comments on this website (PDF).

Denmark

 

Danmarks Lungeforening: the Danish lung association working for better prevention and treatment of lung diseases and helping patients with lung diseases in Denmark.

Read reviewers comments on this website (PDF).

 

Lungeforeningen Boserup Minde: is a Danish lung association providing information to patients on various lung diseases.

Read reviewers comments on this website (PDF).

Finland

 

Heli Hengitysliiton: is Finland’s largest social and health organisation. It is involved in a wide range of activities, including rehabilitation, vocational training, running of work centres and various health promotion activities for lung patients.

Read reviewers comments on this website (PDF).

France

 

Federation Francaise des Associations et Amicales de malades, Insuffisants ou handicapes Respiratoire (FFAAIR): is a French federation of combined lung disease organisations that aim to reduce the handicap of lung disease patients.

Read reviewers comments on this website (PDF).

Comite contre les maladies respiratoires: The national committee against respiratory diseases promotes respiratory health and protection of the lungs.

Read reviewers comments on this website (PDF).

Germany

Deutsche Lungenstiftung: the German lung foundation was created by members of the German Pulmonary Society and provides information to lung disease patients.

Read reviewers comments on this website (PDF).

Deutsche Lungentag: the German lung day is an annual event aimed to increase the public awareness of lung diseases and their symptoms.

Read reviewers comments on this website (PDF).

Bundesverband der Pneumologen: the German Federation of Lung Health acts as an information platform for lung health topics.

Read reviewers comments on this website (PDF).

Patientenliga Atemwegserkrankungen: the German association of respiratory disease is a combination of local respiratory groups which aim to improve the lives’ of lung disease sufferers.

Read reviewers comments on this website (PDF).

Deutsche Atemwegsliga: Germany breathe easy works with experts in the field of respiratory medicine to put scientific discoveries into practice and provide information for lung patients.

Read reviewers comments on this website (PDF).

 

 

Magyar Tüdőgyógyász Társaság (MTT): the Hungarian Respiratory Society contains patient information for asthma patients.

Read reviewers comments on this website (PDF).

Norway

 

Landsforeningen for hjerte- og lungesyke (LHL): Norwegian heart and lung association aims to improve the lives’ of heart and lung patients.
www.lhl.no

Read reviewers comments on this website (PDF).

UK

The British Lung Foundation: support people affected by lung disease through the individual challenges they will face.

International

National Heart Lung and Blood Institute (NHLBI): provides leadership for a national program in diseases of the heart, blood vessels, lung, and blood; blood resources; and sleep disorders.

The Global Alliance against Chronic Respiratory Diseases (GARD): works towards the common goal of fighting chronic respiratory diseases.

News

The news presented here is taken from sources on different websites. A brief summary of the news is given, along with a link to the original article.
10 results on 1469 – Page 146/147

Smoking ban in all pubs and clubs in England

MPs have voted by a huge margin to ban smoking from all pubs and private members’ clubs in England.

06/02/2006 Tobacco control efforts growing worldwide as countries build on momentum of global tobacco convention

Countries representing three-quarters of the world’s population meet in Geneva to plan the effective implementation of the tobacco control treaty.

06/02/2006 Brussels to fight for child-resistant lighters

The European Commission is set to push for new measures requiring all lighters produced and sold in the EU to be child-resistant.

06/02/2006 Smokers face ban at home if nurse calls in UK

Hundreds of thousands of smokers will be banned from lighting up in their own homes when nurses or other health workers visit them, under controversial new rules drawn up by the nurses’ professional body.

06/02/2006 Asthma harder to control in heavy individuals

The findings from a new study indicate that asthma is more difficult to control in overweight individuals than in their leaner counterparts.

27/01/2006 Bird flu ‘could be 21st-century Black Death’

Avian flu has the potential to develop into a global pandemic that would be as devastating as the Black Death of the 14th century, the World Economic Forum warned yesterday in its assessment of the risks threatening stability and prosperity.

27/01/2006 Sudden bid to quit smoking ‘best’

Spur of the moment attempts to stop smoking are more likely to succeed than planned ones, a study says.

27/01/2006 Food preservative ‘cuts lung bug’

Cystic fibrosis clogs the lungs with thick, sticky mucus
A common food preservative might provide treatment for cystic fibrosis (CF) patients, research suggests.

27/01/2006 Gates gives $600m more to stop TB

The Global Plan to Stop Tuberculosis has received a $600m (£337m) boost from Microsoft chairman Bill Gates.

26/01/2006 Asbestos claims ruling overturned

The Court of Appeal has overturned a ruling that thousands of people suffering from an asbestos-related condition should receive compensation.
More.

News

The news presented here is taken from sources on different websites. A brief summary of the news is given, along with a link to the original article.

02/03/2006 Antioxidant nutrients independently influence asthma

UK researchers have shown that eating less fruit, vitamin C and manganese is associated with symptomatic asthma in adults.

28/02/2006 Australia mulls car smoking ban

Authorities in Australia’s most populous state, New South Wales, are to consider banning smoking in cars.
17/02/2006 Reduced air pollution improves children’s health

Recently published WHO report “Effects of Air Pollution on Children’s Health and Development”, demonstrates that children are particularly sensible to air pollution exposure.

16/02/2006 Asthma ‘limits children’s lives’

Four out of 10 children with asthma say the condition places limitations on their lives, a UK-wide survey suggests.

15/02/2006 EU divided on response to threat from avian flu

European governments yesterday announced a raft of measures to help prevent bird flu from spreading across the region, but their varied response underlined disparities across the European Union about how to tackle the threat.

14/02/2006 Smoking ban in all pubs and clubs in England

MPs have voted by a huge margin to ban smoking from all pubs and private members’ clubs in England.

06/02/2006 Tobacco control efforts growing worldwide as countries build on momentum of global tobacco convention

Countries representing three-quarters of the world’s population meet in Geneva to plan the effective implementation of the tobacco control treaty.

06/02/2006 Brussels to fight for child-resistant lighters

The European Commission is set to push for new measures requiring all lighters produced and sold in the EU to be child-resistant.

06/02/2006 Smokers face ban at home if nurse calls in UK

Hundreds of thousands of smokers will be banned from lighting up in their own homes when nurses or other health workers visit them, under controversial new rules drawn up by the nurses’ professional body.

06/02/2006 Asthma harder to control in heavy individuals

The findings from a new study indicate that asthma is more difficult to control in overweight individuals than in their leaner counterparts.

All links

ELF Home > All links
All links

The ELF has carefully selected websites on lung health and related issues from around Europe and internationally.

Select a topic below to access a list of top quality websites that are arranged in countries. You will be able to find reliable lung health information in your native language.

All of these links have been read and reviewed by experts in the appropriate field from the ERS.
General links

General lung links
General lung

Disease links

Asthma Links
Asthma

COPD Links
COPD

Lung cancer Links
Lung cancer

TB Links
Tuberculosis

Cystic fibrosis Links
Cystic fibrosis

Sleep apnoea Links
Sleep apnoea

Risk factor links

Tobacco Links
Tobacco

Environment Links
Environment

Diet and nutrition Links
Diet and nutrition

Artificial lung’s museum showing

The prototype of a portable artificial lung that aims to give patients greater mobility has gone on show in London.

Researchers said the device, being developed at Swansea University, could make a big difference to people with conditions such as cystic fibrosis.

They said it was unique as it mimics a human lung’s behaviour, and also means patients could move around more.

The research was started by Professor Bill Johns, after his eldest son Graham died from cystic fibrosis aged 32.

Prof Johns is the managing director of Haemair Ltd, which is developing the device in conjunction with university researchers in Swansea.

World COPD Day

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).

World COPD Day was first launched in 2002 and has since attracted more than 50 countries worldwide to run awareness campaigns each year.

2011

World COPD Day 2011 will be November 16 – more details to follow.

Previous World COPD Days

Publications

The ELF is involved in the publication of material for the general public, patients and politicians.
Lung Health in Europe

Lung health in Europe – facts and figures
Lung factsheets

All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

Latest lung factsheet

Living an active life with COPD

Please see below for the full range of doctor approved factsheets.
Bird flu The normal lung
Pulmonary arterial hypertension Sleep apnoea
Diet and the lungs Indoor air pollution
Outdoor air pollution Dirty air and the lungs
Pneumonia Work-related lung diseases
Asbestos-related lung diseases Alpha 1-anti trypsin deficiency
Dirty air indoors and your lungs Spirometry
Rare and ‘orphan’ lung diseases Allergic rhinitis or “hayfever”
Climate change and the lungs Tuberculosis
Smoking and the lungs Living well with COPD
Asthma and infection Acute Bronchitis
MDR-TB Asthma in elite athletes
Sarcoidosis CPAP
Living an active life with COPD

Pneumonia

Pneumonia is a common condition. It affects many people throughout Europe, although it is more common in less developed countries, young children and the elderly.

What is pneumonia?

What causes pneumonia?

Treatment of pneumonia

Burden in Europe

Areas for action

Testimonies

Pneumonia in the news

SARS

 

Beatriz Amat

  • Update May 2007
  • Update March 2007
  • UPDATE January 2007

Final Report – December 2007

I cannot believe it but my fellowship has finished. When you look back, you always feel that it has been too short but, sincerely, I feel that my time here has been adequate to achieve the objective of the fellowship.

At the beginning, it was not very easy because I was the first fellow in this hospital and appropriate time was needed in order to clarify the objectives of my fellowship, but the assistance from Dr. Freitag (my host supervisor and Chief of the Department), Dr. Reichle (my tutor) and my colleagues and coworkers, has been excellent, allowing me to integrate into the work group.

The principal objective of my fellowship was to learn interventional bronchoscopy. During this year I have acquired a good technique related to rigid bronchoscopy and the use of APC, cryotherapy, EBUS and stent placement and have performed more than 200 procedures. I have also learnt other techniques such as thoracoscopy and thoracic ultrasound. The ERS encourages one to participate in all the activities at the hospital and so I treated and was responsible for the care of some patients (around eight) including on the private ward under Dr. Freitag’s supervision, the oncology department under Dr. Reichle’s supervision and, during the last three months, under Dr. Westhoff’s supervision learning sleep-medicine and ventilation technique.

Under Dr. Freitag’s and Dr. Reichle’s supervision, I have undertaken an interesting research project about a new technique to treat tracheobronchial stenosis. The results were presented in the ERS Congress in Stockholm and I hope that they will be soon published. I have also carried out a second research project using the real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and at present I am writing a second paper. Therefore, I feel the fellowship has contributed to improving my skills as a researcher and has allowed me to see how my tutor and host supervisor have collaborated in the development of different techniques, bronchoscopes and other medical instruments.

In January 2007, I attended the Hemer-Heidelberg bronchoscopy three day course (7th Workshop of thoracic endoscopy) hosted in our hospital. I also had the opportunity to attend the X International Meeting on Respiratory Endoscopy in Barcelona. In both courses, I was introduced to bronchoscopy specialists and it was a great honour to speak with such world famous experts.

The Lungenklinik Hemer is a hospital with a recognised prestige, and as such I had the opportunity to meet a past ERS fellow from Greece, others doctors from Germany and other countries (Holland, Slovenia, China and Spain) who visited the Lungenklinik Hemer to learn interventional bronchoscopy.

Although no beginning is easy and it has been challenging at times, after 12 months of the fellowship, I am really satisfied to have had the opportunity to work with Dr. Freitag and his team.

I want to thank the ERS/ELF, Dr. Freitag, Dr. Reichle and all my colleagues and co-workers of the Lungenklinik Hemer for their help.

I highly recommend the Lungenklinik Hemer to others wishing undertake a similar fellowship.
Update May 2007

During my training as a specialist in Pneumology I received a Fellowship SEPAR 2003: “Learning Rigid Bronchoscopy” for 3 months in the Lungenklinik Hemer (Germany). However, three months were not enough time to learn and practice all the different endoscopic treatment modalities that are now available.

Therefore, I am grateful to the ERS/ELF for awarding me with this fellowship and it is a great honour for my and for my Chief that ERS/ELF selected our project last year. I appreciate this great opportunity to continue my postgraduate training.

I have one supervisor, Dr.Reichle. He is not only a very good physician, but also a most helpful colleague who has taught me many things. Together we are at present involved in a research that we will be presented in the ERS Congress in Stockholm.

In our hospital we use the wolf bronchoscopes that have been developed in cooperation with the Lungenklinik Hemer by Dr. Reichle (my tutor) and Dr. Pobloth (he is the Assistant Medical Director in the Anaesthetic Department).

This particular bronchoscope has four ports: one to insert the telescope lens, a second one to measure the CO2 and pressure in the trachea, a third one that is connected to the jet ventilator and a fourth one that permits spontaneous ventilation. We use the low frequency Venturi jet ventilation, because it is an open system that facilitates endoscopic procedures while maintaining an effective gas exchange. We have 8 different forceps called “Hemeraner forceps”. Their names match with their shape or movement that they do. We have different sizes of bronchoscope with different diameter (it is refer to the inner diameter: from 3 to 14 mm) and different length (from 250 to 430 mm). We have tracheoscopes and bronchoscopes. That is important to select the most appropriate on e.g. in cases of tracheobronchial stenosis. While bronchoscopes have side holes for ventilation the shorter tracheoscopes do not have those.

I have learnt to use Argon Plasma Coagulation (APC). Dr. Reichle has developed this technique of APC during the last two decades and has gained a reputation around the world. I had the privilege to help him in developing the different algorithms with different programmes to achieve the desired effects in patients. I have managed stop tumour bleedings with APC and could remove large tumour pieces with the rigid forceps.

Regarding to pleural procedures I performed fifteen medical thoracoscopies under guided supervision of Prof. Freitag and Dr. Reichle. We performed the procedures under local anaesthesia and conscious sedation without intubating the patient. During the procedure he is breathing spontaneously. Another advantage is that we perform it in an endoscopy suite and it is cheaper than video-assisted-thoracoscopy surgery.

Update March 2007

In the Lungenklinik-Hemer we start work at 7:30am. We perform approximately 20-25 flexible bronchoscopies and 6-8 rigid bronchoscopies every day. Between eight and ten thoracoscopies are performed every month.

In our hospital we use the wolf bronchoscopes that have been developed in cooperation with the Lungenklinik Hemer by Dr. Reichle (my tutor) and Dr. Pobloth (the Assistant Medical Director in the Anaesthetic Department).

Over the last five months I performed more than 50 rigid intubations and now I am very confident with this technique. I really enjoyed doing these bronchoscopic interventions under the supervision of Dr. Reichle.

With regard to other techniques of interventional bronchoscopy, the Lungenklinik Hemer is taking part in a multi-centre trial testing the feasibility of endobronchial cryobiopsy. The hypothesis is that biopsy specimen taken with a freezing probe will increase the diagnostic yield compared to conventional forceps biopsies. Within this study I performed several cryobiopsies obtaining relatively large tumour biopsies.

Furthermore I was permitted to perform two endobronchial cryotherapies in patients with obstructing tumours under the supervision of Dr. Reichle.

We guide all pleural procedures (pleura punctures, pleura drainage and thoracoscopy) with ultrasound. I had not been able to use sonography before I came to Germany and I learnt to appreciate it as a most useful technique. It provides a lot of information and helps to detect even small pleural effusions. It allows also to distinguish pleural fluid from pleural thickening.

I have performed more than 50 pleural ultrasound examinations and I can highly recommended learning this technique. The ultrasound also permits you to look for the appropriate location for a transthoracic puncture. I think it is very useful for example in countries like Spain because using a CT scanner for puncture procedures is often blocked by radiologists and the limited accessability results in inacceptably long waiting times. I experienced that using the ultrasound in patients with peripheral masses transthoracical needle aspiration became easy. This is not only fast and efficient but also cost saving.

In January 2007, I attended for three days the Hemer-Heidelberg bronchoscopy course (7. Workshop of thoracic endoscopy) in our hospital. For me it was a wonderful opportunity to learn not just the theory but also to practice actively the different procedures of interventional bronchoscopy during the hands-on course. It is also very nice and helpful to speak with such these world famous experts. The message was that everybody had been struggling first but that everything can be accomplished with enthusiasm and effort.
UPDATE January 2007

I started my ERS training fellowship on 01.11.2006.

The aim of my fellowship is to learn how and when I should use a technique called rigid bronchoscopy.

Rigid bronchoscopy is a very important instrument in the diagnosis and treatment of many lung diseases. For the last two or three decades, we have seen the revival of rigid bronchoscopy.

The problem is that apprenticeships in rigid bronchoscopy are not possible in all hospitals. Also, it is not part of the current program in the pneumology speciality in many countries, including my country, Spain.

For this reason I have come to the Lungenklinik Hemer, a lung hospital in Germany.

I chose the Lungenklinik Hemer because I worked in this hospital for three months in 2004. It is a hospital with a recognised prestige in the diagnosis and treatment of lung diseases. It has more than 50 years experience. This hospital contains 240 beds: 135 belong to the pneumology department, 85 to the thorax surgery and 20 to radiotherapy. They perform approximately 6,950 bronchoscopies each year.

Now I am learning when to use rigid bronchoscopy, acquiring knowledge and becoming familiar with the use of rigid bronchoscopy. I am practising rigid bronchoscopy in different situations, both diagnostic and therapeutic. I am also learning the technique and indications of the medical thoracoscopy.

For example, I have met different patients with an endobronchial tumour with an obstruction in the main right/left bronchus. This obstruction causes an obstructive pneumonitis.

With the use of rigid bronchoscopy, we can remove the tumour, we can help the patients to relieve their symptoms and perhaps to improve their survival.

In the next update, I will provide more details about how we perform the technique.

In the next week I will start a scientific project with my chief, Dr. Freitag.

New evidence links birth season to asthma development

New evidence links birth season to asthma development

Children who are born four months before the height of the cold and flu season have a greater risk of developing childhood asthma than children born at any other time of year.

The study looked at over 95,000 children and their mothers in the USA to see if there was a relationship between date of birth and childhood asthma risk.

The researchers found that children who suffered with the respiratory infection bronchiolitis during early childhood and those who were born in Autumn, had the highest risk of asthma.

Autumn shows the highest amount of respiratory viruses and children born approximately four months before this peak are most likely to develop asthma.

The study demonstrated for the first time that timing of birth in relation to the peak in winter virus activity independently predicts asthma development.

Read the original press release from the American Thoracic Society.

Respiratory infections: upper and lower respiratory tract infections

The respiratory system is the district with the highest incidence and prevalence of infections due to the obvious reason of its easy and wide access to foreign agents.

Rhinosinusitis is represented in most cases by viral infections of the common cold, only rarely contaminated by bacterial overlap. These are diseases with spontaneous resolution, usually without the need for antibiotic treatment, with the possible use of symptomatic treatments aimed at controlling fever and hypersecretion.

Rhinosinusitis can be a major pathological problem when accompanied by high hyperpyrexia, last for more than ten days, produce mucopurulent secretions or are associated with significant low respiratory symptoms. Such conditions open up the reasonable opportunity for antibiotic treatment.

Respiratory tract infection and inflammation

The diagnosis of acute bronchitis is usually clinical, therefore based on the objectivity of the patient, who manifests cough, fever, and has fairly typical auscultatory signs in the form of humid noises, crackles, any wheezing. The auscultatory finding is however very variable, it can also be silent even in the presence of a relevant infection, and depends on the degree of anatomical damage to the bronchial tree that has developed following previous recurrent infections.

Respiratory tract infection and inflammationAn X-ray examination is indicated in cases of suspected pneumonia, or in conditions of particular risk, for example in the elderly. In these circumstances, an examination of the sputum and a related antibiogram may also be appropriate.

However, acute bronchitis tends to spontaneous self-resolution, favored by a supportive anti-inflammatory treatment as well as adequate hydration.

The boundary dividing the need or the uselessness of antibiotic treatment is often blurred. On the one hand, bronchitis represent a typical pathological area of ​​antibiotic abuse; on the other hand, it would be deleterious to leave the infectious focus free to produce irreversible lesions to the bronchial tree for the sole obstinacy to avoid the use of antibiotics.

Therefore, the usual classification of pneumonia is not of an etiological but environmental type, recognizing community pneumonias (ie arising in the normal community of life) and nosocomial pneumonia, that is linked to hospitalization. The identification of a specific nosocomial category takes into account the epidemiological relevance of a complication that is often difficult to prevent or control, namely the superimposition of a respiratory infection in a patient hospitalized for other reasons.

Another way to classify pneumonia

– older but always practical for its clinical value – is that linked to anatomical localization and radiological findings. They therefore stand out

  • lobar pneumonia, linked to the involvement of an entire lung lobe due to the spread of the infectious process by contiguity from the alveoli to neighboring areas, but without going beyond the serous
  • lobular or broncholobular pneumonia, with multiple and disseminated thickening, including in both lungs
  • interstitial pneumonia, with involvement of the connective, interlobar and interalveolar septa.

Another way to classify pneumoniaImmunological diagnostics has expanded the possibilities of identifying the etiology of pneumonia, allowing to identify pathological antibody rates for various agents including Mycoplasma, Chlamydia, Legionella. The qualitative antibody profile distinguishes recent infection (increase in IgM) from a previous one (increase in IgG).

The elevation of numerous inflammatory parameters, however non-specific, is usual: ESR, PCR, alpha2-globulins, neutrophilia.

The radiological examination may show school-type images (frank lobar densities), but more often the display is in the form of multiple thickenings, spot, or ground glass (especially in interstitial forms).

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Ask the doctor – Allergic rhinitis or “hayfever”

About ERS Specialist Prof. Paul Brand

Professor Paul L P Brand (1961) is a consultant paediatrician who is based at the Princess Amalia Children’s Clinic of the Isala Klinieken in Zwolle, the Netherlands. Paul’s research interest focuses on the diagnosis and management of paediatric asthma and allergy. He is the Chair of the Paediatric Asthma and Allergy Group of the ERS, and is an honorary professor of Clinical Medical Education of the University Medical Centre in Groningen, the Netherlands. Paul is married with 5 children.

The ELF would like to thank ERS specialist Paul Brand for taking the time to answer your questions.

Keep checking the ELF homepage for details about the next ‘ask the doctor’ video.

Asthma in the news

07/07/2011 Asthma in children linked to depression during pregnancy
Women who are stressed or depressed during pregnancy could have an increased risk of their child developing asthma.

More…
01/07/2011 Herbal medicine shown to reduce asthma symptoms
A traditional herbal medicine has been shown to reduce inflammation in people who suffer from asthma caused by allergens.

More…
29/06/2011 New trial tests Botox as a treatment for asthma
A new medical trial in Australia is set to test whether Botox can be used to help people with asthma breathe more easily.

More…
23/06/2011 Vitamin A deficiency does not affect onset of asthma
Vitamin A deficiency does not increase the risk of asthma, according to new research published in the European Respiratory Journal.

More…
20/06/2011 Higher immunity to colds makes asthma worse
Scientists have found that increasing immunity in the body, using nutritional supplements, cold remedies and fortified foods, can cause an exacerbation of symptoms for people with asthma.

More…
14/06/2011 Cockroaches could cause asthma in children
Cockroaches have been identified as a possible cause for high rates of asthma in certain neighbourhoods in New York City, USA.

More…
10/06/2011 Mouldy homes linked to children’s asthma
New research has found that mouldy homes could be linked to asthma in children.

More…
08/06/2011 UK doctors begin pioneering asthma treatment
Doctors in Manchester and Glasgow have started treating NHS asthma patients with a new treatment which is said to “melt away” muscle in the airways.

More…
11/05/2011 Asthma risk higher in babies born early
Babies born early could be at a higher risk of asthma during childhood and adolescence, according to a new study.

More…
05/05/2011 Asthma pill as effective as inhalers
New research has suggested that a pill to treat asthma is as effective as inhalers in managing asthma symptoms, and is much easier to use.

More…

News

Babies born by elective caesarean are more likely to contract a serious lung infection, known as bronchiolitis, in their first year or life, according to researchers in Australia.

More…
02/11/2011 Social media could help track flu outbreaks
Social media sites such as Twitter and Facebook could be used to help doctors detect areas where outbreaks of flu and other diseases are most likely, according to researchers from the UK.

More…
01/11/2011 Idiopathic Pulmonary Fibrosis survival predicted by a blood protein
A new study has identified a protein found in the blood which could help determine how long a person with idiopathic pulmonary fibrosis (IPF) has left to live.

More…
31/10/2011 Air pollution tied to lung cancer in non-smokers
People who have never smoked but who live in areas with high air pollution levels are more likely to develop lung cancer than people who live in areas of cleaner air.

More…
28/10/2011 Study identifies risk factors for altitude sickness
A new study has identified a number of risk factors for altitude sickness.

More…
28/10/2011 Scientists urge public not to doubt flu vaccine
A group of European scientists are urging members of the public not to doubt the benefits of the influenza vaccine.

More…
27/10/2011 Annual chest x-ray does not reduce rate of lung cancer deaths
New research suggests that annual screening using a chest x-ray does not cut the number of deaths from lung cancer.

More…
26/10/2011 Exercise benefits people with asthma
Physical training programmes involving aerobic exercise can benefit patients with asthma according to new research.

More…
25/10/2011 Heavy alcohol consumption linked to lung cancer
Recent studies show that heavy alcohol consumption could be linked to a greater risk of developing lung cancer.

More…
24/10/2011 Lung cancer vaccine shows promise
A vaccine, which causes the immune system to attack the most common type of lung cancer, could help slow the progression of the disease, according to new research.

 

Asthma in the news

10/10/2011 Workplace pollutants linked to childhood asthma
A mother’s exposure to airborne pollutants during pregnancy may increase the likelihood that her unborn child will later develop asthma, according to a new study.

More…
19/09/2011 Low-fat yoghurt intake when pregnant may lead to child asthma and hay fever
Eating low-fat yoghurt whilst pregnant can increase the risk of your child developing asthma and allergic rhinitis (hay fever), according to recent findings.

More…
15/09/2011 Children who drink raw milk have less asthma and allergies
Children who drink raw milk (unpasteurised) are less likely to develop asthma and allergies compared with those who drink pasteurised milk, according to a large European study.

More…
13/09/2011 New device gives hope to asthma sufferers
A new device, similar to a tiny whisk, which is inserted into the lungs, is proving to be a successful treatment for people with severe asthma.

More…
09/09/2011 New method to aid treatment of asthma attacks during pregnancy
Scientists in Australia have developed a new technique for treating pregnant women with asthma, to help cut flare-ups during pregnancy.

More…
25/08/2011 Dust mite allergy could predict asthma risk
Children who show an allergy to dust mites at an early age have a higher risk of developing asthma in later life.

More…
16/08/2011 Children of obese mothers face asthma risk
Mothers who are overweight or obese when they become pregnant are more likely to have children who suffer from asthma or wheezing symptoms, according to new research.

More…
15/08/2011 Potential new treatment for delayed asthma attacks
Scientists have found a potential new treatment for delayed asthma attacks, which can occur several hours after exposure to allergens.

More…
03/08/2011 Magnetic field exposure linked to asthma risk
Mothers who have a high exposure to electromagnetic fields while pregnant could have an increased risk of their child developing asthma.

More…
18/07/2011 Overall care can improve asthma symptoms
A new study has shown that caring for people with asthma, and not just providing drugs, can help them feel better.

More…

Asthma in the news

11/01/2012 Caesarean birth may increase risk of children developing asthma by age of 3
A new study has found that babies delivered by caesarean section were more likely to develop asthma by the age of three than children delivered naturally.

More…
21/12/2011 Child’s weight can determine asthma risk
Overweight children who don’t lose their baby fat as they grow up are more likely to develop asthma, according to new research.

More…
14/12/2011 Severe asthma attacks could be reduced by improved medication use
One quarter of severe asthma attacks could be prevented if people with asthma consistently took their medication as prescribed, according to new research.

More…
05/12/2011 Arsenic in water tied to breathing issues
People in Bangladesh exposed to high levels of arsenic in drinking water were more likely to report shortness of breath in a new study than those who drank water with lower arsenic concentrations.

More…
28/11/2011 New data on most common respiratory allergies in the EU
One in every two Europeans will suffer an allergy by 2015, according to a new book launched at the European Parliament last week (25 November 2011

More…
24/11/2011 Night time airflow device eases asthma symptoms
A device which is able to filter out airborne triggers of asthma during sleep can ease persistent symptoms of the condition during the day and improve overall quality of life, according to recent research published in the journal Thorax.

More…
14/11/2011 Survey provides insight into allergies in the home
A new survey has shed light on the number of people affected by allergies in the home.

More…
03/11/2011 Caesarean link to infant lung infections
Babies born by elective caesarean are more likely to contract a serious lung infection, known as bronchiolitis, in their first year or life, according to researchers in Australia.

More…
28/10/2011 Study identifies risk factors for altitude sickness
A new study has identified a number of risk factors for altitude sickness.

More…
26/10/2011 Exercise benefits people with asthma
Physical training programmes involving aerobic exercise can benefit patients with asthma according to new research.

More…

News

08/12/2011 New study challenges current understanding of lung growth
Researchers in the UK have challenged the current medical understanding that the lungs are completely formed by the age of 3 years.

More…
07/12/2011 European doctor launches warning of “grave health consequences”
A medical expert from the Health and Environment Alliance (HEAL) has presented a call to action to the first ever Global Climate and Health Summit, which took place in Durban, South Africa, last weekend (4 December 2011).

More…
05/12/2011 Arsenic in water tied to breathing issues
People in Bangladesh exposed to high levels of arsenic in drinking water were more likely to report shortness of breath in a new study than those who drank water with lower arsenic concentrations.

More…
30/11/2011 Pneumonia most common infection after heart surgery
Pneumonia is the most common infection after heart surgery, according to new research.

More…
29/11/2011 Scientists modify bird-flu virus to show that it has the potential to spread between humans
Scientists have manipulated the bird flu virus (H5N1) to show that it can transform to spread between humans.

More…
28/11/2011 New data on most common respiratory allergies in the EU
One in every two Europeans will suffer an allergy by 2015, according to a new book launched at the European Parliament last week (25 November 2011

More…
25/11/2011 Air pollution costs Europe billions
A new report has found that air pollution caused more than 100 billion euros in health and environmental damage.

More…
24/11/2011 Night time airflow device eases asthma symptoms
A device which is able to filter out airborne triggers of asthma during sleep can ease persistent symptoms of the condition during the day and improve overall quality of life, according to recent research published in the journal Thorax.

More…
23/11/2011 Lack of improvement in lung cancer survival rates over 40 years
New figures have revealed a lack of improvement in survival rates for lung cancer in the UK over the last forty years.

More…
22/11/2011 Awareness of chronic obstructive pulmonary disease (COPD) continues to rise in the USA
The results of a recent web-based survey carried out by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health, USA, indicate that awareness of COPD continues to rise.

 

Asthma in the news

19/03/2012 Common use of antibiotics linked with asthma
Commonly prescribed antibiotics may increase the incidence and severity of allergic asthma in children, according to new findings.

More…
08/03/2012 Asthma and allergies societies join forces to improve treatment
Four of the world’s largest medical organisations in the field of asthma and allergy have joined forces to improve awareness, funding and treatment of the conditions.

More…
02/03/2012 Lung health risks linked to early birth
Babies born just a few weeks early can have a slightly higher risk of health problems, a new study has found.

More…
24/02/2012 Study explores relationship between obesity and asthma
New research shows that both fat and lean body tissue can have a negative impact upon lung function, with this relationship being most significant for adult females.

More…
16/02/2012 Molecule discovery helps in fight against allergy
Scientists in the UK have discovered a molecule that could offer the hope of new treatments for people allergic to the house dust mite.

More…
08/02/2012 Asthma and COPD could be connected to fizzy drinks
New research suggests that drinking fizzy drinks could increase the risk of developing asthma or chronic obstructive pulmonary disease (COPD).

More…
03/02/2012 Breastfeeding improves lung function for school age children
Children who are breastfed have improved lung function at school age, according to new findings.

More…
01/02/2012 New online test tries to cut deaths from asthma attacks
A new online test being rolled out in the UK will help people with asthma gauge to what extent they are at risk from a serious attack.

More…
20/01/2012 Accelerated growth in babies linked to future asthma symptoms
Babies who have accelerated growth in the first three months of life have an increased risk of asthma symptoms, according to a new study.

More…
12/01/2012 Pool chlorine causes lung damage in elite swimmers.
A study shows that competitive swimmers using indoor pools to train, may develop changes in the lungs, similar to those seen in people with mild asthma.

More…

News

05/01/2012 Bad dental health can lead to pneumonia
Older people are at risk of developing pneumonia if they fail to brush their teeth effectively, according to new findings.

More…
03/01/2012 British heart group calls for plain tobacco packs
Campaigners are urging the British government to follow Australia’s lead and ban all eye-catching designs and branding from cigarette packaging.

More…
03/01/2012 CT scan helps identify patients at risk of COPD exacerbation
A new study suggests that a type of computed tomography scan (CT scan), which allows doctors to create a 3D image of the body, can help predict the likely course of chronic obstructive pulmonary disease (COPD) and provide valuable information in addition to standard breathing tests.

More…
21/12/2011 Child’s weight can determine asthma risk
Overweight children who don’t lose their baby fat as they grow up are more likely to develop asthma, according to new research.

More…
16/12/2011 Critics blast Dutch government for anti-smoking policies
Anti-smoking campaigners have criticised the government in the Netherlands for backtracking on tobacco control policies.

More…
15/12/2011 Statins may cut deaths for people hospitalised with influenza
New research suggests that cholesterol-lowering drugs, known as statins, could be used to control influenza.

More…
14/12/2011 Severe asthma attacks could be reduced by improved medication use
One quarter of severe asthma attacks could be prevented if people with asthma consistently took their medication as prescribed, according to new research.

More…
13/12/2011 Acute lung injuries can lead to depression and reduced activity
Feeling depressed and needing help with daily activities are two common and long-lasting consequences of an acute lung injury, according to a new study.

More…
12/12/2011 Risk of emergency hospital admission increases after dust storms
Dust storms have an adverse effect on emergency hospital admissions for chronic lung disease, according to a new study.

More…
09/12/2011 Diagnosis of TB is increased in new mothers
The diagnosis of TB is significantly increased in mothers who’ve just given birth, according to a new study.

More…

Asthma in the news

06/06/2006 Asthma – an occupational hazard
The type of work you do can put you at greater risk of developing asthma as an adult, a new study by Australia’s leading respiratory research organisation, the Woolcock Institute of Medical Research, has found.

More…
18/05/2006 Mild asthmatics should take medication on a regular basis
Mild asthmatics should take preventer medication on a regular basis, rather than take it intermittently when their symptoms worsen, a new Australian study has found.

More…
12/05/2006 Heat-based technique could ease asthma
A new therapy called “bronchial thermoplasty,” designed to reduce inflammation-related narrowing of the airways, may prove a boon to asthmatics, Canadian researchers report.

More…
11/05/2006 Europe wide study to examine causes of asthma
Imperial College London and Ludwig-Maximilians-Universität (LMU) Munich are to take the lead in a Euro 11 million (GBP 8 million) study to examine how genetics and environment influence the development of asthma in Europe.

More…
04/05/2006 Children living near major roads face higher asthma risk
Young children who live near a major road are significantly more likely to have asthma than children who live only blocks away, according to a study that appears in the May issue of Environmental Health Perspectives.

More…
25/04/2006 Finding suggests alternative treatment approach for common skin disorders and asthma
A finding by researchers at the National Institutes of Health provides new insight into the cause of a series of related, common and complex illnesses – including hay fever and asthma as well as the skin disorders eczema and psoriasis – and suggests a novel therapeutic approach.

More…
12/04/2006 Antibiotics ‘could treat asthma’
Antibiotics could be useful in the treatment of asthma, research suggests.

More…
11/04/2006 Prenatal smoking boosts teen girls’ asthma risk
Girls whose mothers smoked heavily during pregnancy are more likely to have asthma symptoms at age 14, a study from Australia shows. However, the researchers found no such link between a mother’s smoking and boys’ asthma risk.

More…
14/03/2006 Antibiotic use in infants may double asthma risk
Children exposed to at least one course of antibiotics in their 1st year of life may have an increased risk of developing childhood asthma.

More…
16/02/2006 Asthma ‘limits children’s lives’
Four out of 10 children with asthma say the condition places limitations on their lives, a UK-wide survey suggests.

More…

News

09/01/2006 Crunch time for EU environmental policies
Europe is gearing up for the next phase of its controversial climate change programme while member states prepare to take key decisions on strategies that will define EU environmental policies for the years to come.

More…
07/01/2006 Can dogs sniff out cancer?
In a society where lung and breast cancers are leading causes of cancer death worldwide, early detection of the disease is highly desirable.

More…
06/01/2006 Smoking parents can still keep kids from starting
Parents who can’t kick the smoking habit themselves can nevertheless convince their children not to start, a new study shows.

More…
05/01/2006 Many non-smokers develop lung obstruction
It hardly seems fair but nearly one in four Americans with airway obstruction have never smoked, a new analysis shows.

More…
04/01/2006 Mums who smoke after delivery breastfeed less
Women who smoke more than 10 cigarettes a day after giving birth may wean their babies off breastmilk much more quickly than nonsmokers.

More…

Asbestos-related lung diseases

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Author

This factsheet was prepared by the ELF office with assistance from Professor P.S. Burge, of the Occupational Lung Disease Unit, Birmingham Heartlands Hospital, UK. The material was reviewed and approved by the ERS Advisory Board.

Information sources

National Institute of Occupational Safety and Health (NIOSH).
Enviromental Protection Agency.
The Health and Safety Executive.
European Environment Agency.

Interesting links

An article entitled ‘Induced sputum in occupational lung diseases’ published in Breathe 2005, E. Fireman, Y. Lerman

For up to date information about asbestos-related diseases in your country please go to http://osha.europa.eu/good_practice/topics/dangerous_substances/asbestos

Please see below for the full range of doctor approved factsheets.

Bird flu The normal lung
Pulmonary arterial hypertension Sleep apnoea
Diet and the lungs Indoor air pollution
Outdoor air pollution Dirty air and the lungs
Pneumonia Work-related lung diseases
Asbestos-related lung diseases Alpha 1-anti trypsin deficiency
Dirty air indoors and your lungs Spirometry
Rare and ‘orphan’ lung diseases Allergic rhinitis or “hayfever”
Climate change and the lungs Tuberculosis
Smoking and the lungs Living well with COPD
Asthma and infection Acute Bronchitis
MDR-TB

What are the signs and symptoms of bird flu in humans?

In many patients, the disease caused by the H5N1 virus follows an unusually aggressive clinical course, where the patient goes down-hill rapidly.

Initial symptoms include:

high fever (usually higher than 38°C)
flu-like symptoms
And possibly:

diarrhoea
vomiting
abdominal pain
chest pain
bleeding from the nose and gums.
Almost all patients eventually develop pneumonia and many of their organs may dysfunction.

There may be more symptoms and not all patients have presented with the symptoms above.

Asthma UK issues advice on long acting beta-agonists

Asthma UK has issued advice for healthcare professionals in response to media coverage generated by an editorial published in the Journal of the Royal Society of Medicine on a 2003 US clinical trial into long-acting reliever inhalers.
Professor Martyn Partridge, Chief Medical Adviser at Asthma UK, comments: ‘Inhaled steroids remain the most effective medicine available for those with asthma. For those not fully controlled on low dose inhaled steroids the addition of a long acting inhaled beta agonist (LABA) has been shown to improve control, as have to a lesser extent the addition of theophylline or a leukotriene modifier.’

‘The report of adverse effects with long acting inhaled beta agonists is not new and there was a statistically non significant excess of deaths in those on Salmeterol in the original post marketing surveillance study a decade or so ago. Some excess risk may reflect genetic or racial differences not yet taken into account in clinical trials, and some reflects monotherapy i.e. those with socioeconomic deprivation taking the Salmeterol and not the inhaled cortico steroid. Such monotherapy has never been a part of British Asthma Guideline on the Management of Asthma.’

 

Finer particles give more useful air quality data

New air quality research indicates that measuring ultra-fine particles can distinguish between particles generated through human activities, such as combustion, and larger particles, which are more likely to arise from mechanical processes and natural sources.

The smallest air particles are from combustion sources such as vehicles and power plants, and easily enter the body. However, air quality measurements today typically focus on larger particles from mechanical processes, which may be less relevant from a health perspective.

Air quality standards in Europe measure the amount of particles in the air that are less than 2.5 (PM2.5) and 10 (PM10) micrometres in diameter. The limitations of the measurement equipment available at the time were at least partly responsible for the choice of these particle sizes.

Research using data on over 6000 particle samples from a range of environments explored whether measuring PM1 and PM10 levels would lead to a better distinction between the different types of pollution source.

The research found that PM2.5 data were hard to interpret, because they included particles from both mechanical processes and from burning (of fuel, for example). Data from many environments around the world showed a clear cut-off point around the PM1 mark, with particles below this size being derived almost exclusively from burning. This suggests that PM1 and PM10 would be more useful measures of air quality than the current system.

This article was taken from the Science for Environment Policy, a service from the European Commission.

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Pneumonia vaccine could beat asthma symptoms

A vaccine to treat pneumonia in children could also suppress asthma symptoms, researchers say.

A team from the University of Newcastle, Australia, and the nearby John Hunter Hospital said a pneumonia infection significantly reduced the number of inflammatory cells associated with asthma after they induced asthmatic symptoms before injecting a pneumonia bacteria in mice in laboratory tests.

Earlier research has shown that bacteria responsible for causing pneumonia could inhibit inflammatory responses in the lungs from allergic diseases such as asthma.

After killing the bacteria in the mice, the research team then administered the vaccine Prevenar to the mice, again causing a substantial reduction in asthma symptoms, says researcher Alison Thorburn.

Research is still at the preliminary stage because it has only been shown in animal models; however, initial results are encouraging and suggest that a vaccine prescribed for pneumonia may be a potential therapy for the suppression of allergic lung diseases, such as asthma.

Genetic link to smoking addiction

Scientists have identified genetic variations that raise the risk of lung cancer for smokers and former smokers.

There is some evidence to suggest that the variations may make carriers who smoke more addicted to tobacco.

The variants are common in the population – but they only raise lung cancer risk in those who have smoked.

Current or former smokers who carry two copies of both variants, one from each parent – about 15% of the total – have a raised risk of 70-80%.

Those who carry one copy of each variant have a raised risk of around 28%.

All the researchers agree the work is a major stop forward in identifying people at risk for non-small cell lung cancer – which makes up 80% of all lung cancer cases.

 

India: smoking major vector for TB deaths

According to the World Health Organization, tuberculosis killed 1.7 million people in India and China in 2006. Anti-tobacco campaigners claim that smoking was the main factor causing the spread of TB and death from the disease.
Smokers have an increased risk of contracting TB and suffer much worse symptoms.

In India smoking is responsible for the spread of TB and kills more people than lung cancer.

It is thought that 40% of TB deaths among men are caused by smoking. Smoking plays a major role in the spread of TB.

 

Could antidepressants fight cystic fibrosis infections?

Widely-used antidepressants could prevent infections which shorten the lives of many cystic fibrosis patients.

The lung disease is caused by a genetic mutation which creates the perfect environment for bacteria to thrive and cause permanent damage.

German and US scientists, writing in the journal Nature Medicine, say experiments on mice have revealed how this happens.

The most obvious symptom of the disease is the production of too much thick mucous inside the lung, which scientists had believed helped bacteria such as Pseudomonas aeruginosa to get established out of the reach of the body’s immune system.

However, the work by the German and US teams suggests that a direct result of the genetic mutation is to lower the acidity within certain parts of the cell. This, in turn, interferes with the efficiency of two body chemicals whose job it is to control levels of a fat called ceramide.

Rising levels of ceramide cause increased inflammation and death of lung cells, which make it easier for bacteria to survive. Scientists believe that it may be possible to halt this chain reaction with the use of drugs.

 

Coal production undermines communities’ health

Pollution from coal mining may have a negative impact on public health in mining communities according to data analysed in a West Virginia (USA) University research study.

Residents of coal-mining communities are at an increased risk of developing chronic heart, lung and kidney diseases.

Researchers tried to find out whether there is a relationship between coal production and forms of cardiovascular, lung and kidney disease in the state.

They predict that as coal production increases, so does the incidence of chronic illness.

Data collected in the study showed that people in coal mining communities have a 64 per cent increased risk for developing chronic obstructive pulmonary disease (COPD) and are 30 per cent more likely to report high blood pressure (hypertension).

European Respiratory Society Congress 2006

The European Respiratory Society’s congress is the largest annual scientific gathering in respiratory medicine in the world.

Each year, at the ERS congress, doctors, scientists, nurses and other health workers come together from all over the world and from all continents to share ideas and discuss how to improve treatment options for patients.

This exchange of expertise is vital to advance the field of respiratory health and to keep doctors in all parts of the world up to date on the latest treatments and care strategies.
Since the first congress in 1991 the number of participants has grown every year and this year 18,000 participants are expected.

Have your lungs tested

The ELF, in association with the ERS will be running its fifth public spirometry testing event during the Congress in Munich this year.

A spirometry test measures how well your lungs are working by measuring how much you breathe out and how long it takes to breathe out.
This event provides members of the public with the chance to have their lungs tested for free and receive information about lung health and disease.

Testing will take place on Friday, 1 September from 11:00-19:00 and Saturday 2 September from 10:00-18:00 at the Odeonsplatz at the heart of Munich.

 

Fellowships

With your help, each year, the ELF is able to fund young scientists and researchers to further work in the field of lung health and diseases.

What is a Fellowship?

ERS/ELF Fellowship schemes provide young scientists and clinicians with funding to carry out research into the lungs or to complete a training project in any part of Europe. The main aim of the fellowship is to allow people to learn skills that they cannot acquire in their own countries.

How do ERS/ELF Fellowships affect you?
The projects chosen to receive the ERS/ELF Fellowships each year all have a clear impact on lung health and disease. The ELF Council considers all applications and then decides which ones will most help you, that is patients and the general public.

For example:

A project may be chosen because it studies a new treatment for asthma which will make life easier for thousands of people.

A person may be chosen to receive a Fellowship because they are going to learn a new technique that is essential for the area where they work.

The project may be looking at ways that we can improve our lung health and prevent disease, by researching (or tackling) issues such as obesity and the environment.

Glossary

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A
Acute: of rapid or sudden onset (opposite of “chronic”).

Airborne: conveyed by or through the air.

Alveoli: tiny air sacs in the lung.

Antibiotics: substance produced by or derived from a microorganism that destroys or inhibits the growth of other microorganisms. Antibiotics are used to treat infections caused by organisms that are sensitive to them, usually bacteria or fungi.

Antimicrobial: an agent that kills microorganisms or suppresses their multiplication or growth.

Antioxidants: a synthetic or natural substance added to a product to prevent or delay its deterioration by action of oxygen in the air.

α1-antitrypsin: a plasma protein produced in the liver, which inhibits the activity of trypsin and other proteolytic enzymes. Deficiency of this protein is associated with emphysema.

Asphyxia: suffocation: a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system.

Atopic: Hereditary tendency to experience immediate allergic reactions because of the presence of an antibody in the skin.

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B
Bacteria: a group of microorganisms all of which lack a distinct nuclear membrane and have a cell wall of unique composition. Most bacteria are unicellular; Bacteria are very widely distributed, some live in soil, water or air and others are parasites of man, animals and plants. Many parasitic bacteria do not harm their hosts; some cause diseases by producing poisons.

Benign tumour: a tumour that is localized and will not maigrate to other parts of the body, not cancerous, usually harmless.

Biomass fuel: liquid, solid, or gaseous fuel produced by conversion of biomass (vegetable matter used as a source of energy).

Bronchitis: inflammation of the bronchial tubes, characterised by coughing, difficulty in breathing etc., caused by infection or irritation of the respiratory tract.

Bronchoconstrictor: a drug that causes narrowing of the air passages by producing spasm of bronchial smooth muscle.

Bronchodilators: an agent that causes widening of the air passages by relaxing bronchial smooth muscle.

Bronchus: (pl. bronchi) any of the air passages beyond the trachea (windpipe) that has cartilage and mucous glands in its walls.

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C
Carcinogens: any substance that, when exposed to living tissue, may cause the production of cancer.

Cardiovascular: of or relating to the heart and the blood vessels.

Cerebrovascular: of or relating to the blood vessels and the blood supply of the brain.

Chemotherapy: the prevention or treatment of disease by the use of chemical substances. The term is sometimes restricted to the treatment of infectious diseases with antibiotics and other drugs or to the control of cancer.

Chronic: describing a disease of long duration involving very slow changes. Such disease is often of gradual onset. The term does not imply anything about the severity of a disease.

Corticosteroids: any steroid hormone synthesised by the adrenal cortex (part of the adrenal gland, which covers the superior surface of a kidney).

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D
DNA: the genetic material of nearly all living organisms, which controls heredity.
Dysphonia: defective use of the voice.

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E
Emphysema: in pulmonary emphysema the air sacs (alveoli) of the lungs are enlarged and damaged, which reduces the surface area for the exchange of oxygen and carbon dioxide.

Enzymes: a protein that, in small amounts speeds, up the rate of a biological reaction without itself being used up in the reaction.

Epidemic: a sudden outbreak of infectious disease that spreads rapidly through the population, affecting a large proportion of people.

Epidemiology: the study of the occurrence, distribution, and control of diseases in populations.

Epithelial: relates to the layer of cells which form a covering over the internal and external surfaces of the body that communicate with the outsie world. E.g. the inner lining of the lungs, digestive tract, and skin cells.

Exacerbation: to make more intense.

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Fibrosis: thickening and scarring of connective tissue, most often a consequence of inflammation or injury.

Fungi: (pl. of fungus) a simple organism (formerly regarded as a plant) that lacks the green pigment chlorophyll.

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Genes: the basic unit of genetic material.

Genetic: of or relating to genes.

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Hereditary: transmitted from parents to their offspring; inherited.

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Idiopathic: (a disease) of no known cause

Idiopathic pulmonary fibrosis: scarring or thickening of tissues deep in the lung without a known cause.

Immune: protected against a particular infection by the presence of specific antibodies against the organisms concerned.

Immunocompromised: patients in whom the immune response is reduced or defective due to immunosuppression.

Immunosuppressive: a drug that reduces the body’s resistance to infection and other foreign bodies by suppressing the immune system.

Inflammation: the body’s response to injury.

Ischaemic heart disease: atherosclerosis (hardening) of the heart vessels, which makes the patient likely to suffer from angina (chest pain) and myocardial infarction (heart attack).

Incidence: a measure of morbidity based on the number of new episodes of illness arising in a population over a period of time.

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L
Leukotrienes:

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M
Malaise: a general feeling of being unwell.

Metastasis: the distant spread of malignant tumour from its site of origin.

Microorganism: any organism too small to be visible to the naked eye.

Morbidity: the symptoms and/or disability resulting from a disease.

Mortality: the rate of death in the population in a given period.

Mutations: a change in the genetic material (DNA) of a cell, or the change this causes in a characteristic of the individual, which is not caused by normal genetic processes.

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O
Oedema: excessive accumulation of fluid in the body tissues.

Oesophagus: the gullet: a muscular tube, about 23 cm long, that extends from the pharynx to the stomach.

Oxidative stress:

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P
Palliative: a medicine that gives temporary relief from the symptoms of a disease but does not actually cure the disease.

Particulate matter: term used for a mixture of solid particles and liquid droplets suspended in the air.

Pathogen: a microorganism, such as a bacterium, that parasitizes an animal (or plant) or man and produces a disease.

Prevalence rate: a measure of morbidity based on current sickness in a population, estimated either at a particular time or over a stated period.

Pulmonary: relating to, associated with, or affecting the lungs.

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R
Resection: surgical removal of a portion of any part of the body.

Respiratory system: the combination of organs and tissues associated with breathing.

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S
Socioeconomic: involving social as well as economic factors.

Somnolence: causing drowsiness.

Susceptibility: lack of resistance to disease.

Synergistic: a drug that interacts with another to produce increased activity, which is greater then the sum of the effects of the two drugs given separately.

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T
Therapeutic: of or relating to the treatment of disease.

Trachea: the windpipe.

Trypsin: an enzyme that continues the digestion of proteins.

Tumour: a lump of tissue caused by an abnormal growth of cells, can be benign or malignant

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V
Viruses: a minute particle that is capable of replication but only within living cells. They infect animals, plants and microorganisms.

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W
Wheeze: an abnormal high-pitched or low-pitched sound heard during expiration; results from narrowing of the airways or increased secretion or retention of sputum.

World No Tobacco Day 2007

World No Tobacco Day – 31/05/2007
100% Smoke free environments

The Member States of World Health Organization (WHO) created World No Tobacco Day (WNTD) in 1987 to draw global attention to the tobacco epidemic and the preventable death and disease it causes.

The theme of World No Tobacco Day 2007 is “100% Smokefree environments”. This theme is designed to increase awareness on the dangers of smoking and how harmful it is to inhale second-hand smoke.

Tobacco is the second major cause of death in the world. Half of today’s regular smokers, which is about 650 million people, will die of a smoking related disease.

Hundreds of thousands of non-smokers die each year from diseases caused by inhaling second-hand smoke.

100% smoke-free environments is the only answer to protect workers and the public from the serious, harmful effects of tobacco smoke.

 

Testimonies

These pages are provided for people to post their experiences or queries on any aspect of lung health or lung diseases. We hope that you can provide inspiration and information for each other on these pages.

Asthma testimonies

COPD Testimonies

Lung cancer testimonies

Pneumonia testimonies

Tubercolosis testimonies

Cystic fibrosis testimonies
Interstitial Lung Diseases testimonies

US foundation reports improvements in cystic fibrosis indicators

The Cystic Fibrosis Foundation in the USA has reported that key indicators of health for people with cystic fibrosis, including lung function and nutritional status, are rising nationwide across its accredited care center network.
The outlook for people with cystic fibrosis continues to improve steadily each year.

The new data is posted on the CF Foundation’s Web site under “Care Center Network.” It includes four measures vital for the health of people with the disease: lung function, nutritional status (body mass index), screening for cystic fibrosis-related diabetes, and adherence to recommended outpatient clinic visits and tests.

The CF Foundation is a major funder of cystic fibrosis care and research in the USA. In December 2006, it became one of the first organisations of its kind to publicly release health outcomes data in an effort to accelerate the rate of improvement in care.

Marijuana smokers’ style exposes them to extra danger

A study at the University of Monash, Australia, found that lung disease can occur two decades earlier in marijuana smokers than in people who only smoke cigarettes; and the style of smoking is to blame.

Marijuana smokers inhale more and hold their breath four times longer than cigarette smokers, resulting in toxic exposure to the lungs and long-term exposure to the tobacco used to roll the joint.

Dr Matthew Naughton, lead author of the study, says that this type of breathing style increases the concentration and pulmonary deposition of inhaled particulate matter. The research showed this smoking style causes faster and greater lung destruction in research subjects.

 

South Africa facing an asbestos epidemic

Dozens of South Africans still die of asbestos-related diseases every year, despite the closure of asbestos mines in the mid-1980s.
The most recent victims, a 19-year-old and a 60-year-old man from Kuruman in the Northern Cape, died last week from secondary pollution from asbestos.

The deaths came in the wake of a 2005/6 government study on the extent of pollution at former mining sites.

The objective of the study was to highlight the potential extent of secondary pollution.

Dr Shahieda Adams, a medical specialist in occupational and environmental health, said although the government was trying to prohibit the use and manufacture of asbestos, the fibre had a long latency period and problems could manifest only years after people were exposed to it.

 

Young adults more likely to quit smoking successfully

Researchers at the Moores Cancer Centre at the University of California, San Diego have found that young adults are more likely than older adults to quit smoking successfully, partly because they are more likely to make a serious effort to quit.
The study also found that young adults, aged 18 to 24, are more likely to have tried to quit smoking than older adults, aged 50 to 64.

The study used the largest available national data sample, the 2003 Tobacco Use Supplement to the U.S. Current Population Survey, to evaluate the relationship between smoking cessation rates and tobacco-related behaviours between age groups.

Eighty-four percent of smokers aged 18 to 24 reported seriously trying to quit in the prior year compared to just 64 percent of those 50 to 64 years old.

The study also showed that smokers who lived in a smokefree home were four times as successful at quitting as those who lived in a home with a smoker.

Burden in Europe

There are approximately 44 million cases of COPD worldwide. In developed countries, COPD is seen in late-middle and old age, usually after 45 years.
Occurrence in Europe
The frequency of clinically relevant COPD varies in European countries from 4–10% of the adult population.
Data on the frequency of COPD in Central and Eastern Europe are very limited.

Deaths from COPD
Approximately 200,000–300,000 people die each year in Europe because of COPD.
Data provided by the World Health Organization (WHO) in 1997 showed that COPD was the cause of death in 4.1% of men and 2.4% of women in Europe.

The cost of COPD
Among respiratory diseases, COPD is the leading cause of lost work days.
In the EU, approximately 41,300 lost work days per 100,000 people are due to COPD every year.
In Europe, productivity losses due to COPD amount to a total of €28.5 billion annually.

The future?
By 2020, COPD is likely to account for over 6 million deaths worldwide every year, making it the third leading cause of death.

Mothers’ stress may increase children’s asthma

Children whose mothers are chronically stressed during their early years have a higher asthma rate than their peers, regardless of their income, sex or other known asthma risk factors.

In a group of children born in 1995, Canadian researchers found that maternal distress that carries on beyond the period soon after birth is associated with an increased risk of asthma at school-age.

The findings appeared in the second issue for January of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Dr. Anita Kozyrskyj and her colleagues analysed the medical records of nearly 14,000 children born in Manitoba in 1995 who were continuously registered with Manitoba Health Services until 2003.

Even after controlling for the known risk factors for asthma of male sex, mother with asthma, urban location and total healthcare visits, long-term maternal stress was associated with an increase of nearly a third in the prevalence of childhood asthma.

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Merry Christmas from the ELF

Everyone at the European Lung Foundation would like to wish a very Happy and Healthy Christmas and a Joyful New Year to everyone who has read and contributed to our work during 2008. We hope to see you again in 2009.

Christmas Related News Stories

Christmas tree asthma risk 10/12/2007
The Australian National Asthma Council sent out a warning to over 2 million Australians stating that pollens and dust from your Christmas tree can trigger asthma.

A fire without smoke? 19/12/2007

For many people, Christmas is a time for sitting round an open fire with the family, sharing in the warmth as winter does its worst outside. But that cosy glow does hide some health risks.

 

Study points to possibility of blood test to detect lung cancer

A test for four blood proteins may provide a less-invasive follow-up for patients who may have lung cancer.

“CT scans have a very high false positive rate when trying to discover lung cancer,” said Edward Patz, Jr., M.D., a radiologist at Duke and lead investigator on the study.

This leads to several follow-up imaging studies or invasive procedures like biopsy, which have risks of their own.

“This study is the first step in developing a test that would allow us to sample a patient’s blood and determine whether more invasive testing and treatment are necessary.”

 

Diesel traffic makes asthma worse

A spot of Christmas shopping in a busy town centre may damage your health as well as your bank balance.

Air pollution from diesel traffic can worsen lung function in people with asthma, a team of international researchers has said.

The first “real-life” study showed lung function was worse in patients who spent two hours on London’s Oxford Street compared with nearby Hyde Park.

Lung function tests done before and after the walks showed a greater reduction in lung capacity after participants had been exposed to diesel traffic than in the park and more inflammation in the lungs.

The negative effects were greater in those with worse asthma to start with.

 

UK lags behind in lung cancer care

Patients are dying needlessly because UK lung cancer treatment is lagging way behind Europe and the US, it was claimed today.

A study of nearly 19,000 patients showed a five per cent increase in the number of patients receiving treatment in 2006 compared with the previous year. But levels are still way behind those offered in many other countries.

The fraction of British patients having surgery – the most effective treatment – remained at nine per cent, while more than 20 per cent of US sufferers had operations. The European average is 26 per cent for those younger than 70 and 14 per cent for those above that age.

Young people were more likely to receive anti-cancer treatment than the elderly, despite the average age for diagnosis being 71 for men and 72 for women.

Mike Unger, the chief executive of the Roy Castle Lung Cancer Foundation, criticises the gap between the UK and other countries: “The Government needs to wake up and have an awareness campaign. Lung cancer is the big cancer killer with the lowest amount of research money going into it.”

Cleanliness is godliness – Washing hands and wearing masks could block bird flu

Many governments are stocking up on vaccines and antiviral drugs to reduce the spread of respiratory infections, such as avian influenza and SARS, but a new review suggests that simpler, cheaper measures also have a role to play.

A worldwide review of 51 previous studies, published in the British Medical Journal, suggests that simple infection-control measures can be very effective in preventing the spread of respiratory infections, at a fraction of the cost of drug treatment.

The scientists looked at the ability of combined public health measures such as personal hygiene, distancing, and barriers (for instance masks, gowns and gloves) to interrupt or reduce the spread of respiratory viruses.

The results found that wearing masks, gloves and gowns, along with frequent hand washing – particularly in children – can cut the transmission of respiratory viruses. Separately, these measures have been shown to impede the spread of SARS, with estimates of effect ranging from 55% to 91%. “In fact, combining these measures may be more effective than prescribing antiviral drugs in the event of a pandemic,” says the study.

Hospital bugs ‘hit communities’

Virulent bugs are spreading outside hospitals and in the community and may put lives at risk, experts say.

They want doctors to be alert to a potentially lethal form of MRSA which can infect the lungs, and may strike young people in particular.

Panton Valentine leukocidin (PVL) strains of community-acquired MRSA can cause a condition called necrotizing pneumonia, which destroys lung tissue.

This only affects a minority of those infected, but can be deadly.

The condition is spread outside of hospitals via skin-to-skin contact and appears as sores which look like insect bites. In the very worst cases, it can kill in a day.

 

Stress disorder’s ties to asthma

A new study has found a link between asthma and post-traumatic stress disorder, though the reasons remain unknown.

The stress disorder is common among combat veterans and others who have endured severe trauma, such as 9/11 rescue workers.

Researchers used data on 3,065 male twin pairs who had lived together as children and had active duty in the Vietnam War.

They adjusted the findings to eliminate the influence of depression, smoking, age, body mass index, exposure to combat and other variables.

The quarter of men with the most severe symptoms of the stress disorder were more than twice as likely to suffer from asthma as the quarter who showed the fewest stress disorder symptoms.

 

Balding and breathless: how smoking may lead to hair loss

Smoking is known to lead to leg amputation. Now, it appears, it makes men’s hair fall out, too – and possibly for the same reasons.

A study of Asian men, renowned for hanging on to their hair compared with Europeans and Americans, found puffing on cigarettes can speed up male hair loss.

Smoking is known to accelerate ageing and is associated with facial wrinkles and grey hair.

Male pattern baldness runs in families and is partly influenced by male sex hormones but it is also subject to environmental factors.

Scientists studied 740 Taiwanese men with an average age of 65. After gathering information about the age at which they started losing their hair, their smoking history and their height and weight, as well as taking blood samples, they found cigarettes led to significantly more hair loss even after taking other factors into account.

The researchers suggest that smoking may damage the circulation supplying blood to the hair follicles.

 

Testimonies

Do you have an experience or story about or related to COPD that you would like to share with others? Or would you like to read about how other people have coped in similar situations? Share your thoughts here.

Author Testimony
Jeff I was diagnosed with paraseptal emphysema at the age of 26. I have spent my life trying to find out why and how with no progress on either. I would like to see organizations such as European & American Lung Assoc’s do research and give info for us that don’t have terminal lung diseases from smoking & would like info other than blame on cigarette manufacturers. Thats too easy!

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Secondhand smoke damages lungs

For the first time, researchers have identified lung injury to nonsmokers caused by second-hand smoke. This was long suspected but was not previously detectable with medical imaging tools.

The researchers suggest that their findings may strengthen public health efforts to restrict secondhand smoke.

“We used a special type of magnetic resonance imaging to find these structural changes in the lungs,” says study leader Chengbo Wang, a magnetic resonance physicist in the Department of Radiology at the Children’s Hospital of Philadelphia.

The researchers found that almost one-third of nonsmokers with high exposure to secondhand smoke had structural changes in their lungs similar to those found in smokers.

Cough alone a poor predictor of TB: look for fever and weight loss too

Attempts to improve TB diagnosis rates among HIV-positive people may be hampered by an over-simplistic search for one symptom at the expense of a wider range of symptoms.

Intensified case finding is intended to increase TB diagnosis rates among people who are already in HIV care.

At present the degree of focus on TB diagnosis varies from one treatment programme to another, and some use only passive case-finding, diagnosing TB only when patients present to their doctor with serious TB-related symptoms.

Other programmes actively attempt to find cases of TB, often using home-based carers or a regular screening questionaire during hospital visits to identify new cases.

Intensified case-finding is especially important in settings where there is a high level of latent TB infection that might progress to active tuberculosis.

 

Protein may play a role in severe asthma

A protein measured in a simple blood test may be a new biomarker to identify patients with the most serious form of asthma.

Identifying this new biomarker, YKL-40, brings investigators one step closer to a treatment for the millions of people with a severe form of the disease that is difficult to treat, the researchers say.

Asthma is characterised by chronic inflammation and structural changes in the airways. These symptoms are severe in some patients and mild in others.

Investigators are trying to find ways to control the inflammation and to understand the variation in severity.

 

EU car emission rules reveal Franco-German rift

As the European Commission prepares to unveil detailed legislation on cutting carbon dioxide emissions from cars, France has already set itself up for a battle with Germany on the issue, with French Environment Minister Jean-Louis Borloo criticising a German proposal for a system where heavier cars would be allowed to pollute more than others.

Jean-Louis Borloo told the Financial Times on November 14: “By virtue of the polluter pays principle, those with the biggest pollution should make the biggest progress on cutting emissions.”

German manufacturers have been advocating a system where Europe’s automotive industry would receive differentiated caps according to the weight of the vehicles they produce, thus enabling heavier cars, such as SUVs and luxury models, to exceed a target of 130 grammes of carbon dioxide per kilometre set by the Commission.

German manufacturers typically produce larger, high-performance vehicles, while French and Italian manufacturers specialise in smaller, more fuel-efficient models. “Nothing justifies giving a bigger right to pollute to the buyer of a bigger vehicle,” stated Borloo.

A report by the green NGO Transport & Environment (T&E), published on November 15, reveals that French carmakers have much lower average carbon emissions than German ones (144 g/km versus 173 g/km). Moreover, they also succeeded in cutting their emissions by 1.9% between 2005 and 2006, while German manufacturers actually increased their emissions by 0.6%. Borloo said this German proposal would constrain the market for small vehicles and encourage the production of heavier cars rather than promote innovative technologies aimed at making bigger cars lighter.

 

Health experts seek legislation to help Europeans breathe more easily

Health experts seek legislation to help Europeans breathe more easily
14/11/2007

Indoor air quality needs to be improved to reduce a leading cause of death in the European Union, a leading professor in respiratory medicine will tell a meeting to launch a declaration on COPD in the European Parliament today.

Chronic Obstructive Pulmonary Disease (COPD) is a mixture of chronic bronchitis and emphysema, which is often associated with other long-term conditions, such as hypertension and diabetes. November 14 is designated World COPD Day.

“Few people have ever heard of COPD but it is ruining lives and forcing up to 300,000 Europeans to depend on portable oxygen tanks,” says Prof. William MacNee, University of Edinburgh, United Kingdom and a former past president of the European Respiratory Society.

“It is an under-recognised and under-diagnosed problem that is growing in Europe as populations age,” he says. The present death toll is 200,000-300,000 each year in the European Union.

The European Respiratory Society, the European Lung Foundation and the European Federation of Allergy and Airways Diseases Patients Associations hopes that by working with politicians, greater attention will be drawn to the condition among both doctors and the public and to the need for more comprehensive implementation of clean indoor air policies.

 

Shipping pollution ‘kills 60,000 every year’

Pollution from ships, in the form of tiny airborne particles, kills at least 60,000 people each year, says a new study.

Unless action is taken quickly to address the problem – such as by switching to cleaner fuels – the death toll will climb, researchers warn.

The team predicts that premature deaths due to ultra-fine particles thrown out by ships’ exhausts will increase by 40% globally by 2012.

Ships release an estimated 1.2 million to 1.6 million metric tons of tiny airborne particles each year. The tiny particles are less than 10 micrometres in diameter and invisible to the human eye. They are produced from the combustion of shipping fuel which releases the ultra-fine soot. The soot contains carbon particles, sulphur and nitrogen oxides.

Tiny airborne particles are linked to premature deaths worldwide, and are believed to cause heart and lung failures. The particles get into the lungs and are small enough to pass through tissues and enter the blood. They can then trigger inflammations which eventually cause the heart and lungs to fail.

 

Blocking the effects of viral infections may prevent asthma in young children

Babies who get severe viral lung infections are much more likely to suffer from asthma as they get older.

“A severe respiratory infection in infancy greatly increases the risk of developing asthma,” says the study’s lead author Mitchell Grayson, M.D., assistant professor of medicine in the Division of Allergy and Immunology.

“Less than one in 30 people who don’t suffer a severe respiratory infection as a baby develop asthma, but of those who do get these infections, one in five goes on to have asthma.”

Researchers found that mice that developed asthma-like symptoms after a severe respiratory viral infection had an unusual immune reaction similar to that produced during an allergic response instead of the response usually shown to infection.

Patients ‘denied intensive care’

Patients with chronic lung disease are being denied intensive care treatment because doctors are too pessimistic about their chances, research suggests.

A British Medical Journal study of 800 patients admitted to intensive care to help them breathe found survival rates were higher than doctors predicted.

It suggests patients may not be admitted when they would benefit from treatment, the researchers warn.

When patients have a COPD attack, they can benefit from intubation – where a tube is put into their airway to help them breathe – but they have to be admitted to intensive care so they can be sedated for the procedure.

But doctors may be unwilling to admit patients who have a poor prognosis.

Reducing the impact of climate change

The most recent report of the Intergovernmental Panel on Climate Change (IPCC) found that there is overwhelming evidence that humans are affecting climate and highlighted the implications for human health.

The World Health Organization (WHO) is helping countries reduce the impact of climate change by encouraging them to build and reinforce public health systems to manage climate-related health risks.

This change in how the WHO works to manage climate-related health risks occurred partly as a result of the severe heatwaves that engulfed Europe in 2003.

The heatwaves caused thousands of additional deaths in countries that provide more than adequate healthcare. Consequences of changing temperatures include droughts, floods, alterations in the burden of vector-borne disease (diseases carried such as malaria, carried by other organisms) and water-related disease, and increases in freak weather events or natural disasters that can affect health through injury, malnutrition or impoverishment.

The main message WHO has tried to get across to these vulnerable places is the importance of building and reinforcing public health infrastructure, implementing an epidemiological surveillance system and increasing capacity to respond to vector-borne disease.

 

Vitamin A derivative associated with reduced growth in some lung cells

Treatment with a derivative of vitamin A called retinoic acid is associated with reduced lung cell growth in a group of former heavy smokers, according to a study published in the Journal of the National Cancer Institute.
Former smokers remain at elevated risk for lung cancer. According to one hypothesis, lung cells that were damaged during years of smoking may continue to grow and evolve into cancer even after that person has quit smoking.

Previous studies have suggested that retinoids, a class of drugs related to vitamin A, may be effective for preventing lung cancer in former smokers.

Retinoids have also been shown to slow the growth of cancer cells in laboratory experiments.

 

Bird flu finds children’s lungs faster

New findings, reported in the journal Respiratory Research, about how the bird flu virus binds to the respiratory tract and lung suggest children may be particularly susceptible to avian influenza.

John Nicholls and colleagues at the University of Hong Kong and Adelaide Women and Children’s Hospital, in Australia, used chemicals that attach to types of sugar on the surface of cells to look at the way different influenza viruses attack cells in the upper and lower respiratory tract, including the lungs.

Molecules of a sugar called sialic acid on the cell surface act as chemical beacons for the influenza viruses. Different types of sialic acid attract different types of influenza virus. Once the virus finds sialic acid, it can attach and infect the cell. The distribution of sialic acid molecules affects how likely the virus is to find cells to infect.

The researchers found that the type of sialic acid that binds bird flu was particularly common in the lower respiratory tract of children, which could explain why children are especially vulnerable to bird flu.

 

EU launches online spoof tobacco ads

The European Union has launched a series of fake online advertisements for nicotine-based household products.

As part of its drive against tobacco, the EU has launched a fake e-commerce site, www.nicomarket.com, which carries video ads for a series of ‘nicotine-based’ products.

The ads, for products including a toothpaste that makes teeth look dirty and a face cream that gives users a ‘deathly grey complexion’, have been created by French advertising agency Ligaris, and will appear on community websites in Europe.

Simple test can catch smokers who fib

A simple device for detecting carbon monoxide in the blood may help doctors get an honest answer out of patients who smoke.

The device, called a pulse CO-oximeter, is typically used to test for carbon monoxide levels in firefighters, but it can also detect carbon monoxide levels in people who smoke, offering a powerful tool for educating patients about the effects of smoking.

“We were trying to just solve a little problem,” says Dr Sridhar Reddy, a lung specialist in St. Clair, Michigan, USA who presented the study at a scientific meeting of the American College of Chest Physicians in Chicago.

Dr Reddy was looking for a quick, convenient method to detect whether a person smokes. Current tests involve breath, blood or saliva samples, but the pulse CO-oximeter simply involves placing a clip-like device on a finger tip.

 

One in three patients with asthma or COPD misuses inhalers

One out of three patients with asthma or chronic obstructive pulmonary disease (COPD) uses their inhalers incorrectly, a new study shows.

The study, presented at CHEST 2007, the 73rd annual international scientific assembly of the American College of Chest Physicians (ACCP), found that 32.1% of patients made at least one essential error while using a dry powder inhaler (DPI) and that the error rate increased with age and severity of airway obstruction.

“The frequent misuse of dry powder inhalers can lead to the inappropriate dosage of medication, which can result in increased morbidity and mortality for patients,” says study author Siegfried Wieshammer, from the Klinikum Offenburg, Offenburg, Germany.

“Our results suggest that inhaler type, age, severity of lung obstruction, and prior training can determine the risk of inhalation errors. These factors should be considered before prescribing an inhaler for a patient.”

 

European countries adopt milestone declaration on tuberculosis

On October 22, over 300 delegates at the World Health Organization (WHO) European Ministerial Forum “All against Tuberculosis” adopted the Berlin Declaration on Tuberculosis, which describes the disease as “an increasing threat to health security in the WHO European Region”.

The declaration calls for urgent action to halt and reverse the high levels of tuberculosis (TB), including its multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains.

European WHO member states and international partners commit themselves to providing more political support and resources to control and eventually eliminate the disease.

While recognising previous achievements, the declaration calls for more action in specific areas. Some actions, such as investing in and strengthening health systems for better TB control, form part of a region-wide commitment for the first time.

Lifting the smokescreen

First-ever EU figures on passive smoking deaths provoke call for action

A breakthrough report on passive smoking was launched on Tuesday March 21, 2006, in the European Parliament by Liz Lynne, MEP (UK, Liberal Democrat and asthma sufferer) and Adamos Adamou (Cyprus, European United Left–Nordic Green Left). Click here for press release.

The report, entitled “Lifting the smokescreen: 10 reasons for a smoke free Europe”, is available in full PDF format here to download.

This report is also available in German and Spanish.

The report shows that more than 79,000 adults die each year as a result of passive smoking in the 25 countries of the European Union.

The report also provides the evidence that measures to prevent passive smoking are feasible and popular.

It calls for legislation to prevent smoking in all enclosed public areas and workplaces, including bars and restaurants. In Ireland, where the policy was introduced in March 2004, 96% believe that the law is successful, and even 80% of smokers think it was a good idea.

Contents of the report
A summary of the report is given in a 6-page background document.

The Executive Summary of the report is now available in Bulgarian, Czech, German, Greek, English, Spanish, Estonian, French, Italian, Lithuanian, Latvian, Polish, Portuguese and Romanian.

All of the individual chapters, table and figures cited in the background document are available here for separate download:

Cover

Contents Foreword Executive summary
Chapter 1 Table 5 Table 6 Table 7
Table 8 Chapter 2 Chapter 3 Chapter 4
Figure 8 Chapter 5 Chapter 6 Chapter 7
10 reasons for going smoke free
Second-hand smoke exposure kills and harms health

Every worker has the right to be protected from exposure to tobacco smoke

Scientific evidence shows that ventilation does not protect against exposure to tobacco smoke

Smoke free laws do not result in negative economic effects

Freedom of choice includes the responsibility not to harm others

The public supports smoke free legislation

The public complies with smoke free legislation

It has been done elsewhere. It can be done everywhere

It is a cost effective public health intervention

Comprehensive smoke free policies work

The 10 reasons to go smoke free are also available in: Bulgarian, Czech, German, Greek, English, Spanish, Estonian, French, Italian, Lithuanian, Latvian, Polish, Portuguese and Romanian.

 

Spirometry: how to take a lung function test

Spirometry is a test of how well you can breathe and can help in the diagnosis of different lung diseases such as chronic obstructive pulmonary disease (COPD).

The test requires taking in a very deep breath and blowing out as fast as possible into a small device called a spirometer.

Watch the video to learn how to take a test (this video was filmed at the 2009 European Respiratory Society annual congress in Vienna, Austria, courtesy of x-audio/soundbakery).

Images

Images are shown here of a human lung. They were produced using resin casts of the airways and blood vessels, or by using a scanning electron microscope.

Click on any of the images in order to see the pictures more clearly.

Airways and blood vessels

This image shows the airways of the lungs on the left-hand side.The right-hand side shows the airways, with the pulmonary arteries and veins.Image and cast kindly provided by Walter Weber (Institute of Anatomy, University of Bern, Bern, Switzerland).

Close-up of airways and blood vessels

This image shows a close-up version of the image above.

You can see here how closely the arteries follow the airways to the periphery; the veins can be seen lying between the units.

Image kindly provided by Walter Weber.

Gas exchange area with alveoli

This image shows many alveoli bunched together like grapes.

Image kindly provided by Peter Gehr (Institute of Anatomy, University of Bern).

Walls of alveoli

This image shows a close-up version of the alveolar wall.
You can see the red blood cells in a capillary seperated from the air by a very thin tissue barrier.

Image kindly provided by Ewald R. Weibel (Institute of Anatomy, University of Bern).

Movies

Movies are shown here that were produced using several different techniques, including CT scanning. They show different aspects of the chest, lungs and arways.

Click on any of the images to see the movies.
The chest without the lungs

This movie shows the rib cage, the heart and all the major blood vessels of the lungs.
The lungs have been removed to show this more clearly.

The lungs

This movie show the lungs that were removed for the movie above. The contours of the lungs can be seen around 360 degrees.

The lungs and the airways
This movie shows the same lungs as above.
However, the airways can be seen more clearly in this movie.
Fly through the airways
This movie shows a virtual inspection or virtual bronchoscopy of the airways of the lungs.

CT scan of the chest
This movie shows a computed tomography (CT) scan. It shows slices through the chest from top to bottom. The airways of the lungs, the blood vessels of the lungs and the parenchyma can be seen.

Lung diseases

The lungs are essential organs for life, but it is not well known that respiratory diseases are the leading cause of death worldwide.

The impact of lung diseases
A further increase in the number of deaths from lung diseases is predicted between now and 2020, in particular from chronic obstructive pulmonary disease (COPD), lung cancer and tuberculosis (TB).

In 2020, out of 68 million deaths worldwide, 11.9 million will be caused by lung diseases (4.7 by COPD, 2.5 by pneumonia, 2.4 by TB and 2.3 million by lung cancer).
Globally, in terms of mortality, incidence, prevalence and costs, respiratory diseases rank second (after cardiovascular diseases). In some countries (e.g. the UK), they are already the leading killer.

Multiple causes
Two major lung diseases (lung cancer and COPD) are generally, but not exclusively, caused by cigarette smoking. However, it is important to stress that lung diseases are not just related to smoking.

There is a wide variety of other causes, ranging from genetic influences to nutritional, environmental and poverty-related factors. In addition, the human respiratory tract is vulnerable to many infectious agents, such as in severe acute respiratory syndrome (SARS).

Each lung disease, therefore, needs a specific diagnostic and therapeutic approach, according to the nature of its cause. As the environment is subject to constant changes, further research is needed into factors influencing and triggering all the different lung diseases.

Over 100 billion Euros
The total financial burden of lung disease in Europe amounts to nearly €102 billion, a figure comparable to the annual gross domestic product (GDP) of the Republic of Ireland.
COPD contributes to almost one-half of this figure, followed by asthma, pneumonia, lung cancer and TB.

 

Household cleaning products can cause a ‘preventable’ asthma risk

A leading expert in occupational asthma has called for more research into how exposure to some cleaning products can trigger asthma.

Speaking at an international asthma conference in London, Dr Jan-Paul Zock, from the Centre for Research in Environmental Epidemiology in Barcelona, stated that cleaning-related asthma is potentially preventable.
Previous research has shown that janitors, cleaners, housekeepers and nurses are at an increased risk of developing asthma, but researchers do not yet know how the chemicals affect the lungs and what can cause them to trigger asthma.
Dr Zock stated that “Not only those who have cleaning jobs or whose work involves cleaning are at risk, but we also need to consider the ubiquitous use of cleaning products at home.”

With further information on the processes involved in cleaning-related asthma, scientists could help reduce the risk of asthma at home and in the workplace.

Mediterranean diet reduces asthma risk in children

Doctors have found that eating a Mediterranean diet, high in fruits, fish, and vegetables and low in saturated fat, can reduce the likelihood of asthma in children.

The study reported in the June issue of Thorax showed that eating foods similar to those in a Mediterranean diet was associated with a lower risk of both wheeze and asthma.

The study suggested that certain fish, rich in omega-3 polyunsaturated fatty acids, have anti-inflammatory properties that reduce the risk of asthma. Furthermore, fruits and vegetables are high in antioxidants, which also help reduce the risk of asthma.

In addition, the study found that children who ate burgers at least three times a week had increased risk of having asthma. The team of researchers suggest that it may be the dietary intake of trans-fatty acids that caused this association with fast-food burgers.

New lung cancer drug may ‘extend life’

Researchers say a new drug can reduce the chances of dying by a quarter and extend life for women with advanced lung cancer.

Drug trials carried out by Cancer Research UK, found that 15% of women had no progression of their cancer 12 months after taking the drug compared with only 5% of those on a placebo.
Dr Siow Ming Lee, trial leader and senior lecturer at the University College London Cancer Institute, stated “These results are a real step forward in the search for an effective treatment for patients with advanced lung cancer.”

The drug works by interfering with how cancer cells multiply and could offer hope to patients too sick for conventional chemotherapy.

Diabetes affects lung function

Researchers from the Netherlands have found that diabetes may cause impaired lung function, similar to that found in smokers.

The study, published in Chest, showed that diabetes causes a significant impairment in lung function. Further analysis also suggested that this impairment is more common in type-2 diabetes rather than type-1 diabetes.
The researchers speculate that diabetes may speed up lung function decline in those with chronic lung conditions, including chronic obstructive pulmonary disease.

China struggles with WHO anti-tobacco treaty

At least 1 million people in China die every year from the impacts of smoking, but what is being done to reduce this?

As well as ensuring that all indoor public places, workplaces and public transport are smoke-free within five years, the WHO agreement requires countries to fight smoking. This should be done by raising cigarette prices and taxes, implementing health warnings on cigarette packs and banning tobacco advertising.

Whilst many other countries have successfully managed the anti-tobacco treaty backed by the World Health Organization, China appears to be struggling to meet banning smoking at public indoor venues by January 9th next year.

However, despite their struggles with hitting their deadline, they have had some success over the past few years. China has banned tobacco advertising on radio, television and newspapers and outlawed smoking in some places, such as on airplanes. Also during the 2008 Olympics, Beijing and other host cities in China went smoke-free.

Despite all of these successes, the rate of smoking has not changed significantly and tobacco production has actually gone up. A projection by Oxford University professor Sir Richard Peto, shows that of the young Chinese men alive today, one in three will die from tobacco.

Critics say that this is because China falls short of WHO agreement’s requirements. They believe that warnings on Chinese cigarette packages are too small and tobacco tax increases are never passed down to smokers, but instead absorbed by the company.

Breath test detects cancer before symptoms arise

Doctors from Israel have developed a breath test that can diagnose patients with lung, breast, bowel and prostrate cancers before they even show symptoms of the disease.

The study, published in the British Journal of Cancer, found that different types of cancer cells release different chemicals from their surface. These chemicals are released in the breath.

Scientists from the study took samples of breath from patients and stored them in an airtight container. They were then passed through a sensor that detected any chemicals produced by lung, breast, bowel or prostrate tumours.

Professor Abraham Kuten, one of the researchers, believes this machine has the potential to save hundreds of lives by detecting a number of cancers in a single non-invasive test. However, more research is needed before we will see an ‘electronic nose’ in a doctor’s surgery.

The equipment is still in the early stages of development, but the team from Technion Israel Institute of Technology hope that over the next few years they can develop it to test instantly whether a person has cancer.

Genetic fingerprint identifies active TB

Scientists have found a genetic fingerprint that may help predict whether people infected with tuberculosis (TB) will become ill or carry the infection without effects.

Approximately one-third of the world’s population has been exposed to or infected with Mycobacterium tuberculosis (pictured), but only 10% of these people become ill. The study, published in Nature, looked at over 400 blood samples in patients with TB.
In patients infected with TB, scientists found blood molecules in a specific pattern, known as a genetic fingerprint. The authors of the study also found that this genetic fingerprint disappears in people successfully treated.

If developed further, the authors believe that this genetic fingerprint may make it possible to not only diagnose people with TB, but also to monitor the success of treatment.

Plane exhaust kills more people than plane crashes

In recent years, airplane crashes have killed about a thousand people annually, whereas plane emissions kill about ten thousand people each year, researchers say.

Unregulated emissions from planes flying above 3,000 feet are thought to be responsible for most of these deaths.

Airplane exhaust fumes contain a variety of air pollutants, including sulphur dioxide and nitrogen oxides.

Many of these particles of pollution, known as particulates, are smaller than the width of a human hair and become wedged deep in the lungs.
American researchers used a computer model that brought together records of flight paths, the average amount of fuel burned during flights, and their estimated emissions.

The model was used to track where pollutants were likely to fall to the surface, where they may be inhaled.

The team estimated that about 8,000 deaths a year result from pollution from planes at cruising altitude, about 35,000 feet (10,668 metres), whereas about 2,000 deaths result from pollution emitted during takeoffs and landings.

Heavy smokers ‘at increased risk of dementia’

A recent study carried out by US researchers has shown that heavy smokers with a 40-a-day habit face a much higher risk of two common forms of dementia.

The risk of Alzheimer’s is more than doubled in people smoking at least two packs of cigarettes a day in their mid-life.

The US study, looking at over 21,000 people’s records, is published in the Archives of Internal Medicine journal .

Those who smoked two or more packs of cigarettes a day had a 157% increase risk of Alzheimer’s disease and a 172% increase risk of vascular dementia, caused by problems with the blood vessels supplying the brain, compared with a non-smoker.

Smokers who give up the habit in middle age have the same risk of dementia 20 years later as someone who has never smoked.

Ruth Sutherland, from the Alzheimer’s Society, said that stopping smoking was one element of a healthier lifestyle which could protect against dementi

Taste buds in lungs discovery could ease asthma

The discovery of “taste receptors” in the lungs rather than on the tongue could point the way to new medicines for asthma.

Experiments in mice revealed that bombarding the receptors with bitter-tasting compounds helped open the airways, which could ease breathing.

The “taste receptors” discovered in the smooth muscle of the lungs are not the same as those clustered in taste buds in the mouth. They do not send signals to the brain, and yet, when exposed to bitter substances, they still respond.

Researchers assumed that the bitter substances would cause the airways to tighten and trigger coughing. However, the opposite was true. The substances opened the airway more than any other drug used to treat asthma or chronic obstructive pulmonary disease (COPD).

Although new treatments are a long way off, it is thought that an inhaler based on bitter substances such as quinine or saccharine, could enhance or even replace current treatment.

 

Food intake influences respiratory health for babies with lung disease

The long-term health of premature babies with severe lung disease could be influenced by their feeding regime, according to new research.

The study, published in the journal Pediatric Pulmonology, monitored 18 infants with a history of moderate to severe bronchopulmonary dysplasia (BPD).
BDP is a chronic lung disorder, most common among children who are born prematurely. It leads to significant reductions in airflow and lung over-inflation.

Over a one-year span, the American research team found little improvement in the study group’s average airflows and lung volumes. However, the children with above-average weight gain between evaluations showed significantly improved lung volumes, revealing a possible association between lung growth and improved nutrition.

The findings support previous studies in animals which have confirmed the harmful effects of malnutrition on lung development.

Surgery for sleep apnoea reduces daytime drowsiness

Surgical operations to treat sleep apnoea can lead to a better night’s sleep and less drowsiness during the day, according to a new study.

The research, which was carried out in the USA, found that surgery greatly reduced the common side-effect of daytime sleepiness, when compared with other non-surgical treatments for the disorder.

Sleep apnoea occurs due to the collapse of the airway in the throat during sleep, which can hamper breathing.

It can lead to loud snoring or periodic pauses in breathing, disrupting sleep and causing excessive drowsiness during the day.
The study assessed 40 people who underwent surgery to improve their symptoms. The results showed that 38 of the participants reported that their general level of daytime sleepiness was significantly reduced.

The predominant treatment for sleep apnoea is continuous positive airway pressure (CPAP) therapy during sleep, which uses a machine to increase air pressure in the throat to prevent the airway from collapsing. These new findings suggest that CPAP therapy isn’t the only treatment option, and that surgery can also be of benefit for people with the disorder.

 

Study uncovers key cause of asthma and COPD

Researchers have proved that a single enzyme is essential in the production of excess mucus that clogs the airways of people with asthma and chronic obstructive pulmonary disease (COPD).

Existing drugs can already be used to block the enzyme’s actions for other conditions and the researchers believe that this discovery could now lead to new therapies for asthma and COPD sufferers.

The findings, which are published online in the journal PLoS One, found that the enzyme, known as Aldose reductase, is an essential catalyst for some of the symptoms experienced by people with COPD and asthma.
When people with either disease are exposed to allergens such as pollen, mould and dust mites, the cells that line the air passages of the lungs change from their normal state and start to produce excess amounts of mucus.

Previous research has found that the enzyme is a key part of other inflammation disorders, and this new study has shown that suppressing it could help reduce this production of excess amounts of mucus for patients with COPD and asthma.

The next stage for the research is to check that the drugs can effectively be used as therapy for asthma and COPD. The researchers predict that this process will be accelerated due to the fact that the drugs have already undergone clinical trials to treat other diseases.

 

Vitamin D deficiency found to decrease lung function

New research has revealed that vitamin D deficiency could alter lung structure and function.

Vitamin D deficiency has previously been linked to the severity of asthma and chronic obstructive pulmonary disease (COPD) in humans, but until now there has not been any evidence to prove this link.
Australian researchers evaluated the lung responses of 2-week old, vitamin D deficient mice and compared them with healthy mice to determine what effects the deficit may have on the growth, structure or function of the lungs.

The results showed that airway resistance was significantly higher while lung volume was significantly lower in vitamin D-deficient mice. This is the first time vitamin D has been concretely linked to a decreased lung function.

The findings have important implications for the prevention of lung diseases in populations where vitamin D deficiencies are common, however further studies are needed to find out whether taking a vitamin D supplement may improve lung health in susceptible populations.

Risk factors

There are many factors that can have a dramatic effect on lung health and disease. We should all try to understand more about these factors and take actions that will help to combat the damage they inflict.

At a conservative estimate, tobacco kills more than 650,000 people every year in the European Union alone. Many of these deaths are due to respiratory disease. Action needs to be taken in many forms to reduce this preventable mobidity and mortality.

Environment
The environment that we live in can have a dramatic effect on our health. Poor environment quality, both inside our own homes, and in the work place and open air, contributes to many diseases, respiratory diseases in particular.

Diet and nutrition
In recent years, the link between diet and health has become increasingly clear. The role of a bad diet has been well reported in many diseases. But the role that the diet plays in lung diseases is poorly understood.

 

News

The news presented here is taken from sources on different websites. A brief summary of the news is given, along with a link to the orginal article.

Children Living Near Major Roads Face Higher Asthma Risk 04/05/2006
Young children who live near a major road are significantly more likely to have asthma than children who live only blocks away, according to a study that appears in the May issue of Environmental Health Perspectives.

Bile build-up in pregnancy may harm baby’s lungs 03/05/2006
Pregnant women who develop a build-up of bile in the liver, a condition called intrahepatic cholestasis of pregnancy (ICP), have babies with an increased risk of developing respiratory distress syndrome, a potentially fatal disease that occurs when the tiny air sacs of the lungs collapse, according to a report in the journal Pediatrics.
More…
Woman on oxygen finishes marathon 27/04/2006
A woman with a debilitating lung disease has become the first person on oxygen to complete the London Marathon.

Finding suggests alternative treatment approach for common skin disorders and asthma 25/04/2006
A finding by researchers at the National Institutes of Health provides new insight into the cause of a series of related, common and complex illnesses – including hay fever and asthma as well as the skin disorders eczema and psoriasis – and suggests a novel therapeutic approach.

Study offers new hope for people trying to quit smoking. 25/04/2006
In the first study of its kind, University of Pittsburgh psychologist and professor Saul Shiffman has discovered that people who are trying to quit smoking by wearing the nicotine patch are less likely to spiral into a total relapse if they keep wearing the patch, even if they’ve “cheated” and smoked a cigarette.

New drug could treat lung disease 25/04/2006
A new study is under way into a drug which could help people suffering from chronic lung disease.

Genes May Tie Smoking and Drinking 24/04/2006
Four genes expressed in the brain’s prefrontal cortex may help explain why smoking and problem drinking so often go together, Australian research suggests.

Cancer therapy based on tumour location may soon be obsolete 23/04/2006
Traditional cancer treatments have focused on the location of the tumour for identifying the appropriate drug regimen. However, new research shows that this approach may soon be obsolete.

Abnormal sleep patterns appear common in children with Down syndrome 19/04/2006
More than half of children with Down syndrome may have abnormal sleep patterns and obstructive sleep apnoea syndrome, and parents may not be able to determine whether their children are among those with sleep difficulties.

Improved exercise performance for COPD patients using special gas mixture 18/04/2006
Breathing a special gas mixture, called heliox, may significantly improve the exercise performance of individuals with severe chronic obstructive pulmonary disease (COPD). During an endurance walking test, the patients found that they could improve their walking distance by 64 percent with less shortness of breath.

 

Pulmonary arterial hypertension

All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

In English

Auf Deutsch

En Francais

En Espanol

In Italiano

По-русски

Po polsku

στα Ελληνικά

No Português

Author
This factsheet was written with help of ERS pulmonary arterial hypertension expert Prof. Marc Humbert. All material was read and reviewed by the ELF Advisory Board.

Information sources
Background information was taken from the following scientific papers:

Simonneau G, Galiè N, Rubin L, et al. Clinical classification of pulmonary hypertension. Journal of the American College of Cardiology, Volume 43, Issue 12, Pages S5-S12.

Humbert M, Sitbon O, Simonneau G. Treatment of pulmonary arterial hypertension. New England Journal of Medicine, Volume 351, Pages 1425-1436.

Humbert M, Sitbon O, Chaouat A, et al. Pulmonary arterial hypertension in France. American Journal of Respiratory and Critical Care Medicine Volume 173, Pages 1023-1030.

Interesting links
European Association for Pulmonary Hyptertension (PHA Europe): a site with access to all PH organisations across Europe.

Pulmonary Hypertension Association USA (PHA Association).

ORPHANET: a site about all rare lung diseases, of which PH and PAH are included.

Pulmonary Hypertension Association UK (PHA UK).

HTAP France.

PAH Switzerland.

 

ELF Council

The ELF Council is composed of members of the ERS Executive Commitee and external members from industry.

ELF Chair

Laurent P. Nicod
Klinik/Poliklinik fur Pneumologie
Bern
Switzerland

Email

ELF Secretary

Archie Turnbull

ERS Headquarters
Lausanne
Switzerland

Email

ERS Past President

Ronald Dahl
Aarhus University Hospital
Aarhus
Denmark

Email

ERS Treasurer

Gerhard W. Sybrecht
Universitatskliniken des Saarlandes
Hamburg
Germany

Email

 

ERS Secretary General

Martin F. Muers
Leeds General Infirmary
Leeds
UK

Email

ERS Assembly Head

Gilbert Massard
Sce. de Chirurgie Thoracique Hopital
Strasbourg
France

Email

ERS Assembly Head

Tobias Welte
Medizinische Hochschule Hannover
Hannover
Germany

Email

Bernard Fierens
Banque Privée Edmond de Rothschild
Lausanne
Switzerland
Benoit Juranville
Founex
Switzerland
Jean-Pierre Gross
Lausanne
Switzerland

Olivier Zbinden
Banque Piguet & Cie SA
Lausanne
Switzerland

Donate

Why donate?
The lungs are essential organs for life, and many people are not aware that lung diseases are the leading cause of death worldwide.

Not only do lung diseases kill, but they also cause considerable suffering, and the incidence of these diseases is predicted to rise even further between now and 2020.

The ELF is working for all people with lung disease to:

raise awareness in the general public and at a national and EU level
provide information for patients and their families and friends
raise funds for research to help further the treatment of lung diseases
All donations, big or small, made to the ELF will help to achieve its goals, and to help Europe breathe easier.

Thank you for helping us to raise awareness and fight lung disease.

 

ELF Office

For any enquires about the ELF or its activities, please contact the ELF Manager at the address below.

ELF Manager

Pippa Powell
European Lung Foundation
Suite 2.4, Huttons Building
146 West Street
Sheffield
S1 4ES

ELF Web Assistant

Elizabeth Considine
European Lung Foundation
Suite 2.4, Huttons Building
146 West Street
Sheffield
S1 4ES

 

Function of the lungs

The are several different questions that can be asked to find out how the lungs normally work.

How does air get into the body?

What happens to oxygen and carbon dioxide?

Which muscles help with breathing?

How do the lungs protect themselves?

Germany

Germany
Airline Contact
Aero Dienst

Aero Dienst does not provide oxygen on board the aircraft, other than for emergency situations. They will allow you to take a small cylinder of oxygen on board, but you need to notify them in advance and provide a medical certificate.

Air Berlin

Air Berlin provide oxygen on board their aircraft at an additional cost of 100 Euros per flight. You may also bring your own oxygen on board but it cannot exceed 2 litres (maximum weight 8kg, maximum dimension 55x45x20cm). A medical certificate provided by your doctor will be required for the use of oxygen on board the aircraft and the airline must be notified when making a reservation. Liquid oxygen is not permitted on board the aircraft.

Augsburg Airways

Augsburg Airways is part of the Lufthansa Regional group and operates domestic and international services for Lufthansa. Oxygen policies for both airlines are the same.

Augsburg Airways provides oxygen on board their aircraft at an additional cost depending on the amount you need and how long it is needed. They offer a maximum flow rate of 5 litres per minute. You must however provide as much notice as possible for this to be arranged. You may also bring your own oxygen cylinder on board the aircraft but liquid oxygen is not permitted. In both cases, a medical form will be required from your doctor.

Avanti Air

Avanti Air can provide oxygen on board their aircraft at an additional cost. If you need oxygen on one of their flights contact them at least a week in advance and they should be able to provide oxygen at your specific flow rate. The cabin attendants are medically trained in case of an emergency.

Blue Wings

Blue Wings does not provide oxygen on board their aircraft. However, if you contact them 14 days in advance you can request to bring your own oxygen on board. A series of forms will need to be completed by yourself and your doctor, stating the need for oxygen and the flow rates you require. The maximum size bottle they will allow on board their aircraft is 2 litres.

Cirrus Airlines

Cirrus Airlines do not provide oxygen on board their aircraft. However you can bring your own oxygen cylinder on board the aircraft but liquid oxygen is not permitted. You must provide as much notice as possible and a medical form will be required from your doctor.

Eurowings

Eurowings is part of the Lufthansa Regional group and operates domestic and international services for Lufthansa. Oxygen policies for both airlines are the same.

Eurowings provides oxygen on board their aircraft at an additional cost depending on the amount you need and how long it is needed. They offer a maximum flow rate of 5 litres per minute. You must however provide as much notice as possible for this to be arranged. You may also bring your own oxygen cylinder on board the aircraft but liquid oxygen is not permitted. In both cases, a medical form will be required from your doctor.
Germanwings

Germanwings provide oxygen and also allow you to bring your own oxygen on board their aircraft. In both cases you must contact them at [email protected] at least 10 days before the flight and you will need to complete a number of forms along with your doctor.
LTU International Airways

LTU International Airways provides oxygen on board their aircrafts at an additional cost of 100 Euros per flight. You may also bring your own oxygen on board but it cannot exceed 2 litres (maximum weight 8kg, maximum dimension 55x45x20cm). A medical certificate provided by your doctor will be required for both the use of LTU oxygen and your own oxygen cylinders. Liquid oxygen is not permitted on board the aircraft.

Lufthansa

Lufthansa provides oxygen on board their aircraft at an additional cost depending on the amount you need and how long it is needed. They offer a maximum flow rate of 5 litres per minute. You must however provide as much notice as possible for this to be arranged. You may also bring your own oxygen cylinder on board the aircraft but liquid oxygen is not permitted. In both cases, a medical form will be required from your doctor.

Tuifly only provide emergency oxygen on board their aircraft. However, you can bring your own 2 litre gas cylinder (UN-1072) on board at no extra cost. In order to accommodate this, you must contact Tuifly several weeks before your flight or when you book your reservation. All cabin crew are trained in first-aid and in using the in-flight defibrillator.

XL Airways Germany

Link to XL Airways Germany

XL Airways does not allow you to carry your own oxygen or portable oxygen concentrator on board the aircraft. They provide oxygen at an additional cost of 200 GBP per flight. You must contact XL Airways in advance. You will be sent a medical form which needs to be completed by yourself and your doctor. Different flow rates are available and the medical form will allow them to assess which one is most suitable for you.

Smaller Airlines
For the latest information on the smaller airlines please use the contact details below.

ACM Air Charter

Aero Business Charter

Elbe Air

 

Asthma

What is asthma?

What causes asthma?

Treatment of asthma

Burden in Europe

Areas for action

Testimonies

Asthma in the news

Resources

 

 

 

Tobacco and smoking in the news

21/01/2013 Reduced number of hospital admissions for childhood asthma after smoking ban
The number of children admitted to hospital with severe asthma has reduced after smoke-free legislation was introduced in England in 2007.

20/12/2012 EU adopts new guideline to tackle tobacco-related health problems
The EU Commission has adopted new proposals to tackle the health problems caused by tobacco products.

11/12/2012 Doctors should counsel children about not smoking
Doctors should talk to school-aged children about the consequences of smoking and how to avoid peer-pressure to start smoking, according to new research in the USA.

07/12/2012 Quitting smoking can help people with severe back pain
Smokers suffering from severe back pain or spinal disorders have greater discomfort than those who quit smoking, according to new research.

28/11/2012 Tobacco companies ordered to admit they deceived public over health risks
Major tobacco companies in the USA have been ordered to spend their own money on a public advertising campaign saying they lied about the dangers of cigarettes.

26/11/2012 Smoking contributes to decline in brain function
Smoking can damage memory, learning and reasoning in the brain, according to new research.

15/11/2012 Experts debate a smoker’s licence to help curb cigarette use
A radical proposal of introducing a licence to reduce the harmful health effects of tobacco has been debated by two experts.

08/11/2012 Anti-tobacco policies successfully reduce smoking rates in Brazil
Smoking rates in Brazil have dropped by half over the past two decades thanks to tobacco control polices, according to new research.

02/11/2012 Smoking bans cut hospital cases
Smoking bans have significantly reduced the number of people being admitted to hospital for heart attacks, strokes and respiratory diseases.

31/10/2012 Smoking can cause asthma in second generation children
Nicotine exposure during pregnancy could cause asthma in the smoker’s grandchildren, according to a new study.

 

Sleep apnoea in the news

06/02/2012 Link between sleep apnoea and strokes
People with severe sleep apnoea may have an increased risk of silent strokes, according to new research.

18/01/2012 CPAP treatment reduces death risk in women with sleep apnoea
Continuous positive airway pressure (CPAP), which is used to ease the symptoms of obstructive sleep apnoea (OSA), can help reduce the death risk for women with the condition.

09/11/2011 Mediterranean diet and exercise can help reduce sleep apnoea symptoms
Eating a Mediterranean diet combined with physical activity can help to improve some of the symptoms of sleep apnoea, according to new research.

04/11/2011 Study finds links between obesity, sleep and activity in the brain
A new study has shed light on how obesity, sleep problems and activity in the brain, are linked.

26/08/2011 Older women with sleep apnoea more likely to develop dementia
Older women with obstructive sleep apnoea could be at risk of developing dementia according to a new study.

11/08/2011 Withdrawal of CPAP treatment results in a rapid return of sleep apnoea symptoms
The benefits of using continuous positive airway pressure (CPAP) to treat people with obstructive sleep apnoea are quickly reversed when the treatment is stopped, according to a new study by Swiss researchers.

04/08/2011 Compression socks could help people with sleep apnoea
Compression socks, which increase blood circulation, could be used to help improve obstructive sleep apnoea.

12/07/2011 CPAP can improve overall heart health
People with sleep apnoea who use continuous positive airway pressure (CPAP) to manage their condition were found to have improved heart health in a new study.

12/07/2011 Sleep apnoea can cause problems for the heart
Obstructive sleep apnoea can lead to a reduction of blood supply to the heart, according to new research.

13/06/2011 Weight loss improves sleep apnoea
People with obstructive sleep apnoea could benefit from going on a low energy diet according to new research.

Quitting smoking stories in the news

Study offers new hope for people trying to quit smoking. 25/04/2006
In the first study of its kind, University of Pittsburgh psychologist and professor Saul Shiffman has discovered that people who are trying to quit smoking by wearing the nicotine patch are less likely to spiral into a total relapse if they keep wearing the patch, even if they’ve “cheated” and smoked a cigarette.

Another reason to quit smoking for good 06/04/2006
Sone smokers with lung cancer continue smoking, figuring why the hell not. Well, here’s why not: it can stop chemotherapy from working. Nor are patches the answer, as it turns out it is nicotine itself that has the effect.

Older women most successful at quitting smoking 23/03/2006
Women who are 65 years old or older are better at quitting smoking than their male counterparts, and new findings show the older men and women are generally better at staying off cigarettes compared with younger smokers.

A fifth of smokers ‘plan to quit’ 08/03/2006
A fifth of UK smokers plan to quit when the ban on smoking in enclosed public spaces comes in, a survey suggests.

Sudden bid to quit smoking ‘best’ 27/01/2006
Spur of the moment attempts to stop smoking are more likely to succeed than planned ones, a study says.

 

European Respiratory Society

Founded in 1990, the European Respiratory Society (ERS) is a nonprofit making, international medical organisation with over 7,000 members from 100 countries. It is the biggest society in Europe in its field.

The aim of the ERS is to promote and improve lung health in Europe through research, education and advocacy.

ERS Congress

The ERS Congress is Europe’s biggest annual scientific gathering in respiratory medicine, with an attendance of over 16,000 delegates. This event provides a platform for important improvements in the treatment of lung diseases. In 2011, the ERS will meet in Amsterdam, The Netherlands, from 24 to 28 September 2011.

Publications

The ERS produces a number of publications for scientists, doctors and health providers in Europe to keep them up to date on the latest research and developments in lung health and disease treatments:

  • European Respiratory Journal
  • European Respiratory Monograph
  • European Respiratory Review
  • Breathe
  • Buyers’ Guide
  • ERS Newsletter

ERS School

The ERS School is involved in educating doctors across Europe on the best treatment strategies for lung disease and also provides financial assistance for scientists researching new treatments for lung diseases

  • Encouraging new initiatives
  • Producing guidelines
  • Organising numerous postgraduate courses
  • Developing joint documents with international societies
  • Showing a genuine commitment to continuing medical education
  • Actively developing e-learning programmes
  • Sponsoring task forces and seminars
    Breathe is the official educational journal of the ERS school.

Fellowships

The ERS offers training and research fellowships. These fellowships provide money for those involved in research related to lung health.

Collaboration with Central & Eastern Europe

The ERS supports the further development of lung health in Central and Eastern European Countries. More than 200 physicians and scientists from these countries are given support to attend the annual congress.

Advocacy

The ERS is actively involved in lobbying governments, grant agencies and political bodies to provide better lung health in Europe. A recent success was the launch of the:

  • European Lung White Book

This publication was officially launched on November 25, 2003 at the European Parliament in Brussels and was produced in conjunction with the European Lung Foundation (ELF). It provides the first comprehensive survey on respiratory health in Europe. It is also available in an abbreviated version:

  • Lung Health in Europe – Facts and figures

The abbreviated version is also available in French, Dutch, Russian, German, Polish, Spanish and Italian.

 

Fellowships

With your help, each year, the ELF is able to fund young scientists and researchers to further work in the field of lung health and diseases.

What is a Fellowship?

ERS/ELF Fellowship schemes provide young scientists and clinicians with funding to carry out research into the lungs or to complete a training project in any part of Europe. The main aim of the fellowship is to allow people to learn skills that they cannot acquire in their own countries.

How do ERS/ELF Fellowships affect you?
The projects chosen to receive the ERS/ELF Fellowships each year all have a clear impact on lung health and disease. The ELF Council considers all applications and then decides which ones will most help you, that is patients and the general public.

For example:

  • A project may be chosen because it studies a new treatment for asthma which will make life easier for thousands of people.
  • A person may be chosen to receive a Fellowship because they are going to learn a new technique that is essential for the area where they work.
  • The project may be looking at ways that we can improve our lung health and prevent disease, by researching (or tackling) issues such as obesity and the environment.

 

Vitamin E linked to lung cancer

Taking high doses of vitamin E supplements can increase the risk of lung cancer, research suggests.
The US study of 77,000 people found taking 400 milligrams per day long-term increased cancer risk by 28% – with smokers at particular risk.

The researchers followed people aged between 50 and 76 for four years and looked at their average daily use of vitamin C and folic acid, and vitamin E supplements.

It follows warnings about similar risks of excessive beta-carotene use.

An expert said people should get their vitamins from fruit and vegetables.

Vitamin E is known to be an antioxidant – protecting cells from molecules called free radicals. However, if taken in large doses, it can damage cells.

 

Bird flu

What is bird flu?

Can humans catch bird flu?

What is the H5N1 virus?

How can the virus pass from birds to humans?

What are the signs and symptoms of bird flu in humans?

How do you treat bird flu?

What is a pandemic?

How can we prevent a pandemic?

Why is bird flu such a worry now?

Bird flu in the news

ELF Professional Advisory Committee

Who are the Professional Advisory Committee?
The ELF Professional Advisory Committee is made up of a group of specialists from the ERS school and a team of GPs and nurses selected from across Europe.

Why do we have a Professional Advisory Committee?
In order to guide the ELF to topics they should be writing about, and to assess all the material written for and linked to from the ELF website, the ELF has established a Professional Advisory Committee?

The ELF is the public voice of the ERS. This means that all the information and links on the ELF site are accurate and reliable, as they have been reviewed and approved by a member of the ERS.

This is one of the main advantages of the ELF and differentiates it from the many other information sources.

How does the Professional Advisory Committee help the ELF?
The ELF Professional Advisory Committee has helped to produce a set of criteria that they use when assessing education content to be posted on the website. These criteria can be divided up into the following categories:

  • Credibility
  • Content
  • Design
  • Interactiviy
  • Links
  • Overall rating

Indonesia says a three-year-old girl who died this week has tested positive for bird flu.

A health ministry official says the child, from Jakarta’s western suburbs, was admitted to hospital on Thursday and died hours later.

The results of the local test will now be sent to a World Health Organisation (WHO) laboratory for confirmation.

Bird flu (H5N1 strain) has already killed 41 people in Indonesia and 131 people world wide.

A World Health Organisation laboratory test has confirmed a 5-year-old Indonesian boy who died last month was infected with bird flu.

Human cases generally stem from contact with infected birds.

 

ERS Congress

The European Respiratory Society’s congress is the largest annual scientific gathering in respiratory medicine in the world.

Each year, at the ERS Congress, doctors, scientists, nurses and other health workers come together from all over the world and from all continents to share ideas and discuss how to improve treatment options for patients.

This exchange of expertise is vital to advance the field of respiratory health and to keep doctors in all parts of the world up to date on the latest treatments and care strategies.

2011

2010

2009

2008

Smoking kills 104 people per hour in India

The next time you think about lighting a cigarette, think again: India loses 990,000 people every year due to smoking. That’s a scary 104 deaths every hour.

By 2010, 1 million Indians will die every year as the result of smoking – that’s 114 deaths every hour.

It’s the finding of a new study, the most comprehensive to date on the impact of smoking in India.

The study covered over 1 million homes across India. It found that 70 per cent of smokers who die as a result of smoking are aged between 30 and 69.

Tuberculosis is responsible for causing 38 per cent of smoking-related deaths in India and cancer accounts for 32 per cent.

The World Health Organization (WHO) predicts that the number of deaths from smoking-related illnesses will rise to over 8 million in the next 20 years, with the maximum numbers coming from low and middle income countries like India, Bangladesh and Indonesia.

 

How can the virus pass from birds to humans?

In a few cases, exposure of children to chicken faeces when they have been playing in an area with free-ranging poultry is thought to have been the source of infection.

Swimming in water where the bodies of dead infected birds have been discarded or which may have been contaminated by faeces from infected ducks or other birds might be another source of exposure. Other possible sources could be contact with semi-domestic birds, such as pigeons, or the use of untreated bird faeces as fertiliser.

The route of human infection with the H5N1 bird flu virus is by close contact with dead or sick birds. This means that activities such as slaughtering, defeathering, butchering and the preparation of infected birds for eating are very dangerous.

Having said all this, at present, the H5N1 bird flu virus largely remains a disease of birds, as the virus does not easily cross from birds to infect humans.

Despite the infection of tens of millions of poultry over huge areas since mid-2003, fewer than 200 human cases have been confirmed in the laboratory.

For unknown reasons, most cases have occurred in rural households where small flocks of poultry are kept.

Again, for unknown reasons, very few cases have been detected in the groups thought to be at high-risk, such as commercial poultry workers, workers at live poultry markets, vets and health staff caring for patients without adequate protective equipment.

Many scientist are now doing research into the factors that might increase the likelihood of infection into humans.

 

Glossary

A
B
C
D
E
F
G
H
I
L
M
N
N
O
P
R
S
T
V
W
A
Acute: of rapid or sudden onset (opposite of “chronic”).

Airborne: conveyed by or through the air.

Airway: the passages that carry air when we breathe.

Allergen: a substance that causes an allergy e.g dust, pollen.

Alveoli: tiny air sacs in the lung.

Antibiotics: substance produced by, or derived from, a microorganism that destroys or inhibits the growth of other microorganisms. Antibiotics are used to treat infections caused by organisms that are sensitive to them, usually bacteria or fungi.

Antibody: proteins in the blood and body fluids that are used by the immune system to identify and neutralise potentially harmful foreign bodies such as bacteria and viruses (antigens) by binding to their surfaces.

Antigen: a molecule that can stimulate an immune response.

Antimicrobial: an agent that kills microorganisms or suppresses their multiplication or growth.

Antioxidants: a synthetic or natural substance added to a product to prevent or delay its deterioration by action of oxygen in the air, a process known as oxidation.

α1-antitrypsin: a plasma protein produced in the liver, which inhibits the activity of trypsin and other proteolytic enzymes. Deficiency of this protein is associated with emphysema.

Apnoea: the suspension of breathing.

Apnoea of prematurity: occurs in premature babies when the part of the central nervous system (brain and spinal cord) that controls breathing is not yet mature enough to allow continuous breathing. This results in large bursts of breath followed by periods of shallow or stopped breathing.

Asphyxia: suffocation: a life-threatening condition in which oxygen is prevented from reaching the tissues by obstruction of or damage to any part of the respiratory system.

Atopic syndrome: Hereditary tendency to experience immediate allergic reactions on parts of the body that are not in direct contact with the allergen.

B
Bacteria: a group of microorganisms all of which lack a distinct nuclear membrane and have a cell wall of unique composition. Most bacteria are unicellular. Bacteria are very widely distributed, some live in soil, water or air and others are parasites. Many parasitic bacteria do not harm their hosts; some cause diseases by producing poisons.

Benign tumour: a tumour that is localised and will not migrate to other parts of the body, not cancerous, usually harmless.

Biomarker: A specific substance used to measure or indicate the effects or progress of a disease or condition

Biomass fuel: liquid, solid, or gaseous fuel produced by conversion of biomass (vegetable matter used as a source of energy).

Body mass index: a measure of body fat in relation to weight and height. Helps healthcare professionals determine whether or not someone is overweight or obese.

Bronchiectasis: abnormal widening of one or more airways. Excess mucus is made in the abnormal airways, which can lead to infection. Cough is usually the main symptom.

Bronchiolitis: is an infection in the airways that makes breathing difficult.

Bronchitis: inflammation of the bronchial tubes, characterised by coughing, difficulty in breathing etc., caused by infection or irritation of the respiratory tract.

Bronchoalveolar lavage: a medical procedure performed to diagnose lung disease. It involves passing a bronchoscope through the mouth or nose and into the lungs. Fluid is used to wash off cells that are later collected and examined.

Bronchoconstrictor: a drug that causes narrowing of the air passages by producing contraction of bronchial smooth muscle.

Bronchodilators: an agent that causes widening of the air passages by relaxing bronchial smooth muscle.

Bronchoscopy: the procedure carried out by a doctor to look at your throat, larynx, trachea, airways and lungs through a thin viewing instrument called a bronchoscope. It is used to diagnose and treat lung diseases.

Bronchus: (pl. bronchi) any of the air passages beyond the trachea (windpipe) that has cartilage and mucous glands in its walls.

 

C
Cancer stage: (usually numbers I to IV) describes how much the cancer has spread.

Carcinogens: any substance that, when exposed to living tissue, may cause the production of cancer.

Cardiovascular: of or relating to the heart and the blood vessels.

Cerebrovascular: of or relating to the blood vessels and the blood supply of the brain.

Chemotherapy: the prevention or treatment of disease by the use of chemical substances. The term is sometimes restricted to the treatment of infectious diseases with antibiotics and other drugs or to the control of cancer.

Chronic: describing a disease of long duration involving very slow changes. Such disease is often of gradual onset. The term does not imply anything about the severity of a disease.

Coronavirus: A virus so called because of the appearance of a crown (corona) or halo under a microscope. Associatied with gastrointestinal, respiratory, liver and neurological diseases in animals.

Corticosteroids: any steroid hormone synthesised by the adrenal cortex (part of the adrenal gland, at the top of the kidneys).

Cytokine: a substance that is secreted by specific cells of the immune system which carry signals locally between cells, and have an effect on other cells.

 

D
DNA: the genetic material of all living organisms, which controls heredity.

Dysphonia: hoarseness; defective use of the voice.

 

E
Emphysema: the air sacs (alveoli) of the lungs are enlarged and damaged, which reduces the surface area for the exchange of oxygen and carbon dioxide.

Endocrine system: a control system of ductless glands that secrete chemical messengers called hormones that circulate throughout the body in the blood, to affect distant cells within specific organs.

Endoscope: a flexible tube with a camera inside, used to observe internal body structures.

Enzyme: a protein that speeds up the rate of a biological reaction without being used up in the reaction.

Epidemic: a sudden outbreak of infectious disease that spreads rapidly through the population, affecting a large proportion of people.

Epidemiology: the study of the occurrence, distribution, and control of diseases in populations.

Epithelial: relates to the layer of cells which form a covering over the internal and external surfaces of the body. e.g. the inner lining of the lungs, digestive tract, and skin cells.

Exacerbation: to make more intense.

Extrapulmonary: situated or occurring outside the lungs.

F
Fibroblast: a type of cell that forms the structural support of connective tissue and plays a critical role in wound healing.

Fibrosis: thickening and scarring of connective tissue, most often a consequence of inflammation or injury.

Fungi: (plural of fungus) a simple organism (formerly regarded as a plant) that lacks the green pigment chlorophyll.

Fungicide: a chemical substance that destroys or inhibits the growth of fungi.

 

G
Genes: a region of DNA corresponding to a unit of inheritance.

Genetic: of or relating to genes.

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H
Hereditary: transmitted from parents to their offspring; inherited.

Histopathology: examining tissue with a microscope to study disease.

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I
Idiopathic: (a disease) of no known cause

Immune: protected against a particular infection by the presence of specific antibodies against the organisms concerned.

Immunocompromised: patients in whom the immune response is reduced or defective due to immunosuppression.

Immunosuppressant: a drug that reduces the body’s resistance to infection and other foreign bodies by suppressing the immune system.

Inflammation: the body’s response to injury.

Ischaemic heart disease: atherosclerosis (hardening) of the heart vessels, which makes the patient likely to suffer from angina (chest pain) and myocardial infarction (heart attack).

Incidence: the rate of occurrence.

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L
Latency period: the time that it takes for a patient to show symptoms once they have been exposed to a pathogen.

Lung function: is a measure of how well the lungs take in and exhale air and how efficiently they transfer oxygen into the blood.

Lymphatic system: is a major component of the immune system. It is made up of organs, nodes, ducts, tissues, capilliaries and vessels that produce the lymph fluid and transport it to the circulatory system.

Lymph nodes: components of the lymphatic system. They contain white blood cells that trap and destroy bacteria or viruses.

 

M
Malaise: a general feeling of being unwell.

Malignant: describes a disease or diseased growth that is likely to get worse.

Median: a type of average that is calculated by taking the middle value of a collection of data.

Metastasis: the spread of malignant tumour from its site of origin.

Microorganism: any organism too small to be visible to the naked eye.

Morbidity: the symptoms and/or disability resulting from a disease.

Mortality: the rate of death in the population in a given period.

Mutation: a change in the genetic material (DNA) of a cell, or the change this causes in a characteristic of the individual, which is not caused by normal genetic processes.

Mutagenic: an agent capable of causing a mutation.

 

N
Nanometer: a measurement equivalent to one billionth of a meter.

N
Nanometer: a measurement equivalent to one billionth of a meter.

O
Oedema: excessive accumulation of fluid in the body tissues.

Oesophagus: the gullet: a muscular tube, about 23 cm long, that extends from the throat to the stomach.

Oxidative: causing the loss of electrons by a molecule.

Oxidative stress: is a general term used to describe the steady state level of oxidative damage in a cell, tissue, or organ, caused by the reactive oxygen species such as free radicals.

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P
Palliative: a medicine that gives temporary relief from the symptoms of a disease but does not actually cure the disease.

Pandemic: an epidemic over a wide geographic area and affecting a large proportion of the population.

Particulate matter: term used for a mixture of solid particles and liquid droplets suspended in the air.

Pathogen: a biological agent that causes disease or illness to its host.

Pathophysiology: the functional changes associated with disease or injury.

Pharmacogenetics: Scientific medical branch which studies the genetic differences in metabolic pathways that can influence the individual responses to drugs, both in terms of therapeutic and adverse effects.

Plasma: the clear, yellowish fluid portion of the blood in which cells are suspended.

Pleura: membrane lining the lungs and chest cavity.

Pneumoconiosis: a lung disease primarily caused by inhaling dust in the work place.

Prevalence rate: a measure of morbidity based on current sickness in a population, estimated either at a particular time or over a stated period.

Pulmonary: relating to, associated with, or affecting the lungs.

Pulmonary fibrosis: scarring or thickening of tissues deep in the lung without a known cause.

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R
Resection: surgical removal of a portion of any part of the body.

Respiratory system: the combination of organs and tissues associated with breathing.

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S
SIDS: Sudden Infant Death Syndrome

Species barrier: a term referring to the biological divides between different species, for example cows/goats/humans. These biological differences make the transference of viruses between different species difficult and unusual, although not impossible.

Socioeconomic: involving social as well as economic factors.

Somnolence: causing drowsiness.

Susceptibility: lack of resistance to disease.

Synergistic: a drug that interacts with another to produce increased activity, which is greater than the sum of the effects of the two drugs given separately.

Systemic: affecting the body as a whole.

 

T
Therapeutic: of or relating to the treatment of disease.

Trachea: the windpipe.

Trypsin: an enzyme that breaks down/ digests proteins.

Tumour: a lump of tissue caused by an abnormal growth of cells, can be benign or malignant

 

V
Vector: is a vehicle for delivering genetic material, such as DNA, to a cell.

Virology: the scientific study of viruses and the diseases that they cause.

Viruses: a minute particle that is capable of replication but only within living cells. They infect animals, plants and microorganisms.

 

W
Wheeze: an abnormal high-pitched or low-pitched sound heard during expiration; results from narrowing of the airways or increased secretion or retention of sputum.

ELF funding

The European Lung Foundation (ELF) is funded partly by donations from the public and medical professionals. Other organisations have a key role in helping to pay for ELF’s work. The European Respiratory Society partly funds the ELF to provide primary research knowledge and expertise to the public. This allows ELF to produce non-biased patient information regarding treatments for respiratory problems.

The Health and Environment Alliance (HEAL), which receives money from the European Commission, provides partial funding for some of the ELF factsheets. These factsheets are also published in Breathe the educational journal of the European Respiratory Society, which is sent out to doctors and healthcare professionals around Europe.

The annual lung function testing event at the European Respiratory Society Congress is funded largely by Boehringer Ingelheim, a pharmaceutical company. This is the only activity for which ELF accepts industry funding.

Sleep apnoea links

The links on this page will take you to recommended sites that have useful information on all aspects of sleep apnoea.

Belgium
France
Ireland
The Netherlands
UK
Belgium
Link to VAPA

Vereniging Apneu Patienten (VAPA): Belgian sleep apnoea patient organisation.

France

Federation Francaise des Associations et Amicales de malades, Insuffisants ou handicapes Respiratoire (FFAAIR): is a french federation of combined lung disease organisations that aim to reduce the handicap of lung disease patients.

Ireland

Irish Sleep Apnoea Trust (ISAT): a patient support group for sleep apnoea sufferers and their families.

The Netherlands

Apnoevereniging: Sleep Apnoea Information.

UK

The Sleep Apnoea Trust: aims to improve the lives of patients with sleep apnoea.

The Scottish Association of Sleep Apnoea: aims to increase public awareness of the disease

European Lung Foundation

Lung diseases are the leading cause of death and disease in Europe and throughout the world. Anyone can be affected by lung diseases, not just smokers. Lung diseases impact on almost every family in Europe.

Helping Europe to breathe

The ELF provides information on:

lung diseases and how they impact on individuals and on Europe

the lungs and how they function

risk factors that cause lung diseases and how to avoid them

Latest news updates from around the world….

Vehicle fumes ‘stunt lung growth’ 26/01/2007
Living too near a busy road could stunt a child’s lung development, US research involving 3,677 children suggests.

Respiratory infection may be contracted through the eye 25/01/2007
A respiratory pathogen common in newborns may be passed on to the lungs following initial infection in the eye say researchers from the University of South Alabama, College of Medicine.

Brain region that fuels addiction found 25/01/2007
A small area of the brain nestled inside the cerebral cortex might explain why smoking is such a hard habit to break.
More

Diabetes drug slows growth of lung cancer

A drug used to treat diabetes has been shown to slow the growth of lung cancer cells and make them more likely to be killed by radiotherapy, according to a new study.
The research, published in the British Journal of Cancer, analysed lung cancer cells grown in a laboratory and in mice.

The results showed that the drug acted on the defence mechanisms of the cancer cells. These mechanisms  make the cancer cells resistant to treatment and can even help them grow faster.

The study revealed that the diabetes drug, metaformin, reverses these mechanisms, making the cells less resistant to radiotherapy.

Lead author, Dr Theodoros Tsakiridis, said: “We’re now working with other institutions to develop a clinical trial that will investigate metformin in lung cancer patients treated with radiotherapy. If we can prove that this works in patients then we could have a potentially powerful weapon in the fight against the disease.”

Non-smoking guests suffer from third-hand smoke in hotels

Non-smoking guests are still exposed to tobacco smoke in hotels without complete smoking bans, despite staying in non-smoking rooms.

A new study, published in the journal Tobacco Control, examined the effects of tobacco smoke pollution on non-smoking guests.

The researchers used a sample of hotels from California, USA, 10 with complete smoking bans and 30 without complete bans. They analysed surfaces and the air for different pollutants found in tobacco smoke and took urine samples and a finger wipe from non-smoking guests to determine their exposure to the pollutants.

Non-smoking guests staying in hotels without complete smoking bans showed higher levels of nicotine in their urine and on their fingers than those in hotels with complete bans.

The researchers concluded that partial smoking bans do not protect non-smoking guests from exposure to tobacco smoke

New data reveals smoking habits across the world

New data has revealed which countries are refusing to give up smoking and which are successfully managing to kick the habit.

The data was released by the research firm, ERC to mark World No Tobacco Day, which took place last week (31st May 2013).

The results showed that consumption per person was 999 cigarettes a year in 1990 and only 882 in 2012. Smokers lit up 5.9 trillion times last year compared with 5.1 trillion in 1990.

In Western Europe consumption per person fell by 42%—from 1,744 smokes in 1990 to 1,003 last year. However, in other countries the rates have grown. The average Chinese person smoked 30% more in 2012 than in 1990, ranking the country 11th by consumption per head. Eight of the top ten countries, ranked by consumption per person, are in the former Eastern block.

 

E-cigarettes

Smoking is highly addictive and quitting the habit is not easy. In addition to becoming addicted to nicotine, a drug found naturally in tobacco, people also become dependent on the physical and social habit of smoking.

Healthcare professionals play a central role in helping people quit smoking and choosing the most appropriate method out of a range of products and various strategies. These include prescription medicines, nicotine replacement products, such as patches or lozenges and counselling.

E-cigarettes have become increasingly popular throughout the 2000s. Although e-cigarettes have the potential to reduce the harm caused by smoking tobacco, they have not been scientifically evaluated and therefore, their safety and usefulness as a smoking cessation aid is still unknown. Unlike the other products which are commonly available, health authorities in Europe have not yet approved e-cigarettes as an effective tool to help smokers quit.

What are e-cigarettes?

Reprinted with permission of the American Thoracic Society. Copyright © 2013 American Thoracic Society.*
E-cigarettes are designed to look and feel like cigarettes.

They consist of three parts; a battery, a vaporiser and a cartridge. The device works by vaporising the liquid in the cartridge. This creates a mist that can be inhaled by the user and they appear to breathe out smoke.

Unlike normal cigarettes these devices do not contain tobacco, but they contain nicotine in the liquid found in the cartridge. The liquid can have different flavours and different amounts of nicotine from which the user can select.

Why do some people choose to use them?
It is believed that e-cigarettes cause less harm than a normal cigarette and some people choose to use them in order to maintain their habit more safely. Some research into the views of e-cigarette users suggest that a key benefit of the products is that they satisfy a need to smoke.

An e-cigarette user tells us why they chose to use the products:

“I started using e-cigarettes even though I had no intention of actually stopping smoking. One day I realised that I was exclusively using the e-cigarette, and haven’t smoked a normal cigarette since. It may be difficult to get used to the experience at first but once your taste and smell senses return after smoking tobacco for a number of years, you begin to prefer the flavours available in an e-cigarette to the ‘bonfire’ flavour of a tobacco cigarette. I believe that I am using a safer alternative, although I still class myself as a smoker; if e-cigarettes were suddenly to become unavailable, I would go back to smoking tobacco cigarettes.”

Why are some healthcare professionals concerned about the use of e-cigarettes?
E-cigarettes have been the subject of intense debate in the media across Europe as some healthcare professionals are concerned about the promotion and use of the products.

The concerns include:

Products are regulated differently: E-cigarettes are currently regulated differently across Europe. This means that there are no restrictions on the chemicals that can be added to the cartridges. This also means that they are not subject to strict quality control, and products may be labelled the same but have different amounts of chemicals and nicotine in them.

Continuing addictive behaviour: As e-cigarettes look and feel like a cigarette, users are not encouraged to change their behaviour. Their addiction to the physical and emotional elements of smoking continues.

Visibility for others who have quit: There are no restrictions on e-cigarettes being used in offices and other public places where normal smoking is banned. Smoke-free legislation, which bans smoking in public places, has contributed to a change in the perception of smoking, de-normalising it and making it seem abnormal and unacceptable. Some experts believe that visibility to people smoking e-cigarettes could make smoking seem acceptable and could tempt people who have quit, or are trying to quit, to slip back into the habit.

Children’s exposure to smoking: Children who are growing up in areas where smoke free legislation has been common since their childhood are exposed to smoking behaviour when they see e-cigarette users. Some experts feel this will undo the steps made by smoke free legislation in changing the perceptions of smoking. They are concerned that the behaviour of smoking, whether the product is an e-cigarette or a tobacco cigarette, is once more being promoted to children and young people.

Lack of evidence: A key concern for healthcare professionals at the moment is a lack of evidence on the potential harm to the user. Although the products are thought to be less harmful than smoking normal cigarettes, the devices contain various chemicals and long-term studies on the health effects of the products have not yet been carried out. More research is needed on the harm caused by the mist, vapour, flavours and additives delivering nicotine.

The European Lung Foundation and the European Respiratory Society have responded to the uncertainty around the products and will conduct research to find out the short- and long-term effects of the products.

Why is regulation of the product needed?
Nicotine replacement products and devices that are used to help smokers quit are regulated as medicines. This means that the European Medicines Agency will ensure that medicines and medical devices work, and are safe to use. If the product is regulated, the chemicals within e-cigarettes and the quantities of nicotine found within the devices would be controlled. Smokers could make a balanced choice between e-cigarettes and other nicotine replacement therapies to help them quit. It would also give users reassurance that the products are quality controlled and contain chemicals stated on the label.

Current situation in Europe
The restrictions on and regulations of e-cigarettes varies around the world. Australia, Brazil, China, Singapore, Thailand and Uruguay have completely banned the use of e-cigarettes. In New Zealand, the products are regulated as medicines and can only be bought in pharmacies.They are regulated differently in the EU Member States: as tobacco products or pharmaceutical products or as consumer products under the General Product Safety Directive. The European Commission proposed regulating them as medicinal products in its revision of the Tobacco Products Directive.

EU Commissioner for health has lungs tested in the EU Parliament

ELF supported a free lung function testing event yesterday (10 June 2013) at the European Commission.

Monica Fletcher, Tonio
Borg and Catherine Hartman
from the European COPD
Coalition The event, organised by the European COPD Coalition, aimed to raise awareness of chronic obstructive pulmonary disease (COPD) among EU policymakers.
Chair of ELF, Monica Fletcher attended the event and helped prepare the EU Commissioner for Health and Consumer Policy, Tonio Borg for his lung test.

The event was very successful and in 4 hours, no less than 250 people took the test.

In his statement that followed, Tonio Borg highlighted the need for further disease prevention by inviting people to take the test as well.

“The figures are impressive; millions of citizens suffer from chronic obstructive pulmonary disease (COPD) and from asthma. More than 40 million suffer from COPD alone. This can be prevented. If one has a breathing problem, one should really take a spirometry test. It is so easy, I have done it, so everyone can do it”.

 

New vaccine could help people with asthma and allergies

A jab that uses electricity could revolutionise the treatment of asthma and allergies, according to a new study.

The research, presented in the journal Immunology Letters, has taken a step forward in developing a DNA-based vaccine that could be tested in clinical trials for people who are allergic to house dust mites.

The current ‘vaccine’ against asthma is immunotherapy, where the patient could receive multiple injections of small amounts of the harmful dust mite protein.

The idea is that the immune system becomes used to the protein, so no longer overreacts.

The research team are confident that the vaccine could work on humans, although clinical trials will be needed to confirm this. Malayka Rahman, research officer at Asthma UK, a patient organisation, said: “Dust is notoriously difficult to avoid. Although this research is an important step forward towards more effective vaccines, it is in its early stages.”

 

EP ENVI Committee adopts Tobacco Products Directive

The European Parliament’s Environment, Public Health and Food Safety (ENVI) Committee has adopted pictorial health warnings covering 75% of the front and back of tobacco packets.
The European Parliament’s Environment, Public Health and Food Safety (ENVI) Committee has adopted pictorial health warnings covering 75% of the front and back of tobacco packets.

The endorsement by the committee is a further step in the negotiations for the proposed Tobacco Products Directive, which is expected to be adopted before the end of the European Parliament’s current mandate in May 2014.

Following months of negotiations and despite tobacco industry-friendly results in four out of the five opinion-giving Committees, members of the ENVI Committee upheld the need to protect public health by adopting key measures to help prevent disease and deaths caused by tobacco:

 

  • By adopting large mandatory pictorial warnings covering 75% of the front and the back of cigarette packs, roll-your-own and waterpipe tobacco, and by maintaining the ban on slim cigarettes and their attractive “lipstick packs”, MEPs reasserted that the primary goal of this key legislation is to protect children from getting hooked onto a deadly and addictive product. MEPs asserted that children should not be lured by shiny, colourful tobacco packets and pretty cigarettes.

 

  • By adopting a ban on characterising flavours and restrictions on additives, MEPs have confirmed that tobacco should taste like tobacco, and not like menthol, fruit, or various spices. The taste of tobacco will no longer deceive young people across Europe into entering a lifelong addiction.

 

  • By reinforcing the anti-illicit trade provisions of the draft Directive, MEPs recognised the importance of tracking and tracing measures to help control the legal supply chain and prevent smuggling, and of security features to help customs authorities better recognise and control the influx of counterfeit products into the EU.

 

The next stage in the negotiations will be the European Parliament Plenary vote on the report, which is due during its session between 9 and 12 September, opening the way for negotiations with the EU Council on a compromise.

Vaccinating children can protect adults against pneumonia

Children who receive a vaccine to prevent blood and ear infections are reducing the spread of pneumonia to the rest of the population, especially to their grandparents and other older adults.

The results published in the New England Journal of Medicine found that vaccinating infants against pneumococcal bacteria since 2000 has reduced overall hospitalisation due to pneumonia by more than 10 per cent. In children under age 2 this reduction in hospitalisation was as great as 40 per cent.

The researchers looked at a large database for hospitalisation from pneumonia from 1997 to 2009 in the USA. This showed a long-term pattern of how the vaccine pneumococcal conjugate (PCV7 or Prevnar) has affected pneumonia rates since 2000, when children first started being vaccinated.

PCV7 was developed to protect children against seven types of pneumococcal bacteria that cause serious blood and spinal infections, sometimes death. The bacteria are also well known as a leading cause of lung and ear infections in young children.

Dr Marie Griffin, lead author of the study, says, “The protective effect we saw in older adults, who do not receive the vaccine but benefit from vaccination of infants, is quite remarkable. It is one of the most dramatic examples of indirect protection or herd immunity we have seen in recent years.”

COPD increases risk of blood vessel breakages in brain

Chronic obstructive pulmonary disease (COPD) has been linked with an increased risk of a type of breakage in the blood vessels in the brain, known as microbleeds, which is a marker of cerebral small vessel disease.
Researchers have found that people with COPD are more likely to have these tiny cerebral microbleeds than people without the lung condition. Cerebral small vessel disease is a key cause of disability in elderly people and leads to decline in brain function.
The findings of a new study, published in the American Journal of Respiratory and Critical Care Medicine, investigated the link between the two conditions.

The researchers investigated 165 people with COPD and 645 people with normal lung function. They confirmed diagnosis of COPD through a lung function test and analysed cerebral microbleeds with a MRI scan.

The people with COPD had a significantly higher number of cerebral microbleeds throughout their brain, compared with the group with normal lung function. The researchers found that microbleeds were more frequent as the person’s breathing became more difficulty due to the progression of the COPD.

Call to ban smoking on beaches stirs French

A French health minister has called on local authorities to ban smoking in parks and on beaches, sparking widespread debate.

Marisol Touraine told a national newspaper, the Journal du Dimanche, that she wanted to see more tobacco-free zones to protect children’s health. The Socialist minister said she hoped smoking would also be banned outside schools and on university campuses.

Smoke-free beaches have appeared in some French resorts in recent years. Similar steps have already been taken elsewhere in the world, notably in New York City which prohibited smoking on beaches and in parks in the same year.

Her remarks were picked up by other newspapers, generating lively debates online.

Smoking is the main cause of avoidable mortality in France and is regarded as being responsible for 90% of lung cancer cases and 73,000 premature deaths each year, according to the country’s National Institute for Prevention and Health Education.

 

New research suggests glaucoma screenings for people with sleep apnoea

New research suggests glaucoma screenings for people with sleep apnoea

People with sleep apnoea are far more likely to develop glaucoma compared to those without the condition, according to new research.

The findings, published in the journal Ophthalmology, suggest there is a significantly higher prevalence for the eye condition, which sees increased pressure in the eye that causes gradual loss of vision.

The researchers reviewed National Health Insurance medical records for 1,012 patients aged 40 and older throughout Taiwan who were diagnosed with obstructive sleep apnoea between 2001-04, comparing them to 6,072 similar people without the sleep disorder.

They found that the risk of developing the most common form of glaucoma within five years of a diagnosis of obstructive sleep apnoea diagnosis was 1.67 times higher than in those without the condition.

 

News

The news presented here is taken from sources on different websites. A brief summary of the news is given, along with a link to the original article.

 

Idiopathic Pulmonary Fibrosis (IPF) patients could benefit from heartburn treatment 07/03/2013
People with idiopathic pulmonary fibrosis (IPF) could benefit from taking drugs designed to treat heartburn.

New method to aid treatment of asthma attacks during pregnancy 09/09/2011
Scientists in Australia have developed a new technique for treating pregnant women with asthma, to help cut flare-ups during pregnancy.

Future climate change may increase asthma attacks for children 08/09/2011
Climate change could lead to more asthma-related health problems in children and more emergency room visits over the next ten years.

ERS experts call for coordinated strategy to reduce health burden of lung disease 07/09/2011
The European Respiratory Society (ERS) is calling on policy makers and health professionals to work together to tackle the changes that must be made to reduce the growing impact of lung disease.

Children living with a smoker have more absences from school 06/09/2011
Children who live in a household where they are exposed to tobacco smoke, miss more days off school than children living in smoke-free homes, according to new research.

Scientists discover potential TB vaccine breakthrough 05/09/2011
Scientists have found a potential new vaccine which could help kill the tuberculosis (TB) bacteria.

Antibiotic found to reduce COPD exacerbations 02/09/2011
A common antibiotic could help to reduce the symptoms of chronic obstructive pulmonary disease, according to new findings.

Smoking after menopause may increase risk of breast cancer 01/09/2011
Women who smoke after the menopause could be at a higher risk of developing breast cancer.

Women and the poor have lower survival rates for cystic fibrosis 31/08/2011
Women and people from disadvantaged backgrounds with cystic fibrosis continue to die younger than males and people who are more privileged in society, according to the latest findings.

Cholesterol-lowering drugs could help to fight pneumonia 30/08/2011
Drugs which are used to lower cholesterol could be used to help cut deaths from infections such as pneumonia.

 

European Lung Foundation

Lung diseases are the leading cause of death and disease in Europe and throughout the world. Anyone can be affected by lung diseases, not just smokers. Lung diseases impact on almost every family in Europe.

Latest news updates from around the world….
Future climate change may increase asthma attacks for children – 08/09/2011
Climate change could lead to more asthma-related health problems in children and more emergency room visits over the next ten years.

ERS experts call for coordinated strategy to reduce health burden of lung disease – 07/09/2011
The European Respiratory Society (ERS) is calling on policy makers and health professionals to work together to tackle the changes that must be made to reduce the growing impact of lung disease.

Children living with a smoker have more absences from school – 06/09/2011
Children who live in a household where they are exposed to tobacco smoke, miss more days off school than children living in smoke-free homes, according to new research.

 

ELF Council

The ELF Council is composed of members of the ERS Executive Commitee and external members from industry.

ELF Chair

Monica Fletcher
Education for Health
Warwick, UK

 

 

ELF Secretary

Archie Turnbull
ERS Headquarters
Lausanne
Switzerland

 

 

 

ERS Past President

Marc Decramer
Catholic University of Leuven
Belgium

 

ERS Treasurer

Guy Joos
Ghent University Hospital
Department of Respiratory Diseases
Belgium

 

 

ERS Secretary General

Mina Gaga
Athens University,
Greece

 

 

 

 

Bernard Fierens
Banque Privée Edmond de Rothschild
Lausanne
Switzerland

 

Florence Berteletti-Kemp
49-51 Rue de Tréves
BE – 1040 Brussels

 

Breda Flood

 

Hilary Pinnock
University of Edinburgh, UK

 

ELF Office

For any enquires about the ELF or its activities, please contact the ELF Manager at the address below.

ELF Manager

Pippa Powell
European Lung Foundation

Project Development and External Relations (maternity leave Feb-Dec 2012)

Anne-Marie Wish
European Lung Foundation

Project Development and External Relations (maternity cover)

Sarah Masefield
European Lung Foundation

Lauren Anderson
European Lung Foundation

Help the ELF fight lung diseases

Donate securely online via PayPal (a PayPal account is not required). If you dedicate your donation to a loved one this may be published online. Click on an image below to donate a set amount, or click the banner above to donate an amount of your choice.

 

Make a donation

By making a donation, you help bring us closer to a positive change in lung health. Donations enable the ELF to fund lung research, which contributes to improving lung disease treatment and patient lives.

The lungs are essential organs for life, and many people are not aware that lung diseases are the leading cause of death worldwide.
Not only do lung diseases kill, but they also cause considerable suffering, and the incidence of these diseases is predicted to rise even further between now and 2020.

Making a donation is very easy and will only take 2 minutes of your time.

If you do not want to make a monetary donation, there are other ways that you can help the ELF.

Thank you for helping us achieve our goals, and to help Europe breathe more easily.

 

Study finds COPD patients taking inhaled steroids are at risk of severe pneumonia

Patients with COPD (chronic obstructive pulmonary disease) are increasingly being prescribed inhaled corticosteroids to control exacerbations of the disease, but a new study finds that the anti-inflammatory drugs increase the chances that these patients will be hospitalized for pneumonia.

“In a large cohort of patients with COPD, we found that current inhaled corticosteroid use was associated with a significant 70 percent increase in the risk of being hospitalized for pneumonia,” said the researchers. “Furthermore, for the severest pneumonias leading to death within 30 days of hospitalization, the risk with current inhaled corticosteroid use was also significantly increased.”

These and other findings of the population-based study were reported in the second issue of the July American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Pierre Ernst, M.D., a clinical epidemiologist at McGill University, Canada, along with three other researchers from the university’s department of medicine, analyzed the hospitalization and drug prescription information from 1988 to 2003 of 175,906 patients with COPD living in Quebec, Canada. During that time, 23,942 of the patients were hospitalized for pneumonia.

In their report, the researchers noted that the admission rate for pneumonia increased with higher doses of inhaled steroids and that reduction in risk was observed once the medications were stopped. Among all patients taking inhaled steroids, there was a 53 percent increase in pneumonia deaths within 30 days of being admitted to the hospital.

The investigators noted that these findings are particularly relevant, given that pneumonia is the third leading cause of hospitalization in the United States and that inhaled corticosteroid use among patients with COPD increased from 13.2 to 41.4 percent from 1987 to 1995.

“Adverse effects of inhaled corticosteroids in patients with COPD,” the authors said, “are particularly troublesome given the limited evidence for their efficacy.”

In an accompanying editorial, Mark Woodhead, D.M, of Manchester (U.K.) Royal Infirmary, wrote that this report confirms secondary findings from a prospective, placebo-controlled study of an inhaled corticosteroid with long-acting β-agonist that was recently published. Given that this earlier study was not designed to analyze pneumonia frequency, its small size and high drop-out rate, he suggested, might lead a reader to reasonably conclude that its “pneumonia findings were spurious.”

Now, with the addition of the Canadian population-based study, Dr. Woodhead wrote, the unexpected conclusion–that drugs prescribed to prevent COPD exacerbations put patients at greater risk for severe pneumonia—deserves further consideration and study through large prospective studies with objective pneumonia definitions.

“The finding of an association,” he said, “between pneumonia frequency and inhaled corticosteroid use in studies of different design, in different populations, and with evidence of a dose-response relations means that the findings may be real and that these observations cannot simply be dismissed.”

 

Asthma

What is asthma?

What causes asthma?

Treatment of asthma

 

Burden in Europe

Areas for action

 

Testimonies

Asthma in the news

 

Resources

Asthma links

2012/2013

LAKHDAR Ramzi will carry out his research project at ELEGI/Colt laboratory UoE/MRC Centre for Inflammation Research, The Queen’s Medical Research Institute, Edinburgh (UK) looking at muscle wasting and dysfunction in people with Chronic Obstructive Pulmonary Disease (COPD).

Melissa McDonnell will carry out her research at Institute of Cellular Medicine / Freeman Hospital, University of Newcastle-upon-Tyne looking at reflux in the development and progression of bronchiectasis.

 

2012

ERS Congress 2012 – Vienna, Austria
1 -5 September

The 22nd annual European Respiratory Society (ERS) Congress was held in September 2012 at the Messe Wien Congress Centre, Vienna.

Patient organisations at Congress

The ELF was pleased to welcome 16 patient organisations to the ERS Congress again this year, with each having a stand in the World Village where they could raise awareness of their organisations by displaying posters, providing literature, and engaging with professionals on their vital role in supporting patients.

The World Village was located in the heart of the Congress centre ensuring that all delegates would have the opportunity to see the stands and go and speak with the patient organisation representatives.  The ELF also offered a Patient Organisations of Europe ‘break-away’ area for anyone to hold informal meetings, or just to sit and enjoy a cup of coffee whilst looking at the posters supplied by organisations unable to attend.

The ELF would like to say a huge thank you to all the patient organisation representatives that attended for their valuable contribution to the ERS Congress and tireless efforts to communicate with professionals and support patients with lung conditions across Europe:

  • Alpha Europe Federation
  • Associacion Italiana Pazienti BPCO Onlus, Italy
  • Longfonds, Netherlands
  • Asthma UK
  • British Lung Foundation (BLF)
  • Cystic Fibrosis (CF) Europe
  • European Federation of Allergy and Airway Diseases Patients Association (EFA)
  • European LAM Federation
  • European Pulmonary Hypertension Association (PHA)
  • French Federation of Associations of Patients with Respiratory Insufficiency or Handicap (FFAAIR), France
  • La Federación Nacional de Asociaciones de Enfermedades Respiratorias (FENAER), Spain
  • Global Allergy and Asthma Patient Platform (GAAPP)
  • June Hancock Mesothelioma Research Fund, UK
  • Lovexair Foundation, Spain
  • Lungenunion, Austria
  • Romanian Tuberculosis Association (ARB-TB), Romania

Some of the feedback received by the ELF:

‘I wish to thank you very much for your support and collaboration at the ERS and confirm you that the experience at the Congress has been very positive and useful to make visible LAM and the European LAM Federation!’ (Iris Bassi, European LAM federation)

‘Thanks for ERS 2012: we had a great time in Patients Village and found in ELF a real support and help!’ (Marius Dumitru, ARB-TB)

‘I thank you on behalf of myself and of FENAER, being able to attend the ERS Congress in Vienna we had contact with patients associations of various countries and with entities interested in collaborating. These few days have been very interesting and very helpful for FENAER.’ (Marivy Palomares, President of FENAER)

Patient Advisory Committee meeting

Since the first meeting of the Patient Advisory Committee in Amsterdam last year, the advisory committee has continued to provide valuable feedback upon ELF activities, helping the ELF to develop its network of European patient organisations, working together to share information and successes, to support each other to develop both at the national and European level.

During Congress the PAC met for a productive morning of information sharing and discussion. The ELF provided an update on their projects and activities, and thanked the patient organisations for their input into the WSD campaign and development of a patient organisation chapter for the new White Book. Committee members were invited to vote on which ERS Congress 2013 symposia should have patient input, and to suggest topics for patient symposia for ERS Congress 2014. The ELF looks forward to collaborating with PAC members on these projects.

During the meeting information was also given on EFA’s access to air travel lobbying project, the establishment of the European Sleep Apnoea Federation, the progress of the European COPD Coalition (ECC), and with mention of the upcoming EAACI International severe Asthma Forum, and IPF Week (23rd-30th September).

ERS Congress is a great opportunity for patient organisations to come together and be empowered by each other’s activities and we hope that the Patient Advisory Committee will continue to foster this sense of European collaboration between patients, professionals, and patient organisations.

European Patient Ambassador Programme (EPAP)

One of ELF’s major projects this year has been the development of the European Patient Ambassador Programme (EPAP), an online learning resource to help patients and carers gain knowledge, skills and confidence to actively engage in research, guidelines, advocacy and media activities.

A trial version of the programme was launched at Congress, with an introductory event and invitations to try it out and give feedback.
Throughout the conference computers were available on the ELF stand for people to come and try out the four taster modules.

The response was overwhelmingly positive with lots of interest from both patient organisations and professionals. Over 60 login accounts were created and all feedback received will be used to further refine the programme.

ELF symposia

This year the ELF organised three highly successful symposia with patient involvement:

• ELF/EFA joint symposium ‘Patient views on respiratory allergies: raise awareness, release the burden’

• Improving adherence to maintenance medication in asthma: new tools for the clinician [Co-chaired by Monica Fletcher, with David Supple presenting “The patient’s perspective and shared decision making”]

• Patient symposium – The unmet needs of patients with COPD

The room was filled for the presentation of the patient’s perspective in asthma medication adherence with many professionals reporting the value of being reminded of the patient’s perspective.

The patient symposium was another great event, with over 70 patients attending to hear about the ERS COPD Audit and discuss the unmet needs of people with COPD in Europe. Four questions were discussed and a report on the audit and discussion of the symposium will be available on the ELF website soon.

ERS Scientific Taskforces

Encouraged by the positive response from professionals to the involvement of patients in the ERS taskforce on chronic cough, the ELF also attended the meetings of the COPD and activity and Smoking and COPD taskforces. These taskforce groups were keen to include patient voices in their projects, and to work with the ELF to disseminate their work to a wider public audience.

The ELF is excited by these opportunities and looks forward to working with the taskforces to develop patient involvement.

‘Monica Fletcher ELF chair and her team presented their huge experience with patient interaction. This experience is highly welcome in the preparation of the document.’ (Carlos Jimenez-Ruiz, ERS Taskforce: Smoking and COPD)

Press at Congress

The ELF is responsible for disseminating the most interesting and newsworthy research from the ERS Congress to the press and media.
This year, over 500 cuttings were featured in over 10 countries in Europe – bringing important new developments in research to an even wider audience.

The biggest stories have included a new paper on why children with asthma are more likely to be bullied, sleep apnoea in commercial vehicle drivers and the link between smoking rates and the earthquake in Christchurch, New Zealand.

These stories have featured in TV New Zealand, Irish Health and the Huffington Post.

To read the latest science updates, you can view all the Congress news releases on the website.

2009/ 2010

Matteo Bonnini will carry out research at Brigham & Women’s Hospital, Harvard Medical University (Boston, MA United States of America) on the effects of the ADRB2 polymorphisms on the down-regulation of bronchoprotection from exercise provided by long-acting beta-2 agonists.

Learn more about Matteo Bonnini’s work

Parthiban Nadarajan will be based at University College Hospital London (United Kingdom), researching a new pathway with bronchscopic or oesophageal ultrasound for lung cancer diagnosis and staging. Parthiban will start his research in August 2009.

Learn more about Parthiban Nadarajan’s work

Lung health in Europe

WEB_CHEMIN_14262_1232107638

This brochure, published by the European Respiratory Society (ERS) and the European Lung Foundation (ELF) shows how respiratory disease affects European health systems.

It is an adapted and summarised version of the “European Lung White Book” published by the ERS and the ELF, which includes data on the causes, means of prevention and treatment for a wide range of respiratory diseases.

Health-related quality of life

All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

  • What is health-related quality of life?
  • Health-related quality-of-life questionnaires
  • Why are health-related quality-of-life measurements important?
  • How are health-related quality-of-life measurements used in research?
  • Health-related quality of life in COPD research

What is health-related quality of life?

“Health-related quality of life” is a concept used to measure how your health affects how you are feeling physically, mentally and emotionally.

This factsheet explains why these measurements are important and why they might be considered in your treatment plan by your doctor, nurse or physiotherapist (referred to as healthcare professional throughout this factsheet).

Health-related quality-of-life measurements can be used in addition to traditional clinical measurements, such as blood pressure and lung function, to assess the overall impact your condition is having upon your lifestyle.

Health-related quality-of-life questionnaires help healthcare professionals to understand what you would like help with and which areas of your life are most affected, so they are more able to assess which symptoms are causing you the most problems.

This factsheet uses the example of asthma as a condition where quality-of-life measurements may be used to help determine the best treatment plan. This includes advice on behavioural changes as well as prescribed medication.

The two women below are the same age and have the same disease but it affects their lives differently:

Mary Hannah
Female, aged 35 Female, aged 35
Moderate asthma Moderate asthma
Mary works part-time from home. She can fit her work and activities around her asthma. She is generally a relaxed person and her asthma does not bother her too much. Hannah has a fast-paced job in a dusty office. She tends to worry about her health as she is very athletic and enjoys a lot of exercise. As a result, her asthma causes her quality of life to be quite severely impaired.

If Hannah and Mary received the same treatment, they may both show similar improvements in the usual measurements of lung function taken by the healthcare professional. However, the improvement in Hannah’s quality of life is likely to be much greater than that in Mary’s because Hannah would be less unwell at work, could enjoy her hobbies and would be less worried in general.

Health-related quality-of-life questionnaires

Health-related quality-of-life measurements are usually taken from a questionnaire. A person’s answers will help the healthcare professional determine which symptoms are stopping the person continuing with their normal lifestyle and which treatment will be most effective in helping to make this possible.

These questionnaires include a range of questions including:
1. How would you rate your current health?
2. Does your chest trouble interfere with your work?
3. What type’s of activities leave you short of breath?

Consider how Hannah and Mary would answer these questions. How would their answers differ?

Why are health-related quality-of-life measurements important?

Using health-related quality-of-life measurements can also help with shared decision making. Having a say in deciding which treatment plan will be best for you can make you feel more involved in the management of your condition. It can also help you to feel happier about following your treatment plan which will then help control your condition.

“Using health-related quality-of-life measurements turns the usual treatment process, which is led by the doctor, into a successful partnership. This approach changes the dynamic of a consultation and allows the patient to tell the doctor what they would like to help them feel better.”
Professor David Price, a lung health expert who uses quality-of-life measures in research and clinical practice

How are health-related quality-of-life measurements used in research?

Health-related quality-of-life measurements can be used in research to assess whether new treatments are effective enough to improve a patient’s life. This form of measurement is sometimes referred to as a patient-reported outcome.

It is important for researchers to assess the effect a new treatment has on a person. Health-related quality-of-life measurements are often included in scientific research as they help researchers to understand whether new treatments will benefit people with certain diseases. Some treatments may not improve symptoms, but could greatly improve quality of life, and vice versa.

Health-related quality of life in COPD research

The EU-funded PROactive project is an example of a project developing patient-reported outcome measurements. The team are currently developing an patient-reported outcome tool that can record how a treatment affects physical activity in people with COPD.

To develop this tool, the research team is working directly with patients with COPD to understand how they experience physical activity. At the end of the project, the new tool will be used, like the asthma questionnaires mentioned above, to understand more about how a person’s illness is affecting their lifestyle.

The questions will be programmed in an electronic device, that looks like a mobile phone. On this device, patients can indicate on a daily basis the amount of activity (‘what do I do?’), the symptoms (‘how much shortness of breath or tiredness did I experience?’) and the adaptations they need to make (‘did I need to slow down, or take breaks?’). Patient will also wear an activity monitor to give a precise indication of their physical activity. These measurements will be used to test the effectiveness of new treatments for COPD. The progress of the project can be monitored.

Authors

This material was written by the ELF in conjunction with Professor Elizabeth Juniper, Professor David Price and Dr Fabienne Dobbels.

There are a number of health-related quality-of-life questionnaires available which your healthcare provider can use to assess your condition. Below are some examples of these tools:

Asthma questionnaires (adults and children)

St. George’s Respiratory Questionnaire

COPD Questionnaire

Cystic Fibrosis Questionnaire

Other quality of life questionnaires

ELF awards two new fellowships to help fight lung disease

Two young scientists have benefited from an ELF fellowship to help further the field of lung health and disease.

Dr Ramzi Lakhdar and Dr Melissa Jane McDonnell received the funding which will help them study their areas of interest in the UK.

Dr Lakhdar, from Tunisia, completed his PhD at Biological Sciences and Biotechnology from High Institute of Biotechnology in Monastir in 2011. The ELF fellowship will enable him to look at muscle wastage and ageing in chronic obstructive pulmonary disease (COPD). His research project will aim to understand whether the loss of muscle function is caused by premature ageing in people with the condition.

Dr McDonnell, from Ireland, has been completing her specialist training and a Masters degree at the National University of Ireland. The ELF fellowship will enable Dr McDonnell to look at a common chronic lung condition called bronchiectasis. The project will examine whether a reflux from the stomach can contribute to the severity and development of bronchiectasis. It is hoped the findings could lead to more accurate prognostic information and help in determining specific characteristics of the disease that lead to increased severity.

Sleep apnoea may offer protection for heart attack patients

People who suffer from sleep apnoea may be better equipped to recover from a heart attack, according to new research.

Many studies have shown that sleep apnoea is a risk factor for a number of things including high blood pressure and chronic heart failure. Research has also shown that it increases oxygen-related stress and inflammation in the heart and blood vessels. Despite this, people with sleep-related disorders often recover as well as healthy sleepers after a heart attack.

The new study, published in the American Journal of Respiratory and Critical Care Medicine, examined 40 men; a mix of healthy sleepers and those with a sleep-related disorder. The entire group had experienced a heart attack just a few days before the study.

After analysing blood samples, the researchers found that people with sleep problems had higher levels of cells that help to repair and build new blood vessels.
People with sleep apnoea may be better prepared to generate new blood vessels after a heart attack.

Potential new method for early lung cancer detection

Scientists have developed a method to detect early signs of lung cancer by examining cheek cells in humans.

The technique, known as partial wave spectroscopic (PWS) microscopy, can detect cell features as small as 20 nanometers, which would appear as normal when using a standard microscope.

 

The PWS-based test makes use of the “field effect,” a biological phenomenon in which cells located some distance from the malignant or pre-malignant tumour undergo changes to their molecular structure.

After testing the technology in a small-scale trial, American researchers focussed their efforts on a group of smokers because smoking is a major risk factor for lung cancer. Of the 135 patients studied, 63 had lung cancer, 37 had chronic obstructive pulmonary disease (COPD) and 22 were non-smokers.

The researchers swabbed the inside of patients’ mouths, and then the cheek cells were applied to a slide, fixed in ethanol and optically scanned using PWS to measure the “disorder strength” of cells. It has been found previously that the increase in the disorder strength of cells is one of the earliest events in the cancer process (carcinogenesis).

The disorder strength of cells in lung cancer patients was more than 50 per cent greater than in smokers without cancer. The test was equally sensitive to cancers of all stages, including early curable cancers.

ILD links

UK

Child Lung Foundation:

A charity set up to support children with interstitial and diffuse lung disease.

Breathtakers OB Trust

Supporting sufferers of Obliterative Bronchiolitis and other Rare Lung Disease.

Tuberculosis

TB was believed to be almost eradicated in Europe in the 1980s. However, the disease is once again a public health priority in many countries.
What is tuberculosis?

What causes tuberculosis?

Treatment of tuberculosis

 

Burden in Europe

Areas for action

 

Testimonies

Tuberculosis in the news

 

Tuberculosis links

 

Exposure to pollution in infancy harms lung function

Exposure to traffic pollution during infancy is linked with lung function problems in children up to the age of 8.

Previous research has looked at the effects of exposure to pollution among children, but the role of timing of exposure remains unknown.

A new study, published in American Journal of Respiratory and Critical Care Medicine, included more than 1,900 children who were followed from birth until the age of 8. They, and their parents, were asked to complete questionnaires and take spirometry tests. The researchers estimated the outdoor concentrations of air pollution.

The findings revealed that exposure to pollution during the first year of life was linked with reduced lung function at the age of 8. The link was found among all children in the study, but it was particularly strong for boys and children with asthma or other allergies

Lead author, Dr. Pershagen, said: “Our study shows that early exposure to traffic-related air pollution has long-term adverse effects on respiratory health in children, particularly among atopic children. These results add to a large body of evidence demonstrating the detrimental effects of air pollution on human health.”

About ELF

There is a great deal of information available about the lungs and lung diseases on many different websites. We would like to thank you for using the ELF site.

Public voice of the ERS

The ELF is the public voice of the European Respiratory Society (ERS). We aim to share the knowledge and expertise of the ERS with you.

Founded in 1990, the European Respiratory Society is a non-profit making, international medical organisation with over 7,000 members from 100 countries. It is the biggest society in Europe in its field.

What this means is that all the information provided on this website has been reviewed by lung specialists in Europe to ensure that everything is accurate and unbiased. Information will also be regularly modified to make sure that it is up to date.

What can we do for you?

  • provide information, pictures and diagrams about the lungs and how they normally function
  • provide information on the lung disease that you have, someone you know has or that you want to learn more about
  • give you the most up-to-date information on lung topics and news
  • inform you about the factors that damage the lungs and cause disease
  • summarise the latest developments in Europe in relation to lung disease
  • provide links to other reliable sources of information
  • provide a forum for you to share your experiences
  • summarise the latest scientific findings about the lungs and relate these to you and your situation

produce press releases about ELF activities and lung events in Europe

How can you help us?

  • signing up to our mailing list
  • making a donation to the ELF
  • letting us know what you think should be included in the site and what you think of the current content

Spirometry: how to take a lung function test

Spirometry is a test of how well you can breathe and can help in the diagnosis of different lung diseases such as chronic obstructive pulmonary disease (COPD).

The test requires taking in a very deep breath and blowing out as fast as possible into a small device called a spirometer.

Watch the video to learn how to take a test (this video was filmed at the 2009 European Respiratory Society annual congress in Vienna, Austria, courtesy of x-audio/soundbakery).

Italy

Airline:

Air Dolomiti

Air Dolomiti is part of Lufthansa regional group.

Lufthansa will not allow you to take your own oxygen provisions on board. However, they have a special oxygen service, with an ‘on-demand’ system, providing flow rates from 1 to 5.2 litres per minute, at a cost of 300 euros on intercontinental flights and 150 euros on continental flights. Please contact the Lufthansa Medical Desk on  at least 48 hours before your flight. Prior to your flight your fitness to fly will be assessed.

Air Italy

Air Italy does not provide oxygen on board their aircraft and does not allow you to carry your own oxygen provisions.

Air One

Air One is part of Alitalia. Alitalia does not allow you to take your own oxygen on board their aircraft. However, they will provide this service at an additional charge. This is available at a flow rate of 2 or 4 litres per minute.

Please inform Air One at the booking stage, as this service is only available on certain flights. A medical form will also need to be submitted by your doctor.

Alitalia

Alitalia does not allow you to take your own oxygen on board their aircraft. However, they will provide this at an additional charge. This is available in a flow rate of 2 litres or 4 litres per minute. In order to accommodate this, let them know during the booking stage, as it is only available on certain flights. A medical form will also need to be submitted by your doctor.

You need to be accompanied by somebody who can take care of your needs during the flight. Alitalia allow you to take the following types of concentrators on board their aircraft:

AirSep LifeStyle
AirSep FreeStyle
Inogen One
SeQual Eclipse
Respironics, EverGo.

Livingston Energy Flight

Livingston provide oxygen on board their aircraft, but you are not allowed to take your own oxygen supply. They provide oxygen with a continuous flow rate of 2 or 4 litres per minute.

You may be allowed to carry your concentrator, but it must be switched off. You need to request oxygen when you are making a reservation. This must be done at least 72 hours before the flight.

Meridiana

Meridiana provide oxygen on board at no additional cost but it must be booked at least 72 hours before the flight. Oxygen can only be provided at a flow rate of 4 litres per minute. A medical certificate will also need to presented during check-in.

Smaller Airlines

For the latest information on the smaller airlines please use the contact details below.

Air Vallée 

Air Vallée does not provide oxygen on board their aircraft. You can take your own oxygen cylinders or concentrator, but you need to ask the airline for permission. They may ask for a certificate of conformity of your device.

Blu Express 

Blu Express does not provide oxygen on board their aircraft and does not allow you to carry your own oxygen provisions.

Wind Jet

Wind Jet does not provide oxygen on board their aircraft. You can take your own oxygen cylinders or concentrator but you need to ask the airline for permission. They may ask for a certificate of conformity of your device.

Overweight children are more at risk from air pollution

Children with asthma who are overweight are more likely to experience symptoms after exposure to indoor air pollution than normal-weight asthmatic children, according to a new study.

The research, published in the Journal of Allergy and Clinical Immunology, investigated 148 children with persistent asthma, aged 5-17 years, to assess the influence of weight on the effects of indoor exposure to pollutants on a range of asthma symptoms.

4% of the children were underweight, 52% were normal weight, 16% were overweight, and 28% obese. The team measured the amount of nitrogen dioxide (NO2) and fine particulate matter measuring less than 2.5 mm in diameter (PM2.5) in the bedrooms of the children.

The results found that overweight and obese children had significantly more asthma symptoms associated with exposure to the pollutants, than normal-weight children. In the previous 2 weeks, children in these categories had approximately 0.7 more days of exercise-related symptoms and 0.6 more nights waking with asthma symptoms than normal-weight children with asthma.

Burden in Europe

Burden in Europe

 

There is a lack of information on the frequency of pneumonia in different European countries.

 

Finland, Spain and the UK

Precise incidence data exist only for Finland (10.8 per 1,000 adults per year), Spain (1.6 to 2.6 per 1,000 adults per year) and the UK (4.7 per 1,000 adults per year).
Pneumonia is usually more common in men than women, and this difference increases with age.

Intensive care and slow recovery

Patients with severe pneumonia should receive intensive care and may require assisted ventilation.
Recovery from pneumonia is slow. Between 19–31% of patients with CAP are either not back at work or not back to normal health by 6–8 weeks and this figure rises to 55% in the elderly.

Death from pneumonia

In adults, mortality increases with age, with most deaths occurring in the elderly.
The total number of deaths per country varies hugely, suggesting that under recording of pneumonia cases may be common.

App lets you monitor lung health on a smartphone

A new device could allow people to monitor their lung function at home by simply blowing into their smartphone.

A paper presented at the Association for Computing Machinery’s International Conference this month showed that results from the app came within 5% of existing commercial spirometers used to monitor lung function.

 

The researchers, from the University of Washington, use the microphone on the smartphone to detect sound waves. They found that if they could model a person’s trachea and vocal tract as a system of tubes, they could analyse how the breath is travelling through these tubes.

A few similar devices measuring lung function already exist for smart phones butnone of these devices are available yet or medically certified. The next stage for the inventors of the new device will be to begin clinical testing with patients of varying ages and lung health to check the validity of the product.

Patient Advisory Committee meeting 2012

Since the first meeting of the Patient Advisory Committee in Amsterdam last year, the advisory committee has continued to provide valuable feedback upon ELF activities, helping the ELF to develop its network of European patient organisations, working together to share information and successes, to support each other to develop both at the national and European level.

During Congress the PAC met for a productive morning of information sharing and discussion. The ELF provided an update on their projects and activities, and thanked the patient organisations for their input into the WSD campaign and development of a patient organisation chapter for the new White Book.

Committee members were invited to vote on which ERS Congress 2013 symposia should have patient input, and to suggest topics for patient symposia for ERS Congress 2014. The ELF looks forward to collaborating with PAC members on these projects.

During the meeting information was also given on EFA’s access to the air travel lobbying project, the establishment of the European Sleep Apnoea Federation, the progress of the European COPD Coalition (ECC), and with mention of the upcoming EAACI International severe Asthma Forum, and IPF Week (23rd-30th September).

ERS Congress is a great opportunity for patient organisations to come together and be empowered by each other’s activities and we hope that the Patient Advisory Committee will continue to foster this sense of European collaboration between patients, professionals, and patient organisations.

The meeting was chaired by Monica Fletcher (ELF Chair) with Pippa Powell (ELF Head). The following patient organisation representatives attended the meeting:

  • Alpha Europe Federation (Alan Heywood-Jones)
  • Association Italiana Pazienti BPCO Onlus (Rosanna and Fausta Franchi)
  • Asthma UK (Malayka Rahman)
  • Long Fonds (formerly Astma Fonds) (Pim de Boer)
  • Austrian Lungenunion (Otto Spranger)
  • CF Europe (Hilde de Keyser)
  • EFA (Susanna Palkonnen)
  • EFA/ ELF Council (Breda Flood)
  • European LAM Federation (Iris Bassi)
  • FFAAIR (Liliya Belenko Gentet)
  • Global Allergy and Asthma Patient Platform (GAAPP) (Antje-Henriette Fink-Wagner)
  • June Hancock Mesothelioma Research Fund (Kate Hill)
  • Lovexair (Shane Fitch)
  • PHA Europe (Juan Fuertes)
  • Romanian Tuberculosis Association (ARB-TB) (Radu Septelici)

The meeting was also attended by Archie Turnbull (Executive Director, ERS – Secretary, ELF). His attendance reflects the high value that the ERS place in patient involvement in scientific activities, and appreciation of the role of patient organisations in the lives of people with respiratory conditions.

If you would like more information about the ELF’s patient organisation network or patient involvement in ERS activities, please contact us.

Genetic map of cancer reveals trails of mutation that lead to disease

The first detailed map of genetic faults that cause cancers is published today, offering profound insights into the disease.

The map describes more than 20 “genetic signatures”, or patterns of mutation, that alone or in combination drive 30 different types of cancer, including brain, lung, pancreas and breast tumours.

Most cancers are thought to be caused by mutations in DNA, perhaps triggered by chemicals or radiation, which go unrepaired and build up over a person’s lifetime. The mutations eventually lead to the uncontrolled spread of cancerous cells .

The causes of around half the genetic signatures behind cancers are understood, but the rest are a mystery. Scientists believe they may be due to chemicals in the environment, or faults that arise during ageing.

The findings are expected to drive research into the causes of mutations behind each cancer.

Nic Jones, chief scientist at Cancer Research UK, said: “We know that environmental factors like smoking and overexposure to UV rays can cause faults in DNA which can lead to cancer, but for many cancers we don’t know what triggers the faults. The genetic fingerprints identified in this fascinating and important study identify several new processes driving the development of cancer. “

Accessibility

Accessibility
Downloadable documents
Navigation
The inbuilt search engine
Browser compatibility
Downloadable documents
Nearly all the downloadable documents on this site are offered in at least one accessible format (HTML, TXT).

Some rare PDF documents might also be found on this website without any accessible version directly attached.

If you don’t have acrobat reader, you can download it from the Adobe website. Download Acrobat Reader.
Otherwise, you can convert PDF documents into classic HTML by using Adobe’s online conversion engine. In order to do this, copy the link to the PDF file and paste it in the supplied field in the online Adobe conversion tool.

Navigation
1. Site Logo:
The logo is placed on each and every page of the site allowing the direct return to the site’s homepage.

2. Main links
The main links represent the first navigational element available on the top of the page. They are entry points to each of the main sections of the site.

3. Navigational help
The main links have navigational help situated, in graphical browsers, on the top right-hand side of each page. This element gives access to:

The navigation help document
The inbuilt search engine
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Further navigation is set after the navigational help :

As part of the homepage :Quick links to the contents of the site which are set forward on this page such as the contact sheet, the sitemap and accessibility.
Standard navigation: First level navigation is set on the top left-hand side of the page to be easily located by the user.
Sub navigation: On clicking on a first level element, second level navigation will be displayed on the left hand side of the site, replacing the calendar for quick linking. These levels might have one more level (level 3 navigation) included as sub menus to level 2 elements. The text colours have been selected to give the best readability to the user.
5. The last navigation pane available as footer gives quick access to navigational elements giving further information about ELF such as Site map, Legal disclaimer, etc…

The inbuilt search engine
The search engine results pages are “text only” extractions of the pages closest to the search terms. The search terms are set in bold in the results pages to allow rapid identification and to know the relevance of the document compared to expectations.

Browser compatibility
The site is built according to the W3C recommendations. This consortium’s goal is to define the entire international recommendations concerning data processing languages used to define web pages (HTML, Style sheets, etc…) to push the Net to its optimal potential.

Consequently, this site will offer the best user-experience if browsed with new generation browsers while remaining structurally accessible to previous browsers.

It is recommended to use one of the following browsers for best experience:
On Mac OS X platforms: Opera, Safari, Mozilla 1.x, Mozilla Firefox, Internet Explorer 5.x (for Mac OS X, Mac OS 9)
On Windows platforms: Internet Explorer 6, Mozilla 1.x, Mozilla Firefox, Opera
On Linux: Mozilla 1.x, Mozilla Firefox, Opera

 

Treatment of pneumonia

Treatment of pneumoniaEarly treatment of pneumonia with antibiotics can cure bacterial pneumonia.
As yet, there is no general treatment for viral pneumonia, although antiviral drugs may be helpful in particular instances.

Prevention of pneumonia

Preventing people from starting to smoke and stopping those who already smoke is one of the most important means of controlling pneumonia.
Vaccination against some organisms (influenza, pneumoccocus) reduces the likelihood of pneumonia in vulnerable groups.

2008

ERS Congress 2008 – Berlin, Germany

This year’s 18th ERS Congress returned to Berlin, Germany for a third time and was held at the Messe Berlin exhibition grounds. Berlin has hosted two previous ERS Congresses, in 2001 and 1997.

An impressive 19,364 doctors and nurses attended the ERS Congress to give talks and demonstrations to explain their latest lung research. Hot topics discussed included the impacts of climate change, air pollution and obesity on lung health.

A guide to finding the right health website

There are many sources of health information – your doctor, nurse or physiotherapist, the library, magazines and newspapers. Increasingly, many of us use the internet to find information on a disease that we or a family member may have or to look for information on how to improve our health. There are many sites that claim to be able to give you information. But how do you know the information is correct, accurate and trustworthy? How do you know that this information is not influenced, for example, by a pharmaceutical company or someone trying to sell you something? The questions on this card should help you to search for and find the most reliable health information on the web.

Questions you should be able to answer straight away…

 

 

 

 

 

 

Is it clear which company or organisation is responsible for the website? Look for a logo, or the name of the company or organisation. Think about whether this type of company or organisation is one you would want to learn from.

Does the website seem to be selling you something? Organisations may sell advertising (usually in a banner at the top or side of the page) to finance their website, but websites that seem to want you to buy something could contain information biased toward this.

Are there many spelling mistakes and errors? You should be able to get an idea about the quality of a website based on the quality of the writing: lots of silly mistakes could signal that there are also bigger errors.

Is there an indication on the home page or other pages of when the information was posted there? Out-of-date medical information can be very dangerous.

A question you should be able to answer from the “contact us” section…

Does the site provide contact details, including name, physical address and electronic address? You should be able to contact the people running the site if you have any questions or problems.

Answers to these questions are most often found in the “about us” section…

Is the name of the author (or the organisation) clearly stated, as well as their aim? You should judge whether the organisation, company or person writing the information for the site is likely to provide trustworthy information. Registered charities, professional organisations, hospitals or university departments are likely to be good sources of information. Commercial companies have products to sell which may influence what they write.

Is there information about how the content of the website was selected and written? You should be able to find out how the information was compiled, which will help you judge whether you think it is reliable.

Does the site explain that health information should not be taken as health advice or a substitute for visiting a health professional? Any information you find on the web should be taken in combination with other information you have been given or found, and should be discussed with your doctor.

The European Lung Foundation (ELF) website provides trustworthy information on lung diseases and related health issues in 8 European languages: English, French, German, Spanish, Italian, Polish, Russian and Greek.

The website has been written by experts from the European Respiratory Society, an organisation of lung health professionals and scientists who have the most up-to-date information on: asthma, COPD, lung cancer, pneumonia, tuberculosis, cystic fibrosis, sleep apnoea, interstitial lung diseases and much more…

On the website you will also find a list of other websites in your country on specific diseases which have been viewed and approved by the ELF.

Indoor air pollution

Indoor air pollution
Indoor air pollution (exposure in the home) is much lower in Europe than in developing countries, such as India and China.

 

Particulate matter

High levels of particulate matter monitored in the indoor environment have been associated with increased rates of respiratory disease symptoms in children.

Nitrogen dioxide

High levels of nitrogen dioxide (NO2) or simply the presence of gas stoves are also associated with increased rates of respiratory disease symptoms in children.

Radon

Indoor radon exposure has been related to lung cancer in non-smokers. Inside homes with poor ventilation, radon can reach high levels.

People with asthma suffering ‘because doctors can’t understand inhalers’

People with asthma are struggling to use the inhalers correctly, according to a new report.

Writing in the Drug and Therapeutics Bulletin, a British Medical Journal publication, a panel of doctors note that the reason for the misuse could be because doctors don’t understand the devices themselves.

They say asthma sufferers including children are ending up in Accident and Emergency services with serious breathing difficulties because they have not been given clear and accurate advice on how to use inhalers.

The authors warn: “Of perhaps more concern is the fact that many health professionals also do not know how to use inhalers correctly and are therefore not in a position to coach patients effectively.”

One study showed 91 per cent of healthcare professionals who teach patients inhaler use, “could not demonstrate all the recognised steps” in taking inhaled medication.

About ELF

The European Lung Foundation (ELF) was founded by the European Respiratory Society (ERS) in 2000 with the aim of bringing together patients, the public and respiratory professionals to positively influence respiratory medicine.

It is the only European foundation dedicated to all lung diseases.

  • Informing and disseminating
  • Listening and involving
  • What can we do for you?
  • How can you help us?

Informing and disseminating
Our website provides a wealth of useful resources to share the latest developments in lung health research from the ERS and its members, in a clear and straightforward language.

Our material is available in 8 European languages and has been reviewed by ERS experts, including the ELF Advisory Committee, to ensure that we are providing you with reliable, accurate and unbiased information.

Listening and involving

Our mission is to bring people with lung diseases and the general public closer to science by providing opportunities to influence respiratory research agendas at the European level.

We aim to work with patient organisations across the continent to involve people with lung diseases at every level of research and listen to their needs to ensure their voice can be heard by health professionals and politicians.

What can we do for you?

  • Keep you informed on the latest news and developments in lung health via our website and social media pages
  • Supply downloadable factsheets on various lung health-related topics to a wide-reaching audience
  • Provide advice on how to reduce your risk of lung disease and how to cope with your condition
  • Bring people with lung diseases to the annual ERS Congress to meet with lung health professionals and share their experiences
  • Involve people with lung diseases in EU projects to help influence positive research outcomes for the future
  • Offer the opportunity to input into the ERS Guidelines, which provide recommendations on the treatment and care of people with lung diseases

How can you help us?

Are you a respiratory patient organisation looking to raise your profile in Europe?

The ELF is keen to establish relationships with other respiratory patient organisations to better understand the disease priorities and levels of support for patients in different geographical areas. Please contact us if you have patient material that we could link to, are keen to review or translate our materials, or if you would like to feed into future ERS meetings

Are you an individual keen to take part in EU projects?

If you have a lung disease and would you like to take part in an EU project to help bring scientists closer to advancing treatments, please visit our EU projects page for more information on how to get involved.

Do you have an inspirational story?

Send us your stories so we can share them online and help other people in the same position.

Not found what you are looking for?

Tell us what you would like the website to include in the future and where improvements can be made. You can also tell us which aspects you like the most. If you still have a question that needs answering, please contact us.

Childhood respiratory virus fights cancer in adults

A long-term project into the children’s respiratory virus, respiratory syncytial virus (RSV) has found that the virus kills cancer cells while leaving healthy cells alone.

Dr. Santanu Bose, associate professor of microbiology and immunology at the University of Texas Health Science Center, San Antonio, USA, has discovered that the cancer-fighting affect of RSV whilst studying the immune response of normal and cancerous cells to RSV.
Dr. Bose explained that RSV fights cancer cells because it grows only in tumours, not healthy cells, ‘normal cells have weapons to shoot down viruses, but cancer cells have lost their anti-viral arsenal. For this reason, viruses can establish themselves in a tumour, grow and induce cell death.’

Viruses that infect and damage cancer cells are known as oncolytic viruses. The oncolytic properties of RVS have been confirmed in further tests using mice, showing that the virus has a strong anti-cancer effect.

Dr. Chatterjee, Professor of molecular medicine and the South Texas Veterans Health Care System, USA, said it is important that the virus killed tumours even in mice with competent immune systems. This mirrors human patients who have functioning immune defences. RSV also worked whether it was injected directly into the tumour or systemically through the abdomen. ‘This is important because there are some tumours to which you can inject the drug directly, whereas others you can’t and a drug must work systemically,’ Dr. Chatterjee said.

A series of papers published in 2009–2011 have led the researchers to apply for a patent so that they can begin to manufacture the virus for human use in the treatment of cancer.

What is pneumonia?

Pneumonia is an inflammation of the lungs caused by bacteria, viruses, fungi and other microorganisms. They cause the small air sacs in the lungs to become filled with fluid produced by inflamed tissue.

More common in the old and young

Pneumonia occurs more frequently in non-industrialised and less developed countries.
The incidence of pneumonia is highest at the extremes of age, both in very young children and in elderly adults.
Viral pneumonias are usually mild, but they can be life-threatening in very old and very young patients, and in people whose immune systems are weak.

Common symptoms

The severity of pneumonia depends on which organism is causing the infection.
Common symptoms of pneumonia include cough, shortness of breath, fever and malaise.

What is Legionnaires’ disease?

Legionnaires’ disease (LEE-juh-nares) is caused by a type of bacteria called Legionella.
The bacteria got its name in 1976, when many people who went to a Philadelphia convention of the American Legion suffered from an outbreak of this disease, a type of pneumonia (lung infection).

Although this type of bacteria was around before 1976, more illness from Legionnaires’ disease is being detected now. This is because we are now looking for this disease whenever a patient has pneumonia.

Each year, between 8,000 and 18,000 people are hospitalised with Legionnaires’ disease in the U.S. However, many infections are not diagnosed or reported, so this number may be higher. More illness is usually found in the summer and early autumn, but it can happen any time of year.

Asthma in the news

Caesarean link to infant lung infections 03/11/2011
Babies born by elective caesarean are more likely to contract a serious lung infection, known as bronchiolitis, in their first year or life, according to researchers in Australia.

Study identifies risk factors for altitude sickness 28/10/2011
A new study has identified a number of risk factors for altitude sickness.

Exercise benefits people with asthma 26/10/2011
Physical training programmes involving aerobic exercise can benefit patients with asthma according to new research.

Workplace pollutants linked to childhood asthma 10/10/2011
A mother’s exposure to airborne pollutants during pregnancy may increase the likelihood that her unborn child will later develop asthma, according to a new study.

Low-fat yoghurt intake when pregnant may lead to child asthma and hay fever 19/09/2011
Eating low-fat yoghurt whilst pregnant can increase the risk of your child developing asthma and allergic rhinitis (hay fever), according to recent findings.

Children who drink raw milk have less asthma and allergies 15/09/2011
Children who drink raw milk (unpasteurised) are less likely to develop asthma and allergies compared with those who drink pasteurised milk, according to a large European study.

New device gives hope to asthma sufferers 13/09/2011
A new device, similar to a tiny whisk, which is inserted into the lungs, is proving to be a successful treatment for people with severe asthma.

New method to aid treatment of asthma attacks during pregnancy 09/09/2011
Scientists in Australia have developed a new technique for treating pregnant women with asthma, to help cut flare-ups during pregnancy.

Dust mite allergy could predict asthma risk 25/08/2011
Children who show an allergy to dust mites at an early age have a higher risk of developing asthma in later life.

Children of obese mothers face asthma risk 16/08/2011
Mothers who are overweight or obese when they become pregnant are more likely to have children who suffer from asthma or wheezing symptoms, according to new research.

 

Respiratory News The news presented here is taken from sources on different websites. A brief summary of the news is given, along with a link to the original article.

Water exercise boosts endurance in COPD

Exercising in a pool can boost endurance and energy levels for people with chronic obstructive pulmonary disease (COPD).

A new study, published in the European Respiratory Journal, investigated 53 people with COPD. People were divided into three different groups; one doing exercise in a pool, one doing exercise in a gym and one receiving standard medical care without exercise.

Participants in the water-based exercise training group reported an improvement in many functional aspects of their daily life, such as improved stamina and ability to complete tasks, such as walking long distances when shopping.

Whether they worked out on land or in water, patients were able to walk faster after the training than when they just got usual care. But those who exercised in the pool reported less fatigue than the gym trainers and also developed more physical endurance.

In a test for which they had to walk as far as they could at a constant speed, patients who had exercised in water outpaced those who had trained in a gym, by 228 metres (748 feet). Researchers consider a difference of 203 metres to be important.

Water therapy exercises are already used to treat other problems, such as arthritis and joint pain. The lead author said people interested in joining a pool-based exercise programme should contact their local hospital or health provider.

Germany

Airline, Contact:

Aero Dienst

Aero Dienst does not provide oxygen on board the aircraft, except in the event of an emergency. They do not allow you to take your own oxygen cylinders on board, however, you can book a medical flight which is intensive care equipped and offers oxgen flow rates at 2 and 4 litres per minute.

Air Berlin

Air Berlin does not provide oxygen on board. However, they will allow you to bring your own oxygen cylinder or portable oxygen concentrator. You cannot fly with Air Berlin if you require continuous oxygen. To travel with your own oxygen provisions, a medical certificate needs to be signed by your doctor at least 48 hours before your flight.

The following portable oxygen concentrators are currently allowed on board:

– Airsep “Lifestyle”
– Inogen One
– Airsep “Freestyle”
– SeQual Eclipse oder SeQual Eclipse 2
– Inc. Respironics Evergo
– Delphi Central Air
– Invacare XPO2
– iGO
– LifeChoice
– Inogen One G2
– Indepence Oxygen Concentrator

Augsburg Airways

Augsburg Airways is part of the Lufthansa regional group.

Lufthansa will not allow you to take your own oxygen on board their aircraft. However, they have a special oxygen service, with an ‘on-demand’ system, providing flow rates from 1 to 5.2 litres per minute. This service costs 300 euros on an intercontinental flight and 150 euros on a continental flight. For further details and to make a booking, please contact the Lufthansa Medical Desk on at least 48 hours before your flight. Your fitness to fly will be assessed before flying.

 

Avanti Air

Avanti Air can provide oxygen on board their aircraft at an additional cost. If you need oxygen, contact them at least a week in advance and they should be able to provide oxygen at your specific flow rate. The cabin attendants are medically trained in case of an emergency.

 

Eurowings

Eurowings provides oxygen on board their aircraft, but there are some limitations. Please contact the Lufthansa Medical Desk at least 48 hours before departure to enable them to take the necessary precautions. This service must be paid in advance. Ask your health insurance company whether the cost can be reimbursed.

 

Germanwings

Germanwings does not provide oxygen onboard their aircraft, except in the event of an emergency.

You may be allowed to take you own provisions on board subject to gaining permission direct from Germanwings but only 2l/200mbar per person is allowed. Please sent a fax to with information about the equipment that you will require. They will then respond to inform whether or not permission has been granted.
Lufthansa
Lufthansa will not allow you to take your own oxygen on board their aircraft. However, they have a special oxygen service, with an ‘on-demand’ system, providing flow rates from 1 to 5.2 litres per minute, at a cost of 300 euros on intercontinental flights and 150 euros on continental flights.
To order oxygen, please contact the Lufthansa Medical Desk on at least 48 hours before your flight. Prior to your flight your fitness to fly will be assessed.
Tuifly.com

Tuifly.com can provide oxygen equipment on board. They will allow the transportation of their own oxygen equipment, which must be registered 48 hours before departure at the TUIfly Service Centre. Medical baggage must be packed separately and presented at check-in to be tested. The passenger must present a medical certificate with any medical equipment.

Smaller Airlines

For the latest information on the smaller airlines please use the contact details below.

Aero Business Charter

Aero Business Charter allow oxygen on board their aircraft on a case-by-case basis. Oxygen can be requested at the time of booking.

 

Doctors warned to look out for new H7N9 bird flu virus

Doctors are urged to look out for signs of a new strain of bird flu in patients, as experts warn that this “serious threat” could cause a pandemic.

The new strain of H7N9 virus, which first emerged just over a month ago, has now claimed 24 lives in China and has infected at least 126 people.

Around 11,000 British citizens travel to China each week and around 3,500 Chinese visit this country.
Recent research shows that the virus has already started mutating into a highly infectious disease that could spread throughout the human population.

There are currently no cases of the virus in Europe but doctors are taking precautionary measures to avoid it becoming a worldwide threat. However, senior scientists who have carried out research in the UK, insist that the current risk to people living in the UK is “very low”.

The disease causes severe respiratory illness, blood poisoning and even organ failure that can lead to death.

Around a fifth of those infected have died while 60 per cent remain seriously ill in hospital, according to the Chinese health authorities.

Research, published in The Lancet journal, analysed the genetic structure of the H7N9 virus and found that it may have evolved from at least four other flu viruses that have mixed together in wild bird populations, ducks and domestic chickens.

For it to pose more of a threat to humans it would need to mutate in the specific ways that make it able to attach to cells in the human lungs and spread from person to person.

Smoking-related diseases

Smoking-related diseasesIt is also known that smoking is the cause of 90 percent. all cases of lung cancer.

It is also now known that nicotine addiction can cause cataracts, pneumonia and aortic aneurysm.

Smoking also seriously affects the reproductive system. It can cause miscarriages, premature births, low baby weight, sudden infant death and certain childhood illnesses such as ADHD. Newborns of smoking mothers weigh on average 200 grams less than children of non-smoking mothers.

Other smoking-related diseases

Moreover, not only smokers are exposed to the harmful effects of nicotine. Millions of people, including half of the world’s children, are exposed to cigarette smoke. This phenomenon is called passive smoking. There are studies that prove links between passive smoking and an increased risk of cardiovascular disease, lung cancer and other cancers, asthma and other respiratory diseases in adults and asthma and other respiratory diseases, ear inflammation and sudden crib death in children.

In addition to the diseases caused by active and passive smoking, nicotine addiction is itself a disease unit recognized by the International Statistical Classification of diseases and related health problems (ICD-10) as a chronic disease, often accompanied by relapses, tobacco dependence. Requires appropriate treatment.

How to quit smoking effectively?

Quitting is not an easy thing to do and should be supervised by a specialist, especially when the tobacco dependence is long-term or the quitting person often makes attempts to quit and just as often returns to them. Breaking the habit is further complicated when there is a simultaneous physical and mental dependence. There are different methods to combat both types of addiction.

Quitting smoking at any point in life gradually reduces the risk of heart disease, respiratory system and cancer, and after a few years even completely aligns it with people who have never smoked. That is why it is so important to take steps as soon as possible to combat this deadly habit, in the care of their own health and their loved ones.

Protective foods

There is evidence that certain vitamins and nutrients should be included in our diet on a regular basis to keep our lungs as healthy as possible.

 

 

Oxidative stress

Several lung diseases are associated with a process termed oxidative stress. Oxidative stress occurs when the level of oxidant insults (such as cigarette smoke, air pollution and infections) is greater than our body’s antioxidant defence system can deal with.

Lung diseases

The lung diseases that have been associated with oxidative stress include:

  • Asthma
  • Emphysema and COPD
  • Cystic fibrosis
  • Pneumonia
  • Interstitial lung diseases
  • Adult acute respiratory distress syndrome
  • Tuberculosis

Eating the right foods

It is important to ensure we all consume the right dietary factors and nutrients that can help prevent damage and potentially protect our lungs from oxidative stress.

Antioxidant vitamins

Antioxidant vitamins, as the name suggests, are beneficial to lung health. Examples of some of the dietary sources of the various antioxidant vitamins are shown below:

 

Vitamins Dietary source
Vitamin C Citrus fruits and juices, kiwi fruit, broccoli, green pepper
β-carotene Apricot, cantaloupe melon, mango, carrot, pepper, spinach, sweet potato
Vitamin E Wheat germ, grains, vegetable oil, margarine, almond, peanut
Selenium Grains (depending on soil content), animal products, seafood

 

Other nutrients

Other nutrients that have been shown to be beneficial to lung health include magnesium and omega-3 fatty acids.

Magnesium

Magnesium is beneficial as it plays a role in enzyme activity, it is involved in bronchodilation of the smooth muscle of the airways, it inhibits some nerve transmission and it stabilises cells involved in inflammation.

The dietary sources of magnesium include nuts, legumes, cereals, whole grains and seeds, carrots, spinach and seafood.

Omega-3 fatty acids

Omega-3 fatty acids are involved in decreasing leukotrienes synthesis, the inhibition of prostaglandin E2 synthesis and the growth regulation of malignant cells.

It is not the amount of omega-3 fatty acid intake that is the most important for us, but rather the ratio of omega-6 to omega-3 fatty acids.
Omega-3 fatty acids can be found in fish oils, fish and shellfish, soy, flaxseed oil and leafy vegetables.
Omega-6 fatty acids are found in vegetable oil, margarine, mayonnaise and processed food with oil.

We should eat 4 to 10 times more of omega-3 fatty acids when compared to omega 6.

Samples from 200-year old mummy help shed light on recent TB outbreaks

Researchers in the UK have recovered tuberculosis (TB) genomes from the lung tissue of a 215-year old mummy.

A study, published in the New England Journal of Medicine, details how scientists used a technique called metagenomics to analyse DNA from a historical specimen.

The sample came from a Hungarian woman, Terézia Hausmann, who died aged 28 on 25 December 1797. Her mummified remains were recovered from a crypt in the town of Vác, Hungary.

Professor Pallen, lead author of the study, explained the importance of the breakthrough: “Most other attempts to recover DNA sequences from historical or ancient samples have suffered from the risk of contamination, because they rely on amplification of DNA in the laboratory. The beauty of metagenomics is that it provides a simple but highly informative approach that works in a wide variety of contexts.

Professor Pallen added, “It was fascinating to see the similarities between the TB genome sequences we recovered and the genome of a recent outbreak strain in Germany. In this case, metagenomes revealed that some strain lineages have been circulating in Europe for more than two centuries.”

Asthma links

The links on this page will take you to recommended sites that have useful information on all aspects of asthma.

  • Europe
  • Belgium
  • Bulgaria
  • Denmark
  • Finland
  • France
  • Germany
  • Greece
  • Hungary
  • Ireland
  • Italy
  • Lithuania
  • Norway
  • Portugal
  • Serbia
  • Spain
  • Sweden
  • Switzerland
  • The Netherlands
  • UK
  • International
  • Europe

The European Centre for Allergy Research Federation (ECARF): provides comprehensive information about allergies and the various therapies that exist to treat them.

The European Federation of Allergy and Airway Diseases Patients Association (EFA): is a network of allergy, asthma and COPD patient organisations, designed to improve patient quality of life.

Belgium

Astma en Allergie Koepel: is made up of three associations including Asthma Fund, Asthma Foundation Belgium and Allergy Prevention, which aim to improve the quality of life for asthma sufferers.

Bulgaria

Асоциацията на Българите Боледуващи от Астма (ABBA): association of Bulgarians with bronchial asthma.

Denmark

Astma-Allergi Forbundet: asthma and allergy information.

Finland
 Astmaliitto Allergi-och Astmaförbundet: Finish allergy and asthma federation.

France

Association Française pour la Prévention des allergies (AFPRAL): aims to provide information about various allergens that people may be subjected to in every day life, tests to detect allergens and how allergies can be treated.

Asthme and Allergies Association: provides information for asthmatics and their families.

Germany

Deutschen Allergie- und Asthmabund e.V (DAAB): provide information for patients about allergies, asthma and neurodermitis.

Greece

“Aniksi”: aims to fight against allergies and asthma, through information, education, social intervention and support of research.

Hungary

Asztmás és Allergiás Betegek Országos Szövetsége (ABOSZ): national society of asthmatic and allergic patients in Hungary.

Magyar Tüdőgyógyász Társaság (MTT): the Hungarian Respiratory Society contains patient information for asthma patients.

Ireland

Asthma Society of Ireland: provides support for people living with asthma. They aim to to optimise asthma control through support, education, effecting change and research.

Italy
Link to Federasma Federasma: is a network of Italian associations that support the fight against asthma and allergies and provide information to sufferers.

Lithuania Lietuvos astmos klubų taryba (LAKT): Lithuanian council of asthma clubs.

Norway

Norges Astma-og Allergiforbund (NAAP): provides information to patients on allergy and asthma.

Portugal

Associação Portuguesa de Asmáticos (APA): asthma association of Portugal providing information to patients.

Serbia

Dragisamisovic: Serbian patient website for asthma information.

Spain

Link to AAC Associació Asmatològica Catalana (AAC): fights against asthma by promoting and developing its’ methods of prevention, treatment and rehabilitation.

Link to Respirar Respirar – To Breathe: are pediatricians, allergists, neumologists, nurses and other health providers, trying to improve the quality of life in asthmatic children and adolescents.

Sweden

Link to Astma- och Allergiförbundet Astma- och Allergiförbundet: the Swedish asthma and allergy association want to increase awareness about what it is like to have an invisible disability like asthma and allergy.

Switzerland

Asthma Information.

AHA, Swiss centre for Allergy, Skin and Asthma: reaches out to those affected by asthma or allergy by providing information and educating patients about their conditions.

The Netherlands

Stichting Astma Bestrijding (SAB): directly or indirectly supports patients with asthma and chronic obstructive lung disorders.

UK

Asthma UK: is the charity dedicated to improving the health and well-being of the 5.2 million people in the UK whose lives are affected by asthma.

Occupational Asthma: contains information on occupational asthma in general.

International

The Global Initiative for Asthma (GINA): works with health care professionals and public health officials around the world to reduce asthma prevalence, morbidity, and mortality.

The National Asthma council Australia (NAC): an organisation that aims to increase the awareness of asthma by providing useful information.

Dirty air and the lungs

  • In English
  • Auf Deutsch
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  • En Espanol
  • In Italiano
  • Po polsku
  • По-русски
  • στα Ελληνικά

Author
This information was written and compiled by the European Respiratory Society  Environment and Health Committee.

Information sources
Co-funding and production and content support for this publication has been provided by the Health and Environment Alliance
(HEAL);  through DG Environment, European Commission.

Interesting links
A section on air pollution from US Environment Protection Agency

Many people continue to smoke after being diagnosed with cancer

A large number of lung cancer patients continue to smoke after being diagnosed, according to a new study.
Published in the journal, Cancer, the research also provides valuable information on which cancer patients might need help to quit smoking.

The researchers investigated smoking rates at the time of diagnosis and five month after diagnosis for over 5,000 people with lung and colorectal cancer.

The results showed that at the time of diagnosis 39% of lung cancer patients and 14% of colorectal cancer patients were smoking. Five months after diagnosis, 14% of lung cancer patients and 9% of colorectal cancer patients were still smoking.

The finding demonstrated that a substantial amount of cancer patients continue to smoke after being diagnosed. The results also suggest that colorectal cancer patients are less likely to quit smoking compared to lung cancer patients, following diagnosis.

Privacy policy

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For the purpose of the Data Protection Act 1998 (the Act), the data controller is European Lung Foundation of 442 Glossop Road, Sheffield, S10 2PX, UK.

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We may also use your data, or permit selected third parties to use your data, to provide you with information about goods and services which may be of interest to you and we or they may contact you about these by [post or telephone].

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We do not disclose information about identifiable individuals to our advertisers, but we may provide them with aggregate information about our users (for example, we may inform them that 500 men aged under 30 have clicked on their advertisement on any given day). We may also use such aggregate information to help advertisers reach the kind of audience they want to target (for example, women in SW1). We may make use of the personal data we have collected from you to enable us to comply with our advertisers’ wishes by displaying their advertisement to that target audience.

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We may disclose your personal information to any member of our group, which means our subsidiaries, our ultimate holding company and its subsidiaries, as defined in section 1159 of the UK Companies Act 2006.

We may disclose your personal information to third parties:

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Questions, comments and requests regarding this privacy policy are welcomed and should be addressed to

American agency approves drug to treat TB

The Food and Drug Administration (FDA) in the USA has approved a new treatment for multidrug-resistant tuberculosis (MDR-TB), which can be used in addition to the usual treatments if these have failed.

Treating drug-resistant tuberculosis can take years and can cost 200 times as much as treating the ordinary form of the disease.

The drug, called Sirturo, is the first in a new class of drugs that aims to treat the drug-resistant strain of the disease.

The approval was the first time in 40 years that the agency had approved a drug that attacked tuberculosis in a different way from the current treatments on the market. Sirturo would be used on top of the standard treatment, which is a combination of several drugs.

However, the FDA also warned that the drug carries some significant risks and doctors should make sure they use it appropriately and only in patients who don’t have other treatment options.

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Allergic rhinitis or “hayfever”

What is allergic rhinitis?

Allergic rhinitis is a disease in which the mucous membranes of the nose are swollen and irritated. This is caused by an allergy to grass or tree pollen, house dust mites or sometimes to mould. The lay term is “hay fever”, which is widely used but incorrect: allergic rhinitis has nothing to do with hay or with fever. Approximately 10–15% of 6–7-year-olds and 20–30% of teenagers and young adults have allergic rhinitis. Symptoms can vary from very mild to very serious.

What are the symptoms of allergic rhinitis?

Classical form:

  • runny nose
  • sneezing
  • itchy nose and eyes
  • red eyes in spring or summer

These symptoms are usually accompanied by allergy to tree (spring) or grass summer) pollen, sometimes to weed pollens and fungal spores. This is particularly common in young adults.

Persistent form:

  • persistent symptoms of stuffy (and sometimes runny) nose
  • usually with cough and a general lack of energy

Allergic causes here include dust mites, pet dander and sometimes mould.

How are allergic rhinitis symptoms classified?

Symptoms are classed as “intermittent” if they occur for less than four days a week and last for fewer than four weeks. Symptoms that exist for longer than this are regarded as “persistent”.

What other problems can allergic rhinitis cause?

Effects of rhinitis

Mild

Moderate-to-severe (one or more)

Sleep problems

 

No

Yes

Unable to carry out daily

activities or exercise

 

No

Yes

Unable to perform in the

workplace or at school

 

No

Yes

Troublesome symptoms that fail to clear up

 

No

Yes

 

What is the relationship between allergic rhinitis and asthma?

Allergic rhinitis and asthma are very common allergic disorders and some clinicians think they are both part of a single “united airways” disease. Untreated allergic rhinitis increases the severity and symptoms of asthma. Patients with both asthma and allergic rhinitis have improved control of symptoms when both diseases are treated.

What are the external signs of allergic rhinitis?

The two main external signs are: 1. the “allergic shiners”, as can be seen on the little girl on the left, where the lower eyelids are darkened; and 2. “allergic salute”, shown below, when an individual rubs their itchy nose.

When should you seek medical advice?

Allergic rhinitis can be treated effectively, so visit your doctor if your rhinitis is troubling you, particularly if you experience persistent or moderate-to-severe symptoms and you have associated features of asthma (cough, wheeze or tight chest).

How can allergic rhinitis be treated?

  • Avoid irritants such as tobacco smoke.
  • Allergen avoidance in the home is only possible with house dust mite or pet allergy. Avoidance of house dust mites is only effective if a full package of allergen avoidance is being followed, including mattress, pillow and duvet cover treatment, and a home visit by trained experts. Applying special bed covers is not helpful on its own. Pet allergy can only be treated by removing the pet, which can be a difficult decision. It may not be possible to avoid allergens when you visit other places.
  • Drug treatment:
    • Mild or intermittent symptoms: antihistamine tablets or syrup (non-sedating antihistamines are preferred because they do not cause drowsiness, e.g. loratadine or cetirizine). These relieve rhinitis symptoms (particularly sneezing and runny nose) but are less effective for blocked nose.
    • Moderate-to-severe or persistent symptoms: nasal steroid spray (e.g. budesonide, momethasone, fluticasone). Nasal steroids are more effective than antihistamines. They have to be taken regularly to prevent symptoms.
    • Montelukast tablets may be used as additional medication in troublesome cases.
    • Other drugs are ineffective (including cromoglycate).
  • If such drug treatment is ineffective seek referral to an allergist, ear, nose and throat (ENT) specialist or paediatric pulmonologist. In severe cases, allergen-specific immunotherapy (“allergy shots”) can be added. This is effective in most cases.
All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

In English

Auf Deutsch

En Francais

En Espanol

In Italiano

Po polsku

По-русски

στα Ελληνικά

En Català

Author

This material was compiled with the help of ERS paediatric allergy specialist Prof. Paul Brand and kindly translated by GA²LEN partners.

Information sources
The following article was used to help compile this factsheet:
de Groot et al. Allergic rhinoconjunctivitis in children. British Medical Journal 2007; volume 335: pages 985-988.

Interesting linksEuropean Federation of Allergy and Airway Diseases Patients Association (EFA)

GA²LEN (Global Allergy and Asthma European Network)

EAACI (European Academy of Allergy and Clinical Immunology)

ECARF (European Centre for Allergy Research Foundation)

Swine flu

What is it?

Swine Flu is the common term given to a strain of the flu virus which caused the pandemic of 2009. Scientifically, the strain is referred to as H1N1/2009.

What causes it?

When the outbreak started in March 2009, researchers recognised it as a new strain of the H1N1 influenza virus that had changed its properties to act differently from other previous strains. Tests revealed that it originated from animal influenza viruses and is unrelated to the human seasonal H1N1 viruses that have been in general circulation among people since 1977.

How does it spread?

The virus spreads from person to person via infectious droplets in the air that are breathed out and inhaled.

Why was the World Health Organisation (WHO) more worried about this virus?

Seasonal influenza occurs every year and the viruses change each year – but many people have some immunity to the circulating virus that helps limit infections. Some countries also use seasonal influenza vaccines to reduce illness and deaths.
By contrast, the pandemic H1N1 2009 was a new virus when it emerged and most people had no or little immunity to it. In addition, one of the lessons from history is that influenza pandemics can kill millions. Finally, there was no pandemic influenza vaccine at the outset.

Symptoms

How can you reduce your risk of getting it?

People can try to reduce their risk of catching the virus by washing their hands with soap and water more frequently than normal. In addition people with obvious signs of illness like cough and fever should not be approached and in some cases face masks can be helpful.

2008/ 2009

Santiago Giavedoni will be based at the ELEGI Laboratory, Queens Medical Research Institute (Edinburgh, United Kingdom), researching how lung rehabilitation and statin treatment affects muscle wastage and quality of life in patients who experience severe COPD exacerbations. Santiago’s research will start in October 2008.
Maria Pallayova will carry out research at Johns Hopkins School of Medicine (Baltimore, United States of America) on how the metabolism may influence the function of the upper airways. Maria’s work will start in November 2008.
Dermot Stephen O’Callaghan will study at the Hôpital Antoine Béclère (Paris, France), to look at pulmonary arterial hypertension in Ireland. Dermot’s research will begin in January 2009.

Asthma and pregnancy

All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

Asthma is one of the most common conditions that co-exists with pregnancy. As well as asthma affecting your pregnancy, your pregnancy can also have an impact on your asthma symptoms. This factsheet is designed to give you an overview of what changes can occur, and how you should manage them.

How does asthma affect pregnancy?

If you have asthma, the risk of complications, to yourself and your baby during pregnancy is very small if your asthma is well controlled.

Although it may be tempting to stop your medication when you become pregnant, it is vital that you keep taking it to control your asthma. Studies have shown that it is more dangerous not to take your medication.

To keep your lungs working well, it is important to take medication regularly. This will help prevent an attack or worsening of your asthma which could make it difficult for your baby to get enough oxygen

Top Tip: Stopping your inhaled steroids can cause your asthma symptoms to become worse during pregnancy which can lead to complications. It is safe to keep taking your medication and important that you keep your asthma under control.
How does pregnancy affect asthma?
As your body produces more hormones when you are pregnant, you will notice many changes to your body. This includes changes to your breathing system. It is normal for all women to notice an increased shortness of breath or a blocked nose, particularly in the last three months of pregnancy.Pregnancy affects women with asthma in different ways. Current evidence suggests that one-third of people with asthma have improved symptoms during pregnancy, one-third stay the same, and one-third have worse symptoms.If you have severe asthma, your symptoms are more likely to get worse, whilst people with mild asthma usually see an improvement.

You may feel more stressed or worried during your pregnancy. This can sometimes affect your asthma symptoms. It is important to try to relax during your pregnancy and visit your healthcare provider if you need extra guidance.

“My asthma symptoms did get worse while I was pregnant. I visited my GP regularly to make sure my asthma was as well controlled as possible. I also went to ante-natal yoga classes which really helped me to relax and I also learnt some useful breathing exercises to prepare me for labour.” Rebecca Elder, a new mother with asthma

Your medication

Your asthma medication helps to control your symptoms which can reduce the risk of complications.

For ethical reasons, drugs cannot be tested in trials involving pregnant women, but studies of the routine use of all common asthma drugs, such as β-adrenergic agonists (e.g. salbutamol, salmeterol, terbutaline and formoterol) and inhaled corticosteroids (e.g. beclometasone, budesonide, fluticasone and mometasone), have not shown any cause for concern.

There is less information about newer drugs such as leukotriene antagonists (because fewer women have used them) so most doctors would not advise starting them in pregnancy. However, they have not been shown to have any adverse effects so there is no need to stop them if you are already taking these drugs and they are helping control your asthma.

By using regular medication most acute attacks can be prevented, but if an attack does occur, oral steroids (prednisolone), which are in a tablet form, are safe to use.

Your asthma medication helps to control your symptoms which can reduce the risk of complications for you and your baby. The benefit of taking treatment to keep asthma under good control far outweighs the risk of using regular medication.

It is important that you only take medication prescribed by your doctor to treat your asthma.
Top Tip: Ask your doctor or nurse to check how you use your inhaler and to make sure that you are using the best type of device for you. Using a device that delivers the treatment efficiently to your lungs means that you may need to take less treatment.

What support should you receive?

In the first instance, it is important to visit your healthcare provider. You will then receive care from a midwife, who can provide support during your pregnancy. You could also seek advice from the person providing your asthma care if you need extra help with controlling your symptoms.

To ensure a smooth pregnancy, it is important for all your healthcare providers to work together to provide you with the best care.

Even if you are visiting a midwife to seek advice on your pregnancy, make sure you also talk to them about your asthma symptoms as well.

Ask your healthcare provider about an asthma action plan. This can help provide a structured way of managing your asthma, and help you adjust you treatment if your symptoms change during your pregnancy.

Case Study: Kirsty Warwick

Kirsty has two children and suffers from mild asthma

“My asthma actually improved during pregnancy, although my hay fever got much worse. I received lots of good advice and support from all the health professionals I spoke to. It was reassuring to hear my GP, my midwife and my obstetrician offer the same advice; keep taking your asthma medication. After I gave birth to both my son and my daughter, my asthma returned to normal.

“My advice for other women in my position would be to keep taking your inhalers. If you have any other unusual symptoms make sure you visit your GP or healthcare provider to discuss the best way of managing them.”

Frequently Asked Questions

I’m worried about my asthma during labour, how should I prepare?

Asthma exacerbations are rare during labour as your body produces natural steroid hormones which helps prevent an attack. However, make sure you bring your inhaler with you to the delivery room, in case you need it. Giving birth can be a daunting prospect and there are many things you can do to prepare mentally and physically. These include yoga, breathing exercises and meditation.

Talk to your midwife about the options available in your area. Is it safe to breastfeed my baby while taking asthma drugs? It is safe to breastfeed when you have asthma. In fact, a number of studies have highlighted the benefits of breastfeeding and demonstrated that it can prevent your child getting asthma and allergies. You should continue to use your asthma medication as normal throughout breastfeeding and speak to your doctor if you have any concerns.

Apart from my medication, what else can I do to help control my asthma during pregnancy?

If you currently smoke, you are increasing the risk to your baby during pregnancy and you could exacerbate your asthma symptoms, leading to further complications. If you quit smoking, you can help avoid this risk during pregnancy and help improve your long-term health. In addition to taking your medication, you may want to eat foods which have been suggested as beneficial to asthmatic mothers. A low salt diet and high antioxidant intake may be associated with asthma control and a good immune system. A high intake of vitamin E and olive oil during pregnancy has been suggested to reduce the risk of your baby developing asthma symptoms.

Authors

This material was written by the ELF in conjunction with ERS expert Dr Mina Gaga and Rebecca Elder and Kirsty Warwick, who have both experienced asthma while being pregnant.

Diet and nutrition links

Diet and nutrition linksThe links on this page will take you to recommended sites that have useful information on all aspects of diet and nutrition.

DG SANCO: is the Health & Consumer Protection Directorate General of the EU. DG SANCO helps make Europe’s citizens healthier, safer and more confident.

EHN – European Heart Network

The European Heart Network plays a leading role in the prevention and reduction of cardiovascular disease through advocacy, networking and education.

EPHA – European Public Health Alliance

The European Public Health Alliance (EPHA) represents over 100 non-governmental and other not-for-profit organisations working on public health in Europe.

WHO – World Health Organization

WHO Regional Office

Living an active life with COPD

All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

Keeping active when you have Chronic Obstructive Pulmonary Disease (COPD) can be challenging as breathing takes much more energy and effort than normal.

This factsheet is designed for people with COPD and their families and carers. It explains why activity is affected by your illness, why keeping active is important, and how to live an active life with COPD.

What is COPD?

COPD is the general term given to diseases such as emphysema and chronic bronchitis which cause the airways to become permanently blocked or narrowed. The disease mainly affects your lungs and your ability to breathe, but it can also affect your muscles, heart, bones and overall mood amongst other things. Tobacco smoke is the most common cause of COPD in Europe, but a number of other factors can lead to the development of the disease. These include indoor and outdoor air pollution, as well as dust and chemicals in the workplace and existing illnesses such as chronic asthma. Symptoms tend to worsen over time and you may find that you have to slow down when doing normal daily activities such as walking up stairs, shopping, or having a shower. You may sometimes feel unable to carry out these things. Keeping active can help make these tasks more manageable and help you to feel better in general.

Common symptoms:

  • Shortness of breath during exercise
  • Chronic cough
  • Tight chest
  • Wheeze

Why is activity important?

  • Exercise helps everybody stay fit and healthy
  • If a person is fit, breathing is easier and returns to normal more
  • quickly after exercise
  • The fitter you are, the easier you will find daily activities despite your breathing difficulties
  • Keeping fit and active will help you to stay healthy in the future.
“I still do my household work, but I learnt to do it very slowly and spread tasks over several days. People don’t always understand why you are not more active. I learned to pace myself in order to do more. I’d go out for a walk instead and do things I really enjoy. You need to stay active for as long as possible.” Person with COPD

How does COPD affect me?

One of the earliest signs of COPD is finding that you can’t manage activities as easily as you used to. You may find that you need to stop and recover half way up the stairs, or rest during a walk. Symptoms of breathlessness and tiredness tend to become worse over time, however many patients find that their illness varies from day to day. One day you may feel it is easy to manage your breathlessness, and other days it might stop you carrying out any activities at all. Similarly you could wake up in a morning feeling terrible, but your symptoms may improve by the afternoon.

COPD affects everybody differently depending on the severity of your illness. If your condition is mild or moderate, you may start to notice that walking, exercising, shopping and other leisure activities may become harder. If your condition is more severe, activities such as getting dressed, taking a bath or even combing your hair could make you breathless. As with other long-term illnesses which affect usual lifestyle activities, COPD can cause emotional suffering. Depression, sadness and a feeling of losing control or feeling frightened and panicky, are all common emotional side effects of COPD. COPD can also impact upon relationships as many people start to feel dependent on others for assistance with household activities or lonely if going out becomes difficult. Some people also worry about breathlessness during sexual activity. This breathlessness can be alarming and often reduces a person’s urge for sex or their enjoyment of it. It is important not to feel ashamed and to talk about your concerns with your doctor, nurse or physiotherapist.

What can I do about it?

As well as taking regular treatment, you can also reduce your shortness of breath by training and strengthening your muscles so they work better. Being short of breath during activities can be frightening. It can be tempting to avoid exercise that you think will make you breathless. If you are inactive, you will become unfit and your muscles will become de-conditioned. This means they will lose strength and weaken, making physical activities become more difficult. As a consequence, you will need to breathe even more, which will make even simple activities hard. This can also affect your mood and lead to you feeling depressed. You can stop this vicious circle right at the start by keeping active. If you maintain physical activity, your lungs and muscles will keep working as well as they can do, and your health will deteriorate much less rapidly. As well as benefits to your general health, keeping active will also help reduce breathlessness when you exercise, reduce leg tiredness, raise energy levels, improve muscle strength, boost your immune system and improve your self-esteem and mood.

Keeping active according to your level of breathlessness

If you are regularly short of breath, ask your doctor to find out why this is happening. The following tips may help people with COPD to deal with breathlessness during physical activity:

Your level of breathlessness How to keep active
Not troubled by breathlessness except on strenuous exercise
  • Stick to a regular activity plan including 30 minutes of moderate exercise on at least 5 days per week (e.g. brisk walking)
  • Allow enough time to recover after exercise
Short of breath when hurrying or walking up a slight hill

 

  • Plan activities in advance so you don’t have to rush too much
  • If you are short of time, do not panic as this makes breathlessness worse. Keep going steadily, as best you can
  • Consider using your reliever inhaler that is provided by your doctor when you experience symptoms

 

Walk slower than companions on the level because of breathlessness, or have to stop for breath when walking at own pace

 

  • It is okay to be out of breath. Moderate breathlessness is completely safe and just means you are taking good exercise
  • Take slow deep breaths rather than fast shallow breaths
  • Take a rest if you need to and consider taking your reliever inhaler

 

Stops for breath after about 100 m or after a few minutes on the level

 

  • Include lots of rests in your activity
  • Reach your goal in your own time
  • It’s okay to feel out of breath
  • Consult with an expert in COPD and exercise (e.g. a physiotherapist) to see what exercises you can still do to maintain your physical condition
Too breathless to leave the house, or breathless when dressing or undressing

 

  • Tackle one thing at a time
  • Feeling breathless is scary but it is not harmful. Your breathing should return to normal after a few minutes of rest.
  • Use distractions to take your mind off your breathing for 2 minutes until you get your breath back
  • Continue with simple daily activities as much as possible

 

One of the simplest ways to control shortness of breath is to breathe through pursed lips, as if you were going to whistle. If you take deep breaths through the nose and release air through pursed lips, your airways will be open longer, which will help you regain a normal breathing rate.

Depending on how severe your symptoms are and how you prefer to exercise, keeping active ranges from basic activities around the home to structured exercise sessions. A physiotherapist can help you plan activities that are right for you.

You can try to build different activities into your daily routine in order to maintain your level of fitness:

  • Gardening
  • Walking up and down the stairs
  • Getting off the bus one stop early, or taking a short walk
  • Light swimming
  • Keep-fit exercises
  • Stretching routines at home to strengthen your muscles

If you want to improve your fitness, you can go to expert-led exercise training programmes, or pulmonary rehabilitation programmes. Pulmonary rehabilitation involves organised exercises and education about your lungs and keeping healthy, as part of a group. It can be beneficial if you aren’t used to exercise and would like help to gradually build up your activity levels. It can also help build your confidence and your ability to cope with your illness. As your fitness improves, you may then enjoy structured sessions and classes, such as aqua aerobics, yoga and dancing. Talk to your doctor, nurse or physiotherapist about the type of exercise that is right for you and the programmes available in your area.

Things to remember:

  • Always warm up and cool down after exercise
  • Keep water with you to drink before, during and after exercise
  • Keep your medication nearby
  • Don’t push yourself beyond your limits
  • Pursed-lip breathing

Stop the activity you are doing if you feel any of the following:

  • Tight chest
  • Dizzy or sick
  • Clammy or cold
  • Increasing wheeze
  • Pain in your joints or muscles
  • Abnormally tired

Frequently Asked Questions (FAQs)

Is getting out of breath dangerous?

Breathlessness can feel distressing, but increases in heart rate and breathing are normal during exercise, and are not dangerous. Your breathing should return to normal after you stop the activity. If it does not, you should contact your doctor. If you are more short of breath than people of your own age during exercise, you should consult a doctor and ask for advice. They could recommend a training heart rate for you, which will give you the number of pulse beats per minute which you should be aiming for when exercising. There are often simple solutions which can make physical activities more comfortable for you.

Would oxygen help?

Doctors provide oxygen to people based on the level of oxygen in your blood, not on how breathless you feel. You could be very short of breath, but the levels of oxygen in your blood are sufficient and by contrast, some people may need oxygen even though their breathing feels okay. If the oxygen in your blood stream is below a critical level, then you may be prescribed oxygen.

When do I need to see my doctor?

You should see your doctor initially to find out why you are short of breath during exercise and what type of exercise is right for you. You should also see a doctor if your breathing suddenly becomes worse during exercise, or it doesn’t recover soon after you stop exercising.

The PROactive study

The PROactive study is developing a new tool that will help doctors measure activity in people with COPD. The system works by using an electronic recording device, similar to a mobile phone or electronic diary, to record the user’s activities during the day. It will also take information from an activity monitor, worn by a person with COPD, to see if their activity improves after different treatments for the condition. The research team believe the best way to find out about COPD treatments is to ask people with the condition about their quality of life. Researchers are currently studying hundreds of people with COPD across Europe to see what activities they are doing, what treatments they would like to see in the future, and how they feel when they exercise with their condition. The new tool will be developed based on these answers. If you’d like any information on the outcomes of the study, or if you have a question about the project, please email: [email protected]

 

Q&A video with ERS expert

Do you have a question relating to this factsheet that you would like answered by an ERS expert?

Authors

This material was written by the ELF in conjunction with the PROactive project, part of the EU Innovative Medicines Initiative.

The PROactive project aims to develop a tool that will help doctors assess how activity impacts the lives of people with COPD. For more information on the project and to keep up to date with their findings, visit the PROactive website.

Interesting links

Visit the COPD section for more detailed information
Read our other factsheet on Living Well with COPD
For more information about the PROactive project,

Patient Advisors

Fiona Copeland
Eric Fierens
Catherine Hallinan
Helmut Berck
Goran Radovanovic
Izabela
Dorrit Novel
Sheila Saunders

What is a healthy and balanced diet for

How and what should I eat to stay healthy

In fact, recently there has been more and more evidence of how epigenetics, or the influence of the environment on gene expression, counts a lot in the prevention of chronic diseases such as diabetes, hypertension, cardiovascular diseases or cancers.

How and what should I eat to stay healthy?

The principles related to healthy eating, those that can be adopted by anyone who cares about their state of health, are not complex and you can immediately try to put them into practice in your days, perhaps focusing on an aspect that you had not taken enough into consideration until to now.

In general you should:

  • abound with seasonal fruits and vegetables, because they are rich in antioxidants, vitamins and phytonutrients, substances necessary for cellular function;
  • prefer foods as loose and fresh as possible, trying to avoid putting too many packaged products full of preservatives or additives and paying attention to the quality and origin of what you buy;
  • distribute calories throughout the day according to commitments, eating balanced meals (without skipping them) and if necessary making light snacks (not snacks);
    reduce the glycemic load by eliminating as much sugar, jams, honey, sweets, soft drinks, alcohol as possible and replacing white pasta, bread and rice with wholemeal ones to maintain low insulin levels;
  • use aromatic herbs and spices with imagination to reduce excessively fatty seasonings and limit the salt added to preparations.

Not just “what”, but also “how” to eat

Now you should have a slightly more precise idea of ​​what everyone means by “healthy diet”.

We must not forget, however, that choosing foods is only one of the steps: the way you store, cook and consume your meals can also greatly affect the healthiness of your diet.

A particularly important step is that of preparation and cooking, actions that can in fact greatly affect the nutritional content of foods: for example, some vitamins are sensitive to heat, while mineral salts are easily dispersed in water, which is why it is advisable to alternate the consumption of both raw and cooked fruits and vegetables.

Not just "what", but also "how" to eatIn other cases, cooking a food makes nutrients more available and removes or transforms substances that could normally be harmful to us, such as some proteins or the anti-nutrients found in cereals, legumes and vegetables.

One of the pieces to add to your overview therefore concerns the careful choice of the cooking method of the various foods, in order to have the greatest benefit with the least waste or damage.

The story of eating well and in a healthy way does not end there: there are many other factors related to food that can have an even more positive influence on your general health, such as timing, or the moment you decide to eat, or use of any supplements, which can make your body’s work even more efficient, or even how you decide to combine physical activity and training with nutrition.

Johns Hopkins scientists discover genetic roots of hereditary lung disease

Scientists at Johns Hopkins identified the genetic culprits that trigger a hereditary form of a fatal lung disease — idiopathic pulmonary fibrosis.

Their findings, published in the March 29, 2007, issue of the New England Journal of Medicine, may guide diagnosis and treatment for families that inherit genes for the disease, as well as for those that develop non-inherited forms.

The disease takes its names from fibrosis, or scarring of the lung tissue, which restricts lung function over time. Most people live three to five years after contracting the disease and there are no known approved treatments.

About 200,000 Americans have it, according to the National Institutes of Health. About 50,000 new cases are diagnosed each year, affecting mostly people 50 to 75 years of age.

H1N1 Swine flu update

Since the first identification of the new H1N1 (swine flu) virus in March 2009, the infection has spread all over the world.

According to recent reports from the World Health Organization (WHO), more than 199 countries have reported laboratory-confirmed cases of pandemic influenza H1N1.

In 2010, a total of 500,000 cases have been identified worldwide, with 6,000 deaths. However, most countries have now stopped counting individual cases and the global impact of the current pandemic has not yet been estimated.

According to the World Health Organisation (WHO), the H1N1 virus has reached its peak and largely run its course but this doesn’t mean the virus has disappeared. During winter flu seasons, those with underlying health conditions could still be vulnerable and it is expected that the virus will continue to circulate for some years to come.

What have scientists discovered?

Of the reported cases of ‘swine flu’ many sufferers, had underlying conditions that were linked with severe influenza.

Many patients also had pneumonia, while others also reported vomiting and a fifth had diarrhoea.

The most common cause of death was pneumonia and acute respiratory distress syndrome.

Vaccines for pandemic (H1N1) 2009

Influenza vaccines are one of the most effective ways to protect people from contracting illness during influenza epidemics and pandemics.

The pandemic influenza is a new virus, and virtually everyone is susceptible to infection from it.

Vaccines will boost immunity against the new influenza, and help to protect public health as the pandemic evolves.

nH1N1 is part of the current seasonal flu vaccine.

For more information on the vaccines, please visit the World Health Organisation website.

For more detailed information on H1N1, read the news section in
ERS Breathe (December 2009).

ELF Award 2012

Norweigan Olympic rowing champion, Olaf Tufte and the World Spirometry Day Lung Champions

Watch:

  • Interviews with ELF Awardees

The 2012 ELF Award was presented to the 30 Lung Champions of the World Spirometry Day campaign.

As part of the WSD 2012 campaign, various people with lung diseases have been recognised as ‘Lung Champions’ as a result of their personal achievements in sport and activity. These people were from a range of backgrounds, ages and abilities but had all achieved success in a sport or activity despite living with a lung disease.

The Lung Champion campaign was headed up by Norweigan Olympic rower, Olaf Tufte.

Olaf developed asthma during years of hard work in bad environments on the family farm and hard training in all kinds of weather, but in 2012 he competed in his fifth Olympic Games in London – a feat achieved
by few rowers. His achievements include two gold medals in the Beijing and Athens Olympics in the single sculls and one silver medal at the Sydney Olympics in the double sculls. He finished 9th in the Men’s Single Sculls race at London 2012, out of 33 initial competitors.

Olaf accepted the award at the European Respiratory Society’s annual congress in Vienna, on behalf of the 30 Lung Champions. He was also joined by 11-year old Alex Supple; a dedicated rugby player and Lung Champion from the UK, who also lives with asthma.

Chair of the European Lung Foundation, Monica Fletcher, said: “Olaf is a true champion and does not let his asthma limit or impact on his dedication to his goals. As the face of the World Spirometry Day campaign, we wanted to recognise Olaf’s hard work at achieving his ambitions and inspiring the next generation of athletes. Exercise is such an important part of managing asthma and we hope others with the condition will be motivated by Olaf’s attitude to reaching the peak of his sport.”

Olaf Tufte, Alex Supple, Monica Fletcher and ERS President Klaus Rabe

After receiving the award, Olaf said: “I’m delighted to have received the ELF award and I hope it can inspire others in my position to get involved in exercise or sport, at any level.“I am determined not to let my asthma limit me or restrict my ambitions. Instead, I see it as one challenge among many that I need to master in order to come top in my sport. People with lung conditions can lead healthy, active lives – if they take steps to ensure their condition is identified early enough and treated well.”

To read more about the Lung Champions and their achievements, visit the WSD website.

Interviews with ELF Awardees

Watch the interviews with Olaf Tufte, Alex Supple and David Supple about the ELF Award 2012.

Burden in Europe

The European Influenza Surveillance Scheme (EISS) and the European Centre for Disease Prevention and Control (ECDC) have collected data on influenza activity in Europe over 8 winters (1999-2007).

The total area covered in the scheme includes a population of about 450 million people. This type of surveillance helps researchers find a vaccine that will be effective against circulating viruses and to prepare for pandemics. The main aim of the scheme is to improve knowledge of how influenza spreads to strengthen healthcare protection resources.

Over the period of 8 winters, the average length of a typical flu season was nearly 4 months. Usually the epidemic starts in the west and spreads towards eastern Europe, possibly because Western Europe is most populated and has a greater amount of commuting and air travel, which contribute to the spread of the virus.

From January 2008, there has been a dramatic increase in the number of influenza cases in Europe. Countries experiencing a significant amount of influenza activity include: Austria, Bulgaria, France, Hungary, Ireland, Italy, Luxembourg, The Netherlands, Portugal, Slovenia, Spain, Switzerland and the United Kingdom.

As an example of how influenza varies from year to year and how it affects different age groups, the two graphs on the right show the progress of the 2007-2008 influenza season in Italy and compare it with previous seasons.

Seasonal flu is thought to be responsible for between 40,000 and 220,000 extra deaths per year in Europe.

Testimonies

Do you have an experience or story about or related to asthma that you would like to share with others? Or would you like to read about how other people have coped in similar situations? Share your thoughts here.

Apache2 – default

The respiratory system is a complex of organs that provide the body with oxygen necessary for the life of the cell and remove from the body carbon dioxide formed as a result of oxidation.

It consists of: airways (nasal cavity, throat, larynx, trachea, bronchi and bronchioles) and respiratory organs-lungs.

Chiesi Farmaceutici is fully committed to the care and improvement of the quality of life of people suffering from respiratory diseases, including asthma and COPD (chronic obstructive pulmonary disease). Asthma and COPD are characterised by limited airflow, although they are driven by a different pathophysiological pathway.

Asthma and COPD are characterised

According to the latest WHO (World Health Organization) estimates, 235 million people worldwide suffer from asthma – mainly children, while 65 million people suffer from moderate to severe Apache2 default (WHO 2017), which is the third leading cause of death by 2030. if measures to reduce the risk of the disease – such as smoking-are not adopted, it is estimated that the number of COPD-related deaths ten years. 1

In pursuit of continuous improvement of patients ‘ health, Chiesi Farmaceutici conducts research and develops new therapeutic solutions based on the innovative formulation technology, which allows the creation of spray solutions (pMDI, pressure measuring inhaler) for inhalation capable of delivering additional particles. over. Chiesi Farmaceutici has patented and marketed a medical device based on a dry powder for inhalation (DPI, dry powder inhaler), capable of delivering very fine particles.

Asthma
Asthma is a chronic inflammatory condition characterised by recurrent respiratory symptoms such as shortness of breath, cough and wheezing, and chest tightness. Normally, air circulates freely in our lungs through a complex conductive system also called the airways. Under certain conditions and Apache2 default when the condition of an asthmatic is uncontrolled, the airways are more susceptible to inflammation, which causes an asthma attack.

As a result, there are many changes, including bronchospasm, thickening of the inner mucosa and blockage of the lower respiratory tract, which in turn makes breathing difficult. However, these clinical signs are virtually reversible, although they vary greatly from period to period or from patient to patient. In general, the condition of asthma worsens at night or early in the morning. Although a complete cure for asthma is not possible, optimal control of the disease can be achieved, thus ensuring an adequate quality of life for patients. But what causes asthma Apache2 default?

An asthma attack is triggered by contact with a person who is susceptible to irritants. In particular, predisposing factors are genetic factors (which explains the higher incidence in patients), the presence of allergies, female gender, obesity and ethnicity. At the same time, factors such as allergens, occupational pollution, cigarette smoke, environmental pollution and respiratory infections can trigger an asthma attack if inhaled in large quantities. Asthma is more common in children and adolescents, although in recent years2

Chronic obstructive pulmonary disease (COPD)

COPD is a respiratory disease characterised by persistent (irreversible) bronchial obstruction associated with a chronic increased inflammatory response of the airways to toxins or gas. The classic signs of COPD are shortness of breath, chronic cough and chronic sputum production. In some cases, there may be a chronic worsening of the above symptoms, leading to an exacerbation of COPD.

Bronchoconstriction in COPD patients has a dual mechanism: on the one hand, inflammation of the lower respiratory tract, along with thickening of the airway walls, can increase the resistance to airflow.

On the other hand, progressive destruction of the pulmonary parenchyma (emphysema) associated with loss of elastic lung retraction may occur. It should be emphasized that both mechanisms can coexist, leading to a general decrease in airflow in the lungs. But what are the risk factors associated with COPD? First, there are genetic risk factors that may predispose some individuals to develop the disease.

The most important risk factor is cigarette smoke, as well as exposure to household pollution (associated with cooking food or gases emitted by burning biofuels) or environmental pollution. Secondary factors are age, gender, socioeconomic status, respiratory infections, asthma or chronic bronchitis. In general, COPD patients are more susceptible to cardiovascular disease, osteoporosis, diabetes, lung cancer and bronchial dissection, which in turn increases the risk of hospitalization and / or death. Unlike asthma COPD is an early onset disease

 

ELF Award 2009

Yvo de Boer – ELF Award Winner 2009

ELF Award 2009The ELF Award 2009 was awarded to Yvo de Boer, Executive Secretary of the United Nations Framework Convention on Climate Change (UNFCCC), in recognition of his outstanding efforts to reduce the impact of climate change on respiratory health.

Climate change is often viewed as a purely environmental issue. However, it has serious implications for human health, with one of the main organs affected being the lungs.

The extent to which climate change may affect the respiratory system is not fully known; however, researchers can predict a dramatic impact on patients with conditions such as:

• Asthma;
• Chronic obstructive pulmonary disease (COPD);
• Rhinosinusitis;
• Respiratory tract infections.

The impact of climate change on patients with lung diseases will vary depending on: how much global temperatures rise in relation to their current level; the risk level for excessive rainfall and flooding; and the impact of those changes on other factors relevant to health, such as air pollution, allergens and moulds. Planning for the future is vital.

Mr de Boer, the chief climate change negotiator for the United Nations (UN), has been involved in climate change policies since 1994. He has identified the need to establish measurable actions for developing countries and to help them adapt to the impact that climate change may have on people’s lives.

In preparation for the UN Climate Conference in Copenhagen in December 2009, Mr de Boer hopes to:

• Establish how much the industrialised countries are willing to cut emissions;
• Establish how much major developing countries, such as China and India, are willing to limit the growth of their emissions;
• Help developing countries reduce their emissions and adapt to the impacts of climate change; and
• Determine how these efforts will be financed and how the funds will be managed.

Mr de Boer has earned the ELF Award 2009 as a result of his consistent commitment towards reducing the problem of global climate change and his endeavours to continue this vital work in future years.

EU adopts new guideline to tackle tobacco-related health problems

The EU Commission has adopted new proposals to tackle the health problems caused by tobacco products.

The new Tobacco Products Directive includes a number of measures to control tobacco for the benefit of public health. These measures include;

  • Mandatory warning images covering 75% of the front and the back of cigarette packets.
  • A ban on marketing flavours in cigarettes, including ‘roll your own’ and smokeless tobacco products.
  • A maintained ban on the smokeless tobacco product, snus.

Speaking about the new Directive, European Respiratory Society President, Professor Francesco Blasi, said: “The adoption of the EU Tobacco Products Directive by the European Commission is a step of paramount importance in the fight against tobacco and cigarette use in Europe.

“We hope that this proposal will be the first step of a new health policy in the EU that will lead to a substantial improvement in the prevention of respiratory and cardiovascular diseases through more stringent legislation on tobacco use.”

2007 / 2008

Vincenzo Cannizzaro has started his research at the Telethon Institute for Child Health Research in Perth, Australia. His project is titled Ventilator-associated lung injury (VALI) to develop ventilation strategies and prevent VALI in children.

Learn more about Vincenzo Cannizzaro’s work.

Alan Strassburg will be starting his training project in March 2008. His research is titled ‘Pulmonary correlates of innate and adaptive immune protection against Mycobacterium tuberculosis infection’. The main objectives of the study will be to look at immune responses in the lungs of tuberculosis patients.

Air Travel

The potential problems associated with lung diseases and air travel are well recognised. Many lung patients are now able to safely enjoy the benefits of air travel if they plan their provisions in advance. Here we have tried to compile information from as many airlines in Europe as possible. Airlines are listed in their country of origin.

Airline information

Find airline by country
Find airline by map
If you have a lung disease and decide to travel by air, you may experience a shortage of oxygen during your flight (hypoxia) which may or may not worsen your disease symptoms.

Doctors are unable to predict how a patient may feel at altitude so methods have been devised to recreate this environment in a surgery. Lung patients should see their doctor to find out whether they are fit to fly.

The environment inside an aircraft is hypoxic (limited oxygen) because it has the same amount of oxygen available as if you were 8,000 ft (2438m) above sea level.

Healthy patients can cope with the alteration in oxygen availability however; lung disease patients may find it difficult to breathe and may need extra oxygen to breathe easily in this environment.
Are you fit to fly?

The ‘hypoxic challenge’ is the easiest way for doctors to recreate an aircraft environment to assess how someones breathing may be affected and how effective they may find a supply of extra oxygen. The patient is asked to breathe a mixture of gas resembling the oxygen pressure present in an aircraft for up to 30 minutes. This is thought to be enough time to notice any changes occurring in the patient. If a patient shows symptoms of not having enough oxygen, their breathing should return to normal once they are given extra oxygen.

Oxygen supplementation

Patients are not allowed to take pressurised oxygen cylinders on board a flight from an outside source so they must rely on the airline to provide their oxygen. Policies for oxygen supplementation vary between airline carriers so passengers with lung problems should check before travelling. Oxygen may not be available during take-off and landing.
Some airlines allow passengers to use portable oxygen concentrators, although there may be rules about which models can be used. These devices are capable of providing 1-5 litres of 90% oxygen per minute and need an external power supply for long haul flights but are not yet widely available to all passengers. Airlines often carry a limited supply of oxygen to be used in a medical emergency. If a patient is seriously ill during a flight, cabin crew have the ability to contact emergency medical support if they need to make a diversion before their final destination.

Contact the airline in advance

Some airlines may only provide facemasks for oxygen delivery despite nasal tubes being more comfortable for many people. Oxygen is usually delivered at a rate of between 2 and 4 litres per minute and patients that require a different flow rate to this must make arrangements in advance for their individual needs.

Airlines are usually happy to accommodate patients’ requirements but may ask for a letter from a doctor. Make sure you allow enough time for this to be organised before your trip. The airline will also let you know if there is an extra charge for your requirements.

Patients who need permanent ventilation are usually only allowed to fly if they are accompanied by a medic. Patients should check whether an electrical supply for the ventilator is available and have a back-up battery pack ready in case of an electrical failure.

 

2008/ 2009

Santiago Giavedoni will be based at the ELEGI Laboratory, Queens Medical Research Institute (Edinburgh, United Kingdom), researching how lung rehabilitation and statin treatment affects muscle wastage and quality of life in patients who experience severe COPD exacerbations. Santiago’s research will start in October 2008.

Learn more about Santiago Giavedoni’s work
Maria Pallayova will carry out research at Johns Hopkins School of Medicine (Baltimore, United States of America) on how the metabolism may influence the function of the upper airways.

Learn more about Maria Pallayova’s work
Dermot Stephen O’Callaghan will study at the Hôpital Antoine Béclère (Paris, France), to look at pulmonary arterial hypertension in Ireland. Dermot’s research will begin in May 2009.

Learn more about Dermot O’Callaghan’s work

Tobacco links

The links on this page will take you to recommended sites that have useful information on all aspects of tobacco.

Smokefree partnership

The Smoke Free Partnership is a strategic, independent and flexible partnership between the European Respiratory Society  , Cancer Research UK   the Institut National du Cancer   and the European Heart Network. It aims to promote tobacco control advocacy and policy research at EU and national levels in collaboration with other EU health organisations and EU tobacco control networks.

ASH – Action on Smoking and Health

ASH is a campaigning public health charity working to eliminate the harm caused by tobacco.

ECL – European Cancer Leagues

ECL is a not-for-profit association, which aims to co-ordinate collaboration between European Leagues/Societies in order to reduce the growing burden in Europe.

ENSP – European Network for Smoking Prevention

ENSP is an international non-profit making organisation, which aims to develop a strategy for co-ordinated action among organisations active in tobacco control in Europe.

EPHA – European Public Health Alliance

The European Public Health Alliance (EPHA) represents over 100 non-governmental and other not-for-profit organisations working on public health in Europe.

Framework Convention Alliance

The Framework Convention Alliance is made up of approximately 200 organisations representing about 80 countries around the world. It was created to support the development, ratification, and implementation of the WHO FCTC.

Globalink – The International Tobacco-Control Network

Global Smokefree Partnership

Tobacco Free Initiative (TFI)

The Tobacco Free Initiative (TFI) was established in July 1998 to focus international attention, resources and action on the global tobacco epidemic.

WHO – World Health Organization

WHO Regional Office.

Stivoro voor een rookvrije toekomst

Dutch smoke-free site.

Gezondeluchtwerktbeter

Dutch clean air at work site.

Research finds potential way to reduce risk of asthma attack

A new study has identified ways to reduce the factors that lead to an asthma attack.

The research, published in the Proceedings of the National Academy of Sciences (PNAS), found that the likelihood of having an asthma attack can be reduced if we can control the two most significant biological responses that lead to an attack.

Normally humans have few mucus-producing cells but asthma sufferers have an increased number of these cells in the lining of the tubes that lead to the lungs.

Asthmatics also have an abnormal amount of smooth muscle surrounding the airway tubes. Even the slightest stimulus can cause these to contract.

A specific channel in the body controls muscle contraction and secretion in the airways. These are two major factors that lead to an asthma attack. The new study found that if the channel was blocked, it could reduce these two symptoms of asthma.

Researchers will now begin testing the safety and effectiveness of new treatments to see if they can successfully block the channel.

Tuberculosis

What is tuberculosis?

Tuberculosis (sometimes called TB) is a disease caused by an infection commonly in the lungs, although it can occur in other parts of the body. The infection causes lots of small nodules called ‘tubercles’ to appear in the affected organs, which gradually replace the normal structures and partially destroy the tissues, making holes or ‘cavities’. Tuberculosis develops slowly over weeks or months. Without treatment, it will cause death in about half of cases. With the right treatment, it can be cured but may leave scars or deformities within the organs if it is not treated early enough.

What causes tuberculosis?

Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis. It grows very slowly and is not killed by the antibiotics that are active against most bacteria (for instance against ordinary pneumonia or infections).

Where is tuberculosis most common?

Tuberculosis is present all over the world. It is now rare in industrialised countries but much more frequent in Sub-Saharan Africa, Asia and Eastern Europe.

Who gets tuberculosis?

Tuberculosis is transmitted from a person with tuberculosis in the lungs to other people. When people with the active disease cough or sneeze, they expel tiny particles containing Mycobacterium tuberculosis, which can be inhaled by other people into their lungs. In healthy people, the bacteria are normally trapped and destroyed by the lung’s defence mechanisms. However, if the defence mechanism is too slow or not efficient enough, or if there are too many bacteria, the bacteria can grow and cause the disease. Even healthy people can get tuberculosis, but people with weak or damaged immune systems (young children, smokers, diabetics, those receiving immunosuppressive treatment and those living with HIV) have a higher risk of developing the disease if they are exposed to someone with the disease.

What are the symptoms of tuberculosis?

Tuberculosis causes a variety of general symptoms that might be seen in any severe infection. It can also cause symptoms due to the involvement of one or more organs:

General tuberculosis symptoms

  • Fever
  • Tiredness
  • Loss of appetite
  • Weight loss

Local tuberculosis symptoms

In the lungs:

  • Cough
  • Phlegm production
  • Chest pain

In the lymph node:

  • Lymph nodes become enlarged

In bones and joints:

  • Bones and joints are painful

No one symptom is typical of tuberculosis (all of these can be caused by other diseases), but the slow increase of symptoms could suggest that tuberculosis is a possibility.

What can I do to avoid the disease?

The risk of tuberculosis can sometimes be decreased by the standard BCG (Bacillus Calmette-Guérin) vaccine. This vaccine offers limited protection to small children but it is no longer recommended for adults. It is hard to know if you have tuberculosis but if you find out that you do have the disease, you should avoid risk factors, such as smoking, to avoid the disease worsening. Relatives who cough, particularly if they have had a cough for a long time, associated with fever, night sweats and weight loss, should be encouraged to visit a doctor and have appropriate examinations to detect tuberculosis. This is particularly important if they have a condition which reduces their immunity or if they have come from a country where tuberculosis is common. Family members of tuberculosis patients should also be examined to detect whether they have the disease. Patients who are receiving treatment for tuberculosis should be regularly checked by a doctor to see if their condition has improved and to detect possible side-effects or complications.

WHO ‘Stop TB’ Strategy

The World Health Organization (WHO) has developed a strategy called ‘Stop TB’ to try to achieve a tuberculosis-free world. It aims to reduce the amount of tuberculosis sufferers in the world by 2015 by:

  • providing patients with high-quality diagnosis and treatment
  • reducing the amount of people who suffer from tuberculosis and its associated problems
  • protecting vulnerable, high-risk groups from developing tuberculosis and other associated infections
  • developing new tools that may improve tuberculosis treatment

How will I know if I have tuberculosis?

People with suspected tuberculosis symptoms (longlasting cough, weight loss, night sweating) should have a medical examination including a chest X-ray and an examination of phlegm if the chest X-ray is not normal. In some cases, further examinations (CT-scans, bronchoscopy) may be necessary to confirm the diagnosis. The earlier the disease is spotted, the greater the chance of a complete cure.

What should I do if I have the disease?

With appropriate treatment, tuberculosis can be cured, although the treatment is long (at least 6 months) and complex (the patient has to take 4 drugs for 2 months and 2 drugs for a further 4 months to be cured with certainty). If the bacteria are resistant to one or more drugs, the treatment is longer. With proper treatment, patients feel better after a couple of weeks, but it is very important to continue the treatment until the end. If not, there is a risk that the disease may come back and become resistant to certain drugs. Sticking to the treatment and regular medical checks are therefore extremely important. Patients who are at risk of forgetting their regular treatment or who are confused about the drugs to be taken may be helped by regular assistance from a healthcare worker. This is particularly important if the treatment is longer or more complex than usual (multidrug-resistant tuberculosis).

Types of tuberculosis

All forms of tuberculosis are caused by the same bacterium, but as some bacteria develop resistance there are different treatment schedules for the management of the disease. People with a drug-resistant strain may transmit it to other people, who will develop a resistant form of tuberculosis from the beginning.

Bacteria can become resistant to antibiotics if:

  • a patient is given the wrong treatment
  • a patient takes the wrong dose
  • a patient does not complete the full course of drugs

Patients in this situation need to be treated with a different combination of antibiotics and it may take up to 2 years for the patient to be cured.

Once bacteria become resistant to certain drugs, patients with these strains are very difficult to treat, but a cure is still possible with careful selection of the drugs and very regular treatment. Resistance can be avoided by prescribing the most appropriate drugs to patients and making sure they take them correctly and for the full amount of time.

Resources

Information and tools that can help provide information and advice about tobacco and related topics.

Lifting the smokescreen

The report “Lifting the smokescreen – 10 reasons to go smoke free” shows that more than 79,000 adults die each year as a result of passive smoking in the 25 countries of the European Union.
The report also provides the evidence that measures to prevent passive smoking are feasible and popular.
Click here for further information on the report and its launch.

The Executive Summary of the report is now available in Bulgarian, Czech, German, Greek, English, Spanish, Estonian, French, Italian,

Lithuanian, Latvian, Polish, Portuguese and Romanian.

The 10 reasons to go smoke free are also available in the same languages: Bulgarian, Czech, German, Greek, English, Spanish, Estonian,

French, Italian, Lithuanian, Latvian, Polish, Portuguese and Romanian.

 

Limassol recommendations to become a smoke free society

Key recommendations that are mainly based on research findings and the experience of successful countries like Ireland, Norway and Italy.

Tobacco or Health in the European Union

This report represents the first attempt to draw together an analysis of tobacco-control policy in the European Union, including:

  • health and economic cost of smoking and tobacco to European society
  • effectiveness of previous tobacco policies
  • analysis of the extent to which the tobacco industry has influenced political decisions

Smoke Free Europe makes economic sense

This report compares the economics of smoke-free policies, as well as the economic impact of smoking bans in bars and restaurants in different countries.

Images

Images are shown here of a human lung. They were produced using resin casts of the airways and blood vessels, or by using a scanning electron microscope.

Airways and blood vessels

Image of airways and blood vessels present in the lungsThis image shows the airways of the lungs on the left-hand side.The right-hand side shows the airways, with the pulmonary arteries and veins.

Image and cast kindly provided by Walter Weder (Institute of Anatomy, University of Bern, Bern, Switzerland).

Close-up of airways and blood vessels

Close-up image of airways and blood vessels

This image shows a close-up version of the image above.You can see here how closely the arteries follow the airways to the periphery; the veins can be seen lying between the units.Image kindly provided by Walter Weder.

Gas exchange area with alveoli

Image of gas exchange area with alveoli

This image shows many alveoli bunched together like grapes. Image kindly provided by Peter Gehr (Institute of Anatomy, University of Bern).

Walls of alveoli

Image of alveolar wall

This image shows a close-up version of the alveolar wall.
You can see the red blood cells in a capillary seperated from the air by a very thin tissue barrier.

Image kindly provided by Ewald R. Weibel (Institute of Anatomy, University of Bern).

 

 

 

 

Patient organisation survey

Preliminary research

Before circulating the ELF Patient organisation survey, we identified all the respiratory patient organisations and groups that exist in Europe and listed them via disease type and country. These were plotted on a map to illustrate the distribution of respiratory disease support available in Europe, based on our research.

All patient organisations identified are listed in the country pages within this section. Patient organisations highlighted in grey show those who completed our survey and so we have more information about them. Patient organisations highlighted in white did not complete the survey however, we have listed them for information purposes only.

Please note that none of the patient organisation links listed in this section have been reviewed by our experts but enable you to find out more information about organisations who are active in your country.

Distribution of respiratory disease support offered in Europe

Data analysis of survey responses

Of the total number of active respiratory patient organisations and support groups identified in Europe (164), a total of 88 (54%) completed our survey.

Responses were obtained from a wide range of disease areas:

Pie chart to show the proportions of respiratory disease support offered throughout Europe (click graph to zoom)

Activity

Organisations were most likely to produce patient information and offer support to patients, and were least likely to raise funds for research or recruit patients for clinical trials (click graph to zoom)

News

21/10/2011 Noninvasive positive-pressure ventilation (NIPPV) linked to increased hospital mortality rates in a small group of patients
People with chronic obstructive pulmonary disease (COPD) who are hospitalised, frequently require either invasive or noninvasive mechanical ventilation to help them to breathe.

More…
20/10/2011 UEFA EURO 2012 will be a smoke-free zone
The UEFA (Union of European Football Associations) EURO 2012 football tournament will be smoke-free after UEFA announced a complete ban on the use, sale and promotion of tobacco in all stadiums hosting finals matches.

More…
19/10/2011 Cigarette smoke can harm the lungs in a similar way to cystic fibrosis
A new study has shown that smoking negatively affects the lungs in a similar way to other lung diseases, leading to mucus that causes dry cough, chronic bronchitis and chronic obstructive pulmonary disease, among other problems.

More…
17/10/2011 Smoking linked to earlier menopause
Women who smoke may hit menopause about a year earlier than non-smokers.

More…
13/10/2011 Younger COPD sufferers report job and life burdens
New research has revealed the devastating personal and financial impact that chronic obstructive pulmonary disease (COPD) can have on younger people of a working age.

More…
12/10/2011 ‘First ever’ fall in global TB
The number of people suffering from tuberculosis (TB) has declined for the first time, according to the World Health Organization (WHO).

More…
11/10/2011 Air pollution from traffic impairs brain
Air pollution in cities can harm the way the brain functions, according to two new studies.

More…
10/10/2011 Workplace pollutants linked to childhood asthma
A mother’s exposure to airborne pollutants during pregnancy may increase the likelihood that her unborn child will later develop asthma, according to a new study.

More…
07/10/2011 Risk for heart disease rises with COPD
People with chronic obstructive pulmonary disease (COPD) or reduced lung function are at risk of developing heart disease.

More…
06/10/2011 TB smoking toll ‘could reach 40 million’
40 million smokers could die from tuberculosis (TB) by 2050, research suggests.

 

Outdoor air pollution: Air Quality and Health

The term ‘air pollution’ refers to parts in the atmosphere such as chemicals or other material, which can cause damage to the environment and can lead to people becoming ill.

Air pollution includes natural materials that come from processes such as volcano eruptions and dust storms in deserts, and substances that come from human activity, such as burning coal and oil and producing chemicals.

The information in this section of the website is taken from the European Respiratory Society’s Air Quality and Health reference book. Published in September 2010, the book provides an overview of the current knowledge about the nature and health consequences of air pollution.  It is targeted at healthcare professionals and politicians.

EU action on environment


Our health is influenced by a variety of factors, but environment pollutants influence around 25 to 33% of these problems.

Air pollutants have caused very poor air quality in many parts of Europe.

Air pollution doesn’t just damage health; it also disrupts ecosystems and crops and damages buildings and monuments.

Daily concentrations in most of Europe still exceed the EU target value.

 

 

Current ozone air-quality standards focus on minimising the number of days with high peak concentrations. Policies that result in sustained reductions in ozone concentration lead to larger public health benefits when compared with emergency policies aiming to prevent a few extreme peaks. For these reasons, scientists are calling for regulations and policies that reduce ozone levels throughout the summer.

Read the EU Focus on Clean Air document

 Key fact: Sulphur oxide emissions, which are largely from public electricity and heat production, have decreased by almost 70% since 1990 across EU member states.

 

The 6th Environmental Action Plan (EAP)

The EU adopted, in 2002, the 6th Environmental Action Plan (EAP). This environmental strategy outlines the priorities for action on the environment in the coming years. The plan, which concludes in 2012, sets up four main priority areas for action:

* Climate change
* Nature and bio-diversity
* Environment and health
* Sustainable use of natural resources and waste
It also seeks ways to involve citizens and relevant stakeholders in the process of policy making and to make decisions on the basis of sound science.

Seven thematic EU strategies

To tackle more specific environmental problems in the most cost-effective way, the EU have also adopted seven thematic strategies:

1. Air pollution
2. Prevention and recycling of waste
3. Protection and conservation of the marine environment
4. Soil
5. Sustainable use of pesticides
6. Sustainable use of resources
7. Urban environment

Each strategy will be founded on thorough research and science, and will set clear environmental objectives to be achieved by 2020.

ELF Award 2011

Emeritus Professor Elizabeth Juniper

The ELF 2011 Award was presented to Elizabeth Juniper in recognition of her work to promote quality of life in asthma care and clinical research.

Liz spent her early career in exercise physiology and control of breathing research, before moving on to asthma and rhinitis research and clinical trials. In 1989, she was given a faculty appointment in the Department of Clinical Epidemiology and Biostatistics at McMaster University in Canada, and began developing and validating questionnaires to measure  subjective health status.

She has developed and validated disease-specific health-related quality of life tools for adults and children with asthma and rhinoconjunctivitis. These questionnaires are used worldwide both in clinical trials and clinical practice. Her Asthma Control Questionnaire is advocated for use in clinical practice by international guidelines.

Doctors are able to use these valuable tools to quickly and accurately identify the problems and limitations people with asthma face every day.

The questionnaire helps doctors decide on the best treatment and also enables patients to learn more about the features of asthma that are important to control their condition. Doctors and patients can then decide together on the optimum treatment to meet both their goals.

What causes ILD?

In 65% of ILD cases the cause is still unknown (known as idiopathic interstitial pneumonias, of which idiopathic pulmonary fibrosis is the most frequent).

External factors

In 35% of ILD cases, external factors are recognised as the cause of the disease, especially organic or inorganic material, drug reactions and infections.

Health risks

There are many factors that can have a dramatic effect on lung health and disease. We should all try to understand more about these factors and take actions that will help to combat the damage they inflict.

Tobacco

Environment

Diet and nutrition

Hearing the views of smokers who have a lung condition

A team of experts across Europe want to improve the way that doctors and nurses interact with smokers with lung conditions.

Åsikter från rökare som har lungbesvär

En grupp av europiska experter önskar förbättra sättet på vilka läkare och sjuksköterskor handhar rökare med lungbesvär.

Om du är rökare med lungsjukdom så vill vi gärna att du deltar.

Ditt deltagande kommer att hjälpa Europeiska Lungläkarföreningen att utbilda sjukvårds-personal om dina behov.

Vi skulle vilja veta om din lungsjukdom har förändrart din syn på att sluta röka.

Vi vill också veta hur läkare och sjuksköterskor pratade med dig före och efter att du fick din lungsjukdom.

För att få del av din kunskap har vi gjort ett kort frågeformulär. Det innehåller mindre än 15 frågor och tar endast 10 min att fylla i.

Fyll I frågeformuläret

Vi behöver inte ditt namn och kommer ej att kontakta dig om du inte själv önskar bli kontaktad. Ge i så fall din e-mejl adress.

Om du har frågor eller funderingar omkring detta project så får du gärna kontakta oss.

‘Vaccinate now’ to beat bird flu say scientists

A vaccine being tested right now could help save lives in a future bird flu pandemic, UK scientists claim.

A jab against one strain of avian flu, given years earlier, may “prime” the immune system to fight a wide range of bird flu strains.

When a pandemic arises, those who have been pre-vaccinated could be given a booster shot to be protected far more quickly than normal.

Vaccines against new pandemics can only be created once a new strain emerges; by this time, thousands of lives may be claimed and the administration of a ‘pre-vaccination’ may help overcome the problem.

 

ATS, ERS jointly issue asthma assessment guidelines

The American Thoracic Society and the European Respiratory Society have released official standards for clinical trials and practice with respect to the assessment of asthma.

The American Thoracic Society and European Respiratory Society set up the task force of 24 asthma experts from North America, Europe, South Africa, Australia and New Zealand, to provide standardised definitions and measurement recommendations for three main areas: asthma control, asthma severity and asthma exacerbations

Asthma control was defined as the extent to which asthma symptoms have been reduced or removed by treatment, with respect to both current clinical control and future risk.
Asthma severity was defined as the intensity of treatment required to achieve good asthma control.

Asthma exacerbations were defined as events where symptoms worsen enough to require urgent treatment over three or more days to prevent serious consequences.

The task force made the clinical recommendation that doctors routinely ask every asthma patient a few simple questions about their asthma symptoms and management of their condition.

“More research is needed to understand more clearly how asthma control and risks for asthma exacerbations can be best assessed for the different types (i.e., phenotypes) of asthma, which have different responses to therapy,” John Heffner, M.D., past president of the ATS, confirmed.

Stockholm 2007

Spirometry testing event

This year’s European Lung Foundation (ELF)/ European Respiratory Society (ERS) spirometry event took place in Stockholm’s central railway station during the 17th Annual Congress in Sweden, which attracted over 15,000 respiratory professionals to Stockholm.

The main aim of the event was to raise awareness of lung health among local citizens.

The excellent central location encouraged commuters and shoppers of Stockholm to find out about lung health and disease and to learn about chronic obstructive lung disease (COPD).

The event was open for a total of 24 hours over 2 days, in an attempt to beat last year’s record of 2042 individuals, tested in Munich, Germany. Members of the public who had decided to have their lungs tested were seen by a volunteer nurse, in 1 of 18 individual booths. Individuals were asked to blow as hard as they could for 6 seconds into a hand held spirometer. Several doctors and representatives from smoking cessation groups were available on site for individuals to speak to if they wanted any further advice or information.

3 blows were taken from each person to produce an accurate average FEV1 reading. FEV1 is an indication of how much air can be forced out of your lungs in 1 second after taking a deep breath, to provide an important measure of pulmonary function.

The event proved to be hugely popular and attracted passers by and local workers who were happy to visit during lunch breaks and wait, despite the queues. The final number of individuals tested was 2882, 85.5% of whom showed acceptable FEV1 measurements.

Members of the general public who were found to have restricted airways were given guidance from doctors and advised to visit their own GP with the information produced from their lung test.

Thank-you to all the taskforce whose hard work and support made this year’s event a record success. Our aim of beating last year’s total was easily achieved and has raised the standard for next year in Berlin!

Sincere thanks to the following partners:

• The Stockholm Task Force, including the Congress Chairs, and Inger Kull and Anne Renström,
• All volunteer nurses and doctors for pledging their valuable time.
• The generous financial support of Boehringer Ingelheim GmbH, without which the event would not be possible.
• The generous contribution of equipment and professional support from ndd Medizintechnik AG.
• The collaboration of Järnhusen AB and JC Decaux, for allowing the event to take place in the Central station.
• Dohrns exhibitions and Mix PR for their hard work on the project.
• Swedish patient interest groups and lung foundations for contributing to the local lung health awareness campaign.

Cystic fibrosis

Cystic fibrosis or CF is the commonest lethal inherited disease in White races, although the incidence varies across Europe and between different ethnic groups.

What is cystic fibrosis?

Detecting cystic fibrosis

Treatment of cystic fibrosis

 

Burden in Europe

Areas for action

 

Testimonies

Cystic fibrosis in the news

 

Cystic fibrosis links

What causes pneumonia?

Bacteria (in particular pneumococci) represent the leading cause of pneumonia.
Viral pneumonia can be caused by a range of viruses, including those that are responsible for the common cold and severe acute respiratory syndrome (SARS), the recent outbreak of which became a global health concern.

Pneumonia outside hospital

For most countries, studies are not available on the causes of community-acquired pneumonia (CAP). However, more than 10 different microbial causes of CAP have been recognised.

Pneumonia in hospital

Limited information is available on the causes of nosocomial pneumonia (NP). However, the pathogenic agents that cause NP appear to differ between early-onset NP (that occurs within 4 days of hospitalisation) and late-onset NP (occurring after 4 days).

Multidrug resistance

Bacteria causing CAP are increasingly resistant to commonly used antibiotics in most European countries.
Multidrug resistance is also increasingly common in NP.

Risk factors

Smoking is the single most important identified preventable risk factor for CAP.
Increasing age, chronic obstructive pulmonary disease (COPD) and previous respiratory infections also increase the risk of developing CAP.
In older patients, alcoholism, asthma, immunosuppressive therapy, lung diseases, heart disease, institutionalisation and increasing age are related to the risk of contracting pneumonia.

Spread of infection

Situations where many people are in close contact (e.g. schools, army barracks, prisons, shelters for the homeless) facilitate the spread of some of the more infectious causes of pneumonia, leading to local epidemics. Certain occupations (e.g. farming) are linked to some of the most common causes of pneumonia.

Meninger til røykere som har en lungesykdom

En gruppe europeiske forskere ønsker å forbedre hjelpen leger og sykepleiere gir til røykere med lungesykdom.

Vi vil gjerne høre fra røykere som har fått diagnostisert en lungesykdom.

Dine innspill vil bli videreformidlet i informasjonen som den Europeiske lungeforeningen gir til helsearbeidere.

Vi vil gjerne høre fra røykere som har fått diagnostisert en lungesykdom.

Vi vil gjerne finne ut om det å få en lungesykdom motiverer til røykeslutt.

Vi vil også vite hvordan leger og sykepleiere snakker med deg om røyking, både før og etter du fikk lungesykdom.

Vi har laget et kort spørreskjema for å høre  dine meninger. Skjemaet består av mindre enn 15 spørsmål og det tar kun 10 minutter å svare på alle spørsmålene.

Svar på skjemaet

Vi spør deg ikke om navn og vil ikke kontakte deg hvis ikke du vil gi oss din epostadresse slik at vi kan komme tilbake til deg.

Hvis du har flere spørsmål eller vil vite mer om prosjektet, vennligst kontakt oss.

Function of the lungs

The are several different questions that can be asked to find out how the lungs normally work.

How does air get into the body?

What happens to oxygen and carbon dioxide?

Which muscles help with breathing?

How do the lungs protect themselves?

Telemedicine

Telemedicine, also known as telehealth, telecare or e-health, is a new approach to healthcare, which uses technology to help you, as a patient, to manage your own condition from home.

  • What is telemedicine?
  • Telemedicine and lung diseases
  • What are the potential benefits of telemedicine?
  • Risks of telemedicine
  • Case study: Telescot trial
  • Case study: NEXES: Supporting Healthier and Independent Living for Chronic Patients and Elderly
  • Case study: Renewing Health

What is telemedicine?

Telemedicine is an innovative approach that combines medical expertise and equipment with information and communications technology to allow examinations, monitoring and treatment to be carried out in your home.

Across Europe, people are living longer, so that more people suffer from one or more chronic (long-term) conditions. The need for long-term treatment has led to the development of new models of care that enable people to be treated and also monitored at home.Using electronic forms of communication, telemedicine is revolutionising the way healthcare is provided.

Below are some examples of telemedicine services:

  • Video conference with your healthcare professional. This enables you to speak with your doctor online via a video link, reducing the need for you to visit the doctor’s surgery or hospital.
  • Recording your symptoms on an electronic device at home. Symptoms and measurements (such as peak flows and spirometry readings which test your lung function) can be recorded electronically using a touchscreen computer or a device similar to a mobile phone. This will enable you to collect important information on how your condition affects you whilst you are carrying out day-to-day activities either at home or when you are out of the house.   Measurements can then be sent to your healthcare provider who can monitor whether you need further treatment. This also enables you to ask your doctor questions about the measurements you have recorded.
  • Education and self-management support. Technology can be used to help you learn more about your condition, so that you are able to share your knowledge and experience with other people in similar situations. This concept is known as peer-to-peer education. It recognises the value of the lived experience of a condition and provides the opportunity to learn about a condition from first-hand accounts. Technology can also help to support successful self-management by using systems which can interpret your recordings and help with early recognition and management of any problems which may occur.
  • Online health information. Increasingly, many people are using the internet to obtain health information. This can be a valuable resource but it is important to check whether the health website you are using is providing you with accurate information. (Read the ELF’s Guide to Finding the Right Health Website). You can also join social networking sites which often have specific groups for people with similar conditions.
  • Call centres. There has been a growth in call centres providing health information over the telephone. These services enable healthcare professionals to decide who needs urgent medical attention and who can benefit from appropriate over-the-phone advice.

These examples are just some of the ways that telemedicine can help you become more independent by enabling you to have more control and manage your condition.

Telemedicine and lung diseases

Various telemedicine devices and services can enable individuals to monitor lung function and manage lung conditions at home.

Asthma
In recent years, a number of studies have highlighted the potential benefits of telemonitoring for asthma patients. Findings have demonstrated that people conducting their own lung function test, known as spirometry, at home, were able to record accurate results comparable to those collected by a healthcare professional.(1) Another study demonstrated that video monitoring enabled a doctor to assess and treat children with asthma, and the lack of face-to-face contact did not affect the quality of care and experience of the children.(2)

 

Chronic obstructive pulmonary disease (COPD)
It is well recognised that improving a person’s self-monitoring of their COPD symptoms can reduce the frequency of hospitalisations caused by a flare-up (exacerbation) of their symptoms. Using self-monitoring techniques can also reduce the time and cost implications of attending a hospital for treatment or monitoring. In a study which aimed to assess the impact of these services, people with COPD were provided with a videophone, an electronic stethoscope and a digital blood pressure monitor, allowing them to access specialist nursing support quickly. The results showed that remote video technology was effective and well-received by the study participants.(3) A further study showed that accessing web-based call centres after being discharged from hospital reduced the number of repeat hospitalisations.(4)

What are the potential benefits of telemedicine?

  • Enables individuals to have greater control over their condition and their lives by maintaining independence at home
  • Enables services that were previously only available at hospitals to be available at home
  • Reduces the need for hospital and doctor visits, saving time and travel costsSupports the longer-term management of a condition at home
  • The technologies can be tailored to each individual
  • Improving access to services in remote areas
  • Reduces costs of healthcare
  • Some forms of telemedicine provide direct access to a healthcare professional, removing appointment waiting times
  • Some forms of telemedicine provide continuous monitoring, 24 hours a day, 7 days a week
  • Solves the problem of shortages of healthcare providers
Thierry Troosters, an ERS expert in rehabilitation, said “Although telemedicine has not yet obtained the status of ‘usual care’ in most European countries, results of clinical trials are convincingly showing that this technology has a future for respiratory patients”

Risks of telemedicine

There are some concerns over the ethical issues of security, privacy and confidentiality of patients using telemedicine services. To reduce these risks, healthcare providers should follow the same ethical standards and duty of care as in a face to face meeting. As with all new interventions, telemedicine services should be subject to rigorous on-going assessment.

Case study: Telescot trial

The Telescot trial is currently investigating how telemedicine can support people with long-term conditions such as COPD in Scotland. One trial includes over 250 people with severe COPD, half of whom have been given touch-screen technology to record their symptoms every morning.

Patients also use a pulse oximeter to measure blood oxygen and heart rate, a peak flow meter to measure breathing and scales to check weight. These measurements are automatically transferred to a team of healthcare providers via a secure internet connection on a specifically-designed computer programme. This program is able to colour-code each person into a red, yellow or green category, so that the healthcare providers can instantly see who is in need of a visit or telephone call, and whose symptoms are currently stable.

Clair Sparrius, a respiratory physiotherapist who is working on the trial, said: “We’ve had a very positive response from the people involved in the trial and most individuals have enjoyed feeling in control of their own condition. The system enables people to have more say in the management of their condition and they are reassured by the knowledge that a healthcare provider is checking their readings every day. It was a bit of a culture change to get used to operating in a different way for both healthcare providers and individuals with COPD, but we have certainly seen the benefits of being able to monitor individuals in this way.”

Read more about the telescot trial

Case study: NEXES: Supporting Healthier and Independent Living for Chronic Patients and Elderly

NEXES is a European Union project focusing on people with chronic illnesses (chronic obstructive pulmonary disease (COPD); congestive heart failure (CHF); and Diabetes Type II). The aim of this project is to develop four types of care programs (a) Wellness and training; b) Enhanced care for frail patients/ Home hospitalization and early discharge; and, c) support to diagnostic procedures carried out in Primary Care), using information and communication technologies that support healthy and independent living.

Read more on the NEXES website

Case study: Renewing Health

RENEWING HEALTH is an European project working to scale-up tele-monitoring services that already exist at a local level.

The project will aim to give chronic patients suffering from diabetes, chronic obstructive pulmonary or cardiovascular diseases, central management of their condition. The care program will use home-based video conferences and remote monitoring with the aim of decreasing the rate of hospitalisations and emergency room consultations.

Visit the Renewing Health website for more information

Carme Hernández, a respiratory nurse, who is working on the NEXES and Renewing Health projects, said: “Our team is very excited and we have had a high level of response by professionals and the level of patients’ satisfaction is very high. The ICT platform enables professionals and patients to work together, improve patient’s self-management and avoid duplicities.”

Read about a COPD patient’s experience of a telemedicine trial:

“I am a 72 years old COPD patient and I also have alpha-1 antitrypsin deficiency. Some years ago, I was asked by my doctor if I wanted to be followed for one year at home with the aid of telemedicine. I decided to join the trial and I received regular calls from my nurse to check I was feeling well. I also sent him records of my symptoms and how they varied day-to-day. On some occasions, the nurse felt I should speak with the doctor and this was then arranged. I felt very secure with this service and with this process of treatment and I hope it will one day be available to all patients as part of our healthcare systems in Europe.”

This material was compiled with the help of Clair Sparrius, Dr Bruno Balbi (Fondazione Salvatore Maugeri and Associazione Nazionale Alfa-1 AT, Italy) and Carme Hernández RN, MSc (Hospital Clinic. Barcelona)

Research sheds lights on breathing muscles in sleep apnoea

A process in the brain responsible for muscle inactivity has been identified by new research.

The study, published in the American Journal of Respiratory and Critical Care Medicine, has for the first time pinpointed the mechanism responsible for constraining important breathing muscles, such as the tongue.

The inactivity of these muscles can cause snoring and other sleep problems, such as sleep apnoea.

The researchers studied rats when they were asleep and awake and examined parts of the brain responsible for the breathing muscles.

The results of the study could be used to help researchers develop new treatments for sleep apnoea, which target this area of the brain. Lead researcher, Dr Richard Horner, said: “Identifying the fundamental mechanism responsible for the shutting down of a muscle in sleep that is critical for effective breathing also identifies a rational drug target designed to prevent this inactivity and so prevent obstructive sleep apnea and other sleep-related breathing problems.”

Donating your lungs; a choice for life

Organ donation is a sensitive issue for many people to think about and discuss but it is the difference between life and death for a person waiting for a transplant.

Many diseases can cause severe damage to the lungs that cannot be repaired by medication or surgery. The only hope for restoring normal lung function in this instance may be a lung transplant. In Europe, there is a long-standing shortage of organ donors, while the number of people waiting for a lung transplant is expected to rise.

This factsheet explains what organ donation is, how it can benefit people and how you can register to become a donor.

What is organ donation?

Organ donation is the removal of organs from the human body after a person has died. These are donated to people who have damaged organs that need replacing. Receiving an organ transplant can save their life, increase their life expectancy and significantly increase their quality of life.

Every person has a free choice whether they want their organs to be donated after they pass away. It needs to be discussed with friends or family and it is best to think about this while you are in good health. In most European countries, you can register as an organ donor, but your relatives will still need to allow the donation to take place when you die.

There are no good or bad decisions in deciding to donate an organ; however, it is very import that your closest relatives are aware of your intentions as it will help them to agree or not agree with donating your lungs.

When can I become a donor?

The majority of organs are donated when a person has suffered a severe trauma that has severely damaged their brain and affected their ability to breathe. The heart is kept beating by artificial sources, but a person is unable to breathe for themselves.

In each country there are also strict legal criteria for when an organ can be donated. This takes into account how compatible organs are and considers factors such as sex, age and blood group of both the donor and the recipient. It is also important to remember that the identity of the donor will remain anonymous and not told to the person who receives an organ.

Lung transplants

If a person with severe lung disease has tried all other treatment options and their condition hasn’t improved, they may eligible for a lung transplant.

The transplantation team make sure that lungs are donated to people who will receive the maximum benefit from the donation and who will take care of this gift. For example, people who continue to smoke are not eligible for lung transplantation. The chances of lung transplant patients surviving at least three years in 2012 are between 65–75%.

A person on a lung transplant waiting list will be very ill and usually has a life expectancy of 18 months or less. Their quality of life is likely to be significantly reduced. Their lungs will be badly damaged and they may require oxygen 24 hours a day to keep them breathing, or need a wheelchair to get around. They may receive a single or double lung transplant, or both a heart and lung transplant, depending on their condition.

This is the case for many lung conditions.

Lung condition Is lung transplant a possible treatment option?
Cystic fibrosis (CF) In severe cases of CF, when the lungs stop working, a transplant is
recommended. A double transplant is always required as the condition
affects both lungs. These patients are typically aged 20–30 when they receive
new lungs.
Chronic obstructive
pulmonary disease (COPD)
Lung transplantation is an option for only a small number of people with
COPD, and only after other treatments (including pulmonary rehabilitation)
have been tried. In most countries there is an upper age limit to qualify
for a transplant as older people are less likely to survive. A more common
operation is to remove a section of the lung that’s no longer working to give
more space for the healthier lung to work.
Alpha 1-antitrypsin People with the condition could require either a single or a double lung
transplant. Some people will also develop chronic liver disease and may also
require a liver transplant. As with all other conditions, it is only an option
when all other treatment options have failed.
Interstitial lung diseases,
such as pulmonary fibrosis or
sarcoidosis
People with severe, chronic cases of these rare diseases may be eligible for a
lung transplant, but this is not a common treatment for this disease.
Lymphangioleiomyomatosis
(LAM)
Lung transplantation is a possibility for people with LAM, although this is
only undertaken in severe cases.
Pulmonary hypertension For people with severe pulmonary hypertension, a heart–lung transplant
may be an option. As this involves transplanting both the healthy lungs and
heart from a donor, there are minimal opportunities for it to be carried out.
Lung cancer Lung transplantation is not an option for people who have developed lung
cancer as the cancer is likely to return again in the new lungs.

What are the benefits of a transplant?

Transplantation is the last option left to produce a major improvement in lung function and give someone a further chance at life. To understand the true benefits of a lung transplant, two lung transplant patients share their stories:

Case study: Justine Laymond

Justine suffers from a rare lung condition, known as lymphangioleiomyomatosis (LAM). It leads to a progressive decline in lung function and there is no known cure for the condition, which affects women usually of child-bearing age. Justine suffered 15 lung collapses, along with severe chest pain, over a number of years.

Gradually her lung function declined until she was hospitalised with only 30% lung capacity. She required oxygen all the time, and was wheelchair dependant. She was even put into a medically induced coma for a time. After three false alarms and 16 months in hospital, she was told that a pair of lungs had been donated and she could have a transplant.

“I can’t even put into words how I felt at this moment. It was as if the whole room lit up. The thought that someone else had recently died was upsetting but this was an amazing, generous gift that they left behind them. I was out of hospital in 3 weeks and I no longer required oxygen or a wheelchair. As well as physical improvements in my condition, I was also mentally a different person. I now set myself a new goal each year. I’ve learned a range of new sports and took part in the European Transplant Games. I’ve also sailed around the world and visited countries which I could never have done before.

“I am so grateful for this gift and I now spend my life making sure I live it to the full. I would encourage more people to talk about organ donation and make sure others are aware of it. Most people would want to take this gift if they’d been in my position and I hope this would encourage them to also think about giving it.”

Case study: Kirstie Tancock

Kirstie was born with cystic fibrosis. Her lungs were so badly damaged from the condition, that by the age of 21, she needed a double lung transplant. Her illness became so bad that she was connected to an extracorporeal membrane oxygenation (ECMO) machine, which gave her the ventilation needed to keep her alive while she waited for the transplant.

“Most of my life I was struggling for breath or I had a terrible cough and my lungs were full of mucus. Now, I can just breathe. I don’t have to think about it, it just happens. I feel free, like I’m the person I was always supposed to be and able to achieve things I never thought I could.

“Everything has improved since my transplant. There is no medical regime for the length of the whole day. No machinery to take with you on a rare outing. I don’t have to worry that I haven’t got round to creating memory boxes and writing my funeral plan. I can run, I can sing, I can laugh, I can dance and I can live because I can breathe. If people are considering becoming an organ donor, I I would ask them if their daughter, sister, bother, mother, son, husband, wife, needed a life-saving transplant, would they want them to get it? If you’re willing to accept an organ you should be willing to give one.”

People who receive transplants still have to take life-long medication for the rest of their lives to avoid infection and rejection of their new organ. They also have to make frequent visits to the hospital to check how their body has reacted to the new organ. In addition, these patients will take part in pulmonary rehabilitation programmes and are given advice on how to lead an active life to gain full the full benefit of the lungs they received.

However, this level of care is usually far less than a person needed prior to their transplant and they often see a significant improvement in their quality of life.

What are the risks of a transplant?

The main risk is that a person’s body could reject the new lung. This results in the immune system attacking the new tissue, as it believes it to be harmful. This can lead to a reduced lung function, which could happen quickly or slowly over time. There are many different drugs that can be taken to try to stop the immune system rejecting the organ.

How can I donate my lungs?

The process for organ donation differs from one country to another. In some European countries, such as Spain, Austria and Belgium, citizens are automatically considered to be a donor, although your family will still be consulted when you die. You also have an option to actively opt in, which means the family will just be made aware of your decision, or you can opt out if you do not wish your organs to be used.

In other countries, such as the UK, you must volunteer and opt in for your organs to be donated upon your death. It is important to know that a doctor, who hasn’t been directly treating you, will make the decision whether your organs are suitable for donation. This ensures that decisions about your treatment are never linked to the decision to donate or not donate your organs.

Check how the policy in your country operates to find out how you can donate your lungs. One useful website to start with is the Global Observatory on Donation and Transplantation:

What factors could prevent my organs being used?

There are a number of reasons your organs might not be suitable for donation, even if you have agreed to donate them.

Medical conditions: Only well-functioning organs can be used. If you have cancer, HIV or an infectious disease, your organs are unlikely to be used for a transplant.

Damage: In the case of death by injury, organs may be too badly damaged to be used.

Family consent: In some European countries in the event of death, families are consulted and must also give permission for organs to be used. Even if you have agreed to donate your organs, this decision could still be overturned by the family. It is therefore essential to discuss your wishes with your family and friends in advance so they are aware of your wishes.

Organ donation across countries

Organ donation between European countries is a very complex issue. Some countries operate individually and do not allow organs donated in their country to be given to a patient in another country.

Other countries, such as those in Scandanavia, belong to a network (in this case, the Scandiatransplant network), which allows the exchange or organs and tissue between participating transplant centres in five different countries. This is also the case for Austria, Belgium, Croatia, Germany, Luxembourg, the Netherlands and Slovenia, who belong to the Eurotransplant International Foundation.

EU action

The demand for organs outweighs supply all over the European territory. These shortages can generate organ trafficking, where criminals try to steal and traffic organs into other countries for money, which is strongly condemned by lung health and transplant societies across Europe.

To help combat this in 2008, the EU proposed an ‘Action plan on Organ Donation and Transplantation’ for 2009–2015.

One of the key priority areas in this plan was to improve the mobility of patients and donors as part of cooperation between member states. You can find out more about the current EU strategy on their website:

Further reading

The World Health Organization (WHO) has established a set of ‘Guiding Principles for Transplantation’. Visit the linka below to understand more about the ethical principles surrounding transplantation, proposed by the
WHO: www.who.int/transplantation.

Reducing exposure to wood smoke can increase life expectancy

Reducing a person’s exposure to wood or biomass smoke can help increase their life expectancy, according to a new study.

The research, published in the British Medical Journal, found a significant link between reductions in exposure to this type of smoke with an increase in male life expectancy.

The study analysed a community education program, environmental regulation enforcement and a program of wood heater replacement in a city in Tasmania,  Australia. The researchers assessed air pollution levels and mortality in the community over 6.5 years. They compared these to another city in Australia with no air regulations or education programs.

Between 2001 and 2007 in the Tasmanian city, there were significant reductions in death from all causes, death from heart problems and death from lung problems in men of 11.4%, 17.9%, and 22.8%, respectively.

“Our findings highlight the potential for important public health gains from interventions to reduce pollution from biomass smoke,” conclude the authors.

European Lung Foundation

Lung diseases are the leading cause of death and disease in Europe and throughout the world. Anyone can be affected by lung diseases, not just smokers. Lung diseases impact on almost every family in Europe.

European Lung Foundation

Latest news updates from around the world….

European Patient Ambassador Programme (EPAP)

An online learning resource to help patients and carers gain knowledge, skills and confidence to actively engage in research, guidelines, advocacy and media activities.

  • What is the European Patient Ambassador Programme?
  • How does it work?
  • Why become a Patient Ambassador?
  • Further information

What is the European Patient Ambassador Programme?

The European Patient Ambassador Programme (EPAP) has been developed to help patients and carers across Europe understand how healthcare research and guidelines work, how to get involved and engage in advocacy and media activities at any level.

It is a unique programme as it is European, comprehensive, interactive, online and is relevant for anyone living with or caring for someone with any condition. It is aimed at anyone who is passionate about the patient experience in healthcare.

This new programme has been developed by the European Lung Foundation (ELF) with the NIHR CLAHRC (for Leeds, York and Bradford), a UK organisation that brings health research and clinical practice together, as well as with patient organisations and experts across Europe.

By creating a programme and developing a community of Patient Ambassadors the ELF, CLAHRC and other organisations across Europe aim to get patients more involved in influencing healthcare and political decision-making.

At every stage experts in healthcare, research and e-learning, along with patient organisations, patients and carer groups across Europe have been involved to influence the programme and ensure its value as a resource.

“This practical online resource focuses on helping patients’ to advocate for themselves and their families.

The fact that it will help me shape the future of healthcare for people with my condition is very exciting.”

Dan Smyth, (Sleep Apnoea Sufferer) General Secretary of the Irish Sleep Apnoea Trust

How does it work?

The programme has six modules, which the Patient Ambassador works through at their own pace. Animation, audio, and activities are used to support learning, but there are no tests or time limits.

The programme is designed for people to develop knowledge and skills to independently find information about conditions, and engage with research, guidelines, advocacy and media activities at various levels.

The core modules are:

1 Becoming better informed Work out what information is needed, find it, and record it in a clear and concise way
2 Improving public awareness Understand how to develop a campaign / message that is focused on key issues and communicate it a variety of ways
3 Improving treatment and care Understand how guidelines are developed and how you can get involved in  them to improve treatment and care
4 Supporting research and development Understand how clinical research is conducted and how to engage with other stakeholders to influence future research
5 Influencing health policy Find out how health policy is developed and how it can be influenced. Apply skills acquired in other modules to engage with a range of stakeholders in influencing policy
6 Interacting with the media Create media interest and understand how to interact with the media to communicate your message in a clear and authoritative way

An Overview of the programme, Users’ Guide, Technical Support and Glossary are also provided to optimise use and understanding of the programme.

The programme is currently only available in English, although it has been designed to use plain language and explain technical terms to develop the patient ambassador’s understanding of key terms used in research, guidelines and media.

The course will also have additional resources to provide the most up-to-date and relevant stats and information.

“EPAP is a great opportunity to support you to use your experiences to influence research to improve health outcomes”

Lisa Butland, Associate Director NIHR CLAHRC

Why become a Patient Ambassador?

For a long time patients have wanted to be more involved with healthcare decision-making and now there is also a growing wish from healthcare professionals and policy makers to involve patients in many aspects of delivering better treatment and care.

Patients can identify issues that may be overlooked by healthcare professionals, highlight areas where the patient’s perspective differs from health professionals and ensure that research and guidelines address key issues of concern to them.

To be most effective at expressing the patient perspective, patients and carers need to have the core skills and knowledge that will enable healthcare professionals and policy makers to understand their key concerns.

The European Patient Ambassador Programme identifies those skills and helps you to develop them. The course also points you to resources to help you further your knowledge and expand your skills both during and after you have completed the programme.

Patient ambassadors will:

  • Be encouraged to represent patients at local, national and European levels
  • Develop the skills and confidence to interact with professionals, politicians and the media
  • Be able to find reliable information about conditions
  • Gain the skills to learn more about how healthcare works in their country and in Europe
  • Develop the knowledge and skills to contribute to:
    • raising public awareness of a condition
    • improving treatment and care for people with a condition
    • progressing and developing scientific and clinical research

The programme also hopes to:

  • Bring together patient ambassadors by providing a forum and on-going updates
  • Enable the development of a pool of people ready, willing and able to take part in activities such as input into guideline development, research projects, speaking at conferences about the patient perspective, and explaining concerns to policy makers and the media

Triggers of asthma

In an asthmatic person, the narrowing of the airways occurs in response to stimuli (triggers) that usually do not affect non-asthmatic people. Among these triggers:

  • Allergens
  • Infections
  • Irritants
  • Exercise (defined as exercise-induced asthma)
  • Stress and anxiety
  • Aspirin

An asthma attack can be triggered by many inhaled allergens, such as pollen, particles derived from dust mites, secretions from cockroaches, particles from animal feathers and fur. These allergens bind to immunoglobulin E (IgE, a type of antibody) on the surface of mast cells to stimulate the release of asthmogenic substances (this type of asthma is called allergic asthma). Although food allergies can only rarely induce asthma, certain foods (such as shellfish and peanuts) can trigger severe attacks in sensitive individuals.

Reactive airway dysfunction syndrome

Reactive Airways Dysfunction Syndrome (RADS) is a rapid-onset and persistent asthma-like disorder that develops in patients with no history of asthma. It is a form of environmental lung disease caused by a single strong exposure to nitric oxide and volatile organic compounds (such as those contained in certain bleaches and cleaning products). The patient develops symptoms similar to those associated with asthma, with coughing, wheezing and shortness of breath. The treatment is similar to that generally adopted for asthma.

Asthma attacks vary in frequency and severity. Some asthmatics are usually asymptomatic, with sporadic and short-lasting mild episodes of wheezing. Others experience coughing and wheezing and have severe attacks after viral infections, physical activity, or exposure to other triggers.

With wheezing there is a musical sound that can be found during the expiratory phase. In some subjects, cough may be the only symptom (variant of asthma with cough). Some asthmatic patients have clear and sometimes thick (sticky) sputum.

In some cases, asthma attacks occur mainly at night (nocturnal asthma). Asthma attacks that occur during the night may indicate poor disease control.

Symptoms of an asthma attack

Asthma attacks are more frequent in the early hours of the day, when the effects of protective drugs disappear and the body has difficulty in preventing the narrowing of the respiratory tract.

Symptoms of an asthma attackAn asthma crisis can begin suddenly, with wheezing, coughing, and wheezing. At other times, the asthma crisis may arise slowly, with gradual worsening of symptoms. Either way, people with asthma often notice wheezing, coughing, or tightness first. The attack can end after a few minutes or it can last for hours or days. Itchy chest or neck can be an early symptom, especially in children. A dry nocturnal or exertional cough may be the only symptom.

During asthma attacks, dyspnoea (wheezing) can become severe, generating a feeling of deep anxiety. The subject instinctively sits upright and leans forward, using the neck and chest muscles to breathe, but is still looking for air. Sweating is a common reaction to effort and anxiety. Generally, the heart rate becomes more frequent and the person may feel a sensation of chest pressure.

Air pollutants from fireplaces and wood-burning stoves raise health concerns

Research by scientists in Demark has shed new light on the potential health effects associated with air pollutants being released from burning wood in the home.

Their study, published in Chemical Research in Toxicology, found that invisible particles in wood smoke that are inhaled into the lungs, could have several adverse health effects.

There is a body of evidence that currently links the inhalation of fine particles from outdoor air pollution, known as particulate matter, with a range of adverse health effects.

However, relatively little evidence exists concerning the health effects of particulate matter from wood smoke, despite millions of people routinely inhaling wood smoke from heating and cooking in the home.
The researchers analysed levels of particulate matter in a Danish village where most residents used log fires and wood stoves. They found that airborne particles in the village were of a potentially hazardous size and were small enough to be inhaled deep inside the lungs. The particulate matter also included chemicals that may cause cancer, damage to DNA and a stress response in the lungs.

Asthma in elite athletes

This factsheet attempts to explain the increased occurrence of asthma and bronchial hyperresponsiveness among elite athletes, and give information about recommended treatment and testing regulations.

Exercise-induced asthma and bronchial hyperresponsiveness (BHR) have become increasingly common in top athletes, particularly those who compete in endurance sports. BHR is a measure of how easily the airways constrict or become narrow in response to different stimuli such as: physical exercise; viral infections; smells and cold or dry air.

The widespread use of asthma drugs, particularly inhaled β2-agonists, among top athletes has led the International Olympic Committee Medical Commission (IOC-MC) and the World Anti-Doping Association (WADA) to restrict their use to athletes who have been diagnosed with asthma and show evidence of BHR.

Elite athletes may have had asthma since childhood or they may have developed asthma and BHR since becoming active in sports. Asthma and BHR occur most often in endurance sports such as cross-country skiing, biathlon and swimming, particularly in older athletes. Endurance sports require a high level of fitness and stamina to enable the body to keep exercising for a long time.

As you exercise, your breathing will get faster to ensure the body has enough oxygen to keep going. Athletes may inhale potentially harmful substances in the air, depending on the environment, which may cause asthma symptoms or damage the lungs directly.

Examples of potentially harmful substances that are inhaled in different sports:

Sport Potentially harmful substances
Cross-country skiing

Biathlon

Nordic combined

Cold, dry air

 

Swimming

 

Organic chlorine chemicals

(chloramine and trichloramine)

Figure skating

Speed skating

Ice hockey

Nitrogen oxide from freezing machinery

Ultrafine particles from polishing machines

 

Treatment and approval of medication

Most drugs can be used by athletes with documented asthma, except systemic steroids, systemic β2-agonists and other adrenergic drugs. These drugs have strict rules that athletes must follow if they decide to take them. If an athlete declares that they are using inhaled steroids and some inhaled β2-agonists (salbutamol and salmeterol) approval is not required.

For drugs that need to be approved, athletes must show clinical signs of asthma and BHR, which must be confirmed with a bronchial challenge test. In this test you must breathe in a drug which makes your airways become narrow. A lung function test will then show how much they have narrowed.

Inhaled β2-agonists are only approved if a positive result is shown with a bronchial challenge test or if lung function increases by more than 12% after inhaling a bronchodilator (β2-agonist). Asthma must be at least moderately severe for a positive result to be shown in these tests. Tests often show negative results in cases of mild asthma.

If asthma symptoms are shown but the tests do not show positive results, leukotriene antagonists or ipratropium bromides can be used, as these drugs have no restrictions.

Mild asthma can be treated with anti-inflammatories such as inhaled steroids. These counteract any harm caused by sport and reduce the risk of long term injury.

By giving an asthmatic athlete the best treatment, they have a better opportunity to compete on equal terms with other non-asthmatic athletes. Many studies have demonstrated that inhaled β2-agonists and inhaled steroids do not improve performance or offer any benefit to non-asthmatic athletes. However, all athletes who compete at an international level must provide up-to-date information on their asthma treatment.

If you are an elite athlete competing at an Olympic or professional level, you must ensure that your current treatment is permitted by authorities. If you experience asthma symptoms and suspect that you need treatment, visit your doctor and ensure you are treated within the current guidelines.

Author

This factsheet was compiled by the ELF office with the help of ERS asthma expert, Prof. Kai-Hakon Carlsen. The material was reviewed and approved by the ERS Advisory Board.

Interesting links

For more general advice on asthma and exercise, visit the Asthma UK advice pages.

Please go to the asthma section of our website for more information.

RSS Feed

Now you can easily keep up-to-date with the latest quality assured news and updates from the European Lung Foundation. With our online RSS (Rich Site Summary) feed, you can add the latest ELF news and updates to your own website, portal or RSS reader.

What is RSS?

RSS, or Rich Site Summary, lets you choose to receive content from a number of websites and read it in one place via a RSS reader.

The RSS reader will then alert you when new material is posted on the websites that offer RSS feeds. This saves you time as you do not have to then check sites individually. Many websites, including the European Lung Foundation, offer RSS feeds.

What You Need

All you need is a tool known as an RSS reader. There are several versions; some need to be downloaded to your computer, others are web-based. Web based readers such as Google Reader and My Yahoo! are free and very easy to use.

How To Subscribe

Once you have an RSS reader just go to and click the appropriate subscribe button (depending on the reader you are using). Every time ELF has a new science or news update it will then appear in your RSS reader; keeping you up-to-date with the latest ELF reviewed news and updates.

If you have My yahoo! you can add the RSS feed here

Using ELF RSS feeds on your site

If you run your own website or blog, you can use RSS feeds to display the latest quality assured news and updates from ELF on your site.

We encourage the use of ELF RSS feeds in this way; however, we do require that the proper format and attribution is used when ELF content appears. The attribution text should read ‘ELF’ or ‘From ELF’, as appropriate, and be linked back to

Genetic tests could lead to personalised medicine for children with asthma

Routine and inexpensive genetic testing could lead to more personalised asthma treatments, according to a new study.

It is known that certain asthma treatments work better for some people than others, but there are also some drugs that are likely to be ineffective and could cause negative side-effects in some people.

The new research, published in the journal Clinical Science, found that a drug called salmeterol, commonly given for the long-term control of asthma, works poorly in children with a particular genetic variant.

The researchers believe the results support the need for genetic tests to confirm which children are likely to respond well to certain medications. This could help doctors provide tailored treatments for children with asthma.

ELF is involved in two EU projects which are currently working to provide more tailored treatments for asthma and COPD. Visit the U-BIOPRED and AirPROM websites to find out more.

COPD

Chronic obstructive pulmonary disease or COPD is a name that should be as familiar to everyone as asthma or lung cancer, as it is one of the most common lung diseases.
What is COPD?

 

 

What causes COPD?

 

Treatment of COPD

Burden in Europe

Areas for action

 

Testimonies

COPD in the news

 

Resources

COPD links

The European COPD Audit

 

Tobacco

At a conservative estimate, tobacco kills more than 650,000 people every year in the European Union alone. Many of these deaths are due to respiratory disease. Action needs to be taken in many forms to reduce this preventable morbidity and mortality.

Tobacco smoking

Quitting and smoking reduction

Different forms of tobacco smoking

Environmental tobacco smoke

Burden in Europe

EU action

Resources

 

Quit smoking links

Tobacco links

Tobacco and smoking in the news

 

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Greece

Airways

Contact

Aegean Airlines

Aegean airlines do not provide oxygen on board their aircraft. However, they will allow you take your own oxygen on board. Your doctor must ring the reservation helpline +30 210 6261000 and will be required to fill out a number of forms to certify that you are fit to fly. The maximum size of the oxygen cylinder is 2 litres and you will need further documentation certifying its suitability for use during the journey.

Olympic Air

 

 

Olympic Air can provide supplementary medical oxygen bottles on board of all aircrafts. Furthermore, passengers can also use their own oxygen bottle on board. In each case, a request will have to be made at least 48 hours prior to departure.

For further information and clarifications, please contact the reservations department at

 

 

 

 

 

 

Smaller Airlines

For the latest information on the smaller airlines please use the contact details below.

Hellenic Imperial Airways

 

Hellenic Imperial airways only provide oxygen in the event of an emergency. Personal oxygen provisions are accepted if they adhere to international standards. A MEDIF form must be completed.

Albania

Airline Contact
Albanian Airlines

 

Tel: +355 4 269021
 Belle Air

 

Belle Air will allow you to take small cylinders of oxygen, no more than 2 litres, on board their aircraft. A medical certificate is required and you must tell them about your condition when making a reservation.

What happens to oxygen and carbon dioxide?

Tiny blood vessels or capillaries surround every air sac in the lungs. The blood vessels surround the alveoli like a net, and this is where oxygen enters the blood and carbon dioxide leaves.

Trading places

Oxygen from the air enters the blood, and carbon dioxide from the body trades places with the oxygen by leaving the blood and entering the alveoli. Carbon dioxide is then exhaled out of the lungs. Oxygen must enter the blood and carbon dioxide must leave the blood at a regular rate for our body to function correctly.

Blood vessels

The lungs also have two sets of blood vessels. Blood vessels can be arteries or veins. One set of blood vessels feeds into and nourishes the lung, whilst the other set is responsible for transporting oxygen from the lung to the body via the heart.

Oxygen around the body

Blood that has collected oxygen from the lungs goes to the left side of the heart and is pumped around the body to deliver oxygen-rich blood (called arterial blood). After the blood has delivered oxygen to the cells of the body (skin, organs, etc.) it is called venous blood, and returns to the right side of the heart. Venous blood contains high amounts of carbon dioxide and small amounts of oxygen. The venous blood returns to the lungs to get rid of carbon dioxide and to pick up oxygen.

 

 

 

Not enough oxygen

When the lungs are unable to take in enough oxygen or oxygen is blocked from getting into the blood, the lung tries to protect itself by shutting down some blood vessels. The heart then has to pump the same amount of blood as usual through fewer blood vessels. This puts added stress on the heart. The back-up of blood causes the heart to work harder and often results in the heart becoming enlarged. This is termed cor pulmonale or right heart failure.

World TB Day 2011

It’s time to break the barriers to a world free of TB

Following on from 2010, World TB Day 2011 enters the second year of a two-year campaign, On the move against tuberculosis whose goal is to inspire innovation in TB research and care.

This year’s campaign aims to look at the fight against TB in an entirely new way: that every step we take should be a step towards TB elimination.

The campaign is inspired by the ambitious new objectives and targets of the Global Plan to Stop TB 2011-2015: Transforming the Fight-Towards Elimination of Tuberculosis, which was launched by the Stop TB Partnership in October 2010.

The event involves people from national tuberculosis control programmes, civil society groups involved in fighting TB, TB-affected communities and any other groups working to stop TB, holding events and engaging in activities to raise awareness of the burden of TB.

Visit the Stop TB Partnership website for more details on how to get involved.

Your stories: what is it like to have TB?

Read Gabriel Ivan’s experience of how he coped and recovered from TB (courtesy of the Romanian Tuberculosis Association).

If you have a TB story that you would like to share with others.

World TB Day history

World TB Day, falling on March 24th each year, is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of several million people each year, mostly in developing countries.

Organised by the Stop TB Partnership, the event is held on the day when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus.

At the time of Koch’s announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people. Koch’s discovery opened the way towards diagnosing and curing TB.

Previous World TB Days

World TB Day 2010: ‘On the move against tuberculosis: Innovate to Accelerate Action’

World Spirometry Day 2010

On 14 October 2010, the first global lung function testing event took place to raise awareness of lung health and disease and encourage as many people as possible to get their lungs tested.

ERS/ELF win PRCA Health and Wellbeing award 2011

The ERS/ELF World Spirometry Day 2010 campaign has been awarded the PRCA Health and Wellbeing Award at this year’s PR-equivalent of the Oscars.

The ERS/ELF worked together with Munro & Forster to deliver a PR campaign, which encouraged healthcare professionals in Europe to organise lung function testing events for the public.

ELF Chair Monica Fletcher said: “We are delighted that the WSD 2010 PR campaign has been recognised with this award. It was great to see what could be achieved in a relatively short time scale with a limited budget. We would like this award to inspire us to make an even bigger noise across the globe in 2012 and we hope that more people that ever will join us in the race for healthy lungs.”

World Spirometry Day (WSD) 2010

 

The event was a huge success and saw a final total of 102,487 tests achieved from a minimum of 490 events in 64 participating countries (as reported).

 

Spirometry testing in Russia

Starter pack

Explains everything you need to know to run an event:

1. Powerpoint presentation on how easy it is to run an event
2. Practical guide to running mass lung function testing in hospitals
3. Practical guide to running larger events to attract the media
4. Checklist to highlight monthly tasks that will make your event a success

Signage and promotional items

The signage and promotional materials pack contains:

1. A banner to put up outside your event to attract passers-by
2. A poster to advertise the event locally
3. A flyer to distribute in nearby shops, surgeries and clinics before and during the event
4. A banner to thank the sponsors of the event
5. A T-shirt design for staff to wear during the event

Files can be downloaded, edited and personalised using either graphic design software or Microsoft Office PowerPoint.

Correspondence

The correspondence pack contains templates for a questionnaire and a letter to GPs.

The questionnaire is used to obtain personal details from each person taking a test. If hand-held spirometers are used, the questionnaire number should be linked to the spirometer.

The letter for GPs is sent when an individual produces abnormal test results. This encourages that individual to seek further advice from their GP and to gain the correct treatment if necessary.

Patient information

The patient information pack contains factsheets that people can read while they are waiting to take a test. The spirometry factsheet explains the lung test in more detail.

Our spirometry video also gives people a good idea of what to expect if they take a test.

Media toolkit

The media toolkit contains a main press release and factsheet that can be sent out over pan-European news wires and used in local campaigns to promote your event.

  • A template press release announcing your event
  • Pan-European press release to use on the day of your event
  • A media relations “how-to” guide
  • A twitter campaign “how-to” guide
  • A calendar of pre-prepared ‘tweets’ in support of World Spirometry Day
  • A follow up template press release to issue after your event
  • Extra creative ideas to maximise event publicity

October 2012

  • Message from ELF Chair, Monica Fletcher:
  • Olaf Tufte and Alex Supple
  • Factsheets
  • Science Update

Message from ELF Chair, Monica Fletcher:

“After the excitement of the annual ERS Congress, the ELF office is returning to business as usual with our on-going projects.

“The EU project, U-BIOPRED, is moving forward and has recently launched a Twitter feed to keep you updated on its latest developments. You can follow the project on Twitter (@UBIOPRED) and don’t forget to use #ubiopred in any of your tweets about the project.

“Following the launch of the European Patient Ambassador Programme pilot at Congress, we are collecting all the feedback we received to make improvements to the programme. We are still on track for the launch in 2013 and we will keep you updated on progress.

To find out more about the programme, visit the ELF website.

“The minutes of the third Patient Advisory Committee meeting, held in Vienna at the ERS Congress, are now available. To find out more about the outcomes and the activities planned for next year, visit the website to view the minutes.

“On a final note, if you are working on any big campaigns or lung health initiatives for 2013, then we’d like to hear from you! Tell us what you are planning and who you are hoping to reach with the campaign and we’ll do what we can to showcase these activities to patients across Europe.”

Olaf Tufte and Alex Supple

Did you miss the ELF Award presentation at the ERS Congress?

You can now watch the video of Olympic rowing champion, Olaf Tufte, and 12-year old Alex Supple from the UK, receiving the annual ELF Award on behalf of all the World Spirometry Day Lung Champions, including Olaf presenting Alex with his official Olympic kit from London 2012.

Factsheets

Preterm birth and the lungs

The latest ELF factsheet on preterm birth and the lungs is now available in 9 languages.

Upcoming factsheet: Work-related lung disease

We are currently working on our next factsheet covering the topic of work-related lung disease.

If you would like to be involved, either by posing some questions for the factsheets, volunteering to review the factsheets or by sharing existing material on the topic, please contact us.

Russia

Airline

Contact

Aeroflot

Aeroflot can only provide oxygen on board before and after the flight and in cases of an emergency. They do not allow you to take your own oxygen on board their aircraft.

 Domodedovo Airlines

 

Domodedovo Airlines does not provide oxygen on board their aircraft and does not allow you to carry your own oxygen on board.

 

 Rossiya airlines

Rossiya airlines does allow you to take your own oxygen cylinders on board their aircraft and this must be arranged at the time of booking.

 Sibir Airlines (S7)

S7 Sibir Airlines allow you to take your own oxygen on board their aircraft. This must be less than 10 kg in weight and you must inform the arline at the time of booking.

Transaero

Transaero will allow you to bring your own oxygen on board their aircraft. However, they will also provide this service free of charge at a flow rate of 2 or 4 litres per minute. This service must be ordered at the time of booking. A form must be also be completed by your doctor stating the need of oxygen and the flow rate required.

 Ural Airlines

Ural Airlines can only provide emergency oxygen but allow you to bring your own oxygen on board the flight. They must be informed on the bulk size of the cylinder to see whether that particular cylinder can be brought on board. A certificate on the expiry date of the cylinder will also be required (written in Russian). A medical certificate will also be required; this must contain both the hospital stamp and doctors signature.

 

 

UTair

UTair does not allow you to take your own oxygen on board their aircraft. However, they provide oxygen for an additional fee (dependant on journey distance). To accommodate this, you must let them know during the booking stage.

Austria

Airline Contact
Austrian Airlines

 

Austrian Airlines allow you to bring your own portable oxygen concentrators on board their aircraft. Please call the Special Cases Desk on +43 (0) 517 665 1043 at least 48 hours before your flight so they can accommodate your requirements. The following portable oxygen concentrators are allowed:

– Lifestyle
– Freestyle
– Eclipse
– Inogen One
– Inogen One G2
– Invacare XPO2
– SOLO²
– Evergo
– Delphi RS-00400
– iGo
– LifeChoice
– Oxlife Independence Oxygen Concentrator

Lauda Air

Lauda Air does not allow you to use your own oxygen cylinders on board their aircraft but will provide oxygen at a cost of 700 euros for a transatlantic flight.

Oxygen must be ordered when making a reservation and a series of forms may need to be completed by your doctor, stating the flow rate you require and necessity of the oxygen.

LTU Austria

LTU International Airways provides oxygen on board their aircraft at an additional cost of 100 euros per flight. You may also bring your own oxygen on board but it cannot exceed 2 litres (maximum weight 8kg, maximum dimension 55x45x20cm).

A medical certificate provided by your doctor will be required for both the use of LTU oxygen and your own oxygen cylinders.

Liquid oxygen is not permitted on board the aircraft.

Niki

 

Niki is a partner of Air Berlin and has the same oxygen policy.

Niki does not provide oxygen on board its aircraft. However, they will allow you to bring your own oxygen cylinder or portable oxygen concentrator on board. You cannot fly if you require continuous oxygen. To book oxygen, a medical certificate needs to be signed by your doctor at least 48 hours before your flight.

At the moment only the following portable oxygen concentrators are allowed on Air Berlin flights:

– Airsep “Lifestyle”
– Inogen One
– Airsep “Freestyle”
– SeQual Eclipse oder SeQual Eclipse 2
– Inc. Respironics Evergo
– Delphi Central Air
– Invacare XPO2
– iGO
– LifeChoice
– Inogen One G2
– Indepence Oxygen Concentrator

Tyrolean Jet Services

Tyrolean Jet Services does not allow you to use your own oxygen cylinders on board their aircraft but will provide oxygen  at a cost of 700 euros for a transatlantic flight.

Oxygen must be ordered during reservation and a series of forms may need to be completed by your doctor, stating the flow rate you require and necessity of the oxygen.

Smaller Airlines

For the latest information on the smaller airlines please use the contact details below.

Air Alps

Air alps does not provide oxygen on board their aircraft and does not allow you to carry your own oxygen on board.

InterSky

 

Tel: +43 05574 48800 46
Welcome Air

 

Tel: +43 0 512 295296

 

Asthma in the news

07/07/2011 Asthma in children linked to depression during pregnancy

Women who are stressed or depressed during pregnancy could have an increased risk of their child developing asthma.

01/07/2011 Herbal medicine shown to reduce asthma symptoms

A traditional herbal medicine has been shown to reduce inflammation in people who suffer from asthma caused by allergens.

29/06/2011 New trial tests Botox as a treatment for asthma

A new medical trial in Australia is set to test whether Botox can be used to help people with asthma breathe more easily.

23/06/2011 Vitamin A deficiency does not affect onset of asthma

Vitamin A deficiency does not increase the risk of asthma, according to new research published in the European Respiratory Journal.

20/06/2011 Higher immunity to colds makes asthma worse

Scientists have found that increasing immunity in the body, using nutritional supplements, cold remedies and fortified foods, can cause an exacerbation of symptoms for people with asthma.

14/06/2011 Cockroaches could cause asthma in children

Cockroaches have been identified as a possible cause for high rates of asthma in certain neighbourhoods in New York City, USA.

10/06/2011 Mouldy homes linked to children’s asthma

New research has found that mouldy homes could be linked to asthma in children.

08/06/2011 UK doctors begin pioneering asthma treatment

Doctors in Manchester and Glasgow have started treating NHS asthma patients with a new treatment which is said to “melt away” muscle in the airways.

11/05/2011 Asthma risk higher in babies born early

Babies born early could be at a higher risk of asthma during childhood and adolescence, according to a new study.

05/05/2011 Asthma pill as effective as inhalers

New research has suggested that a pill to treat asthma is as effective as inhalers in managing asthma symptoms, and is much easier to use.

Preterm birth and the lungs

In recent years, the number of children surviving premature birth has grown. This means that there is potential to be an increase in the number of children and adults in the future with lung problems due to prematurity.

This fact sheet looks at how preterm birth affects the lungs, what can be done to reduce the impact of problems associated with preterm birth, both as an infant and later in life, and advice for parents of prematurely born babies.

What is preterm birth?

The average pregnancy lasts for approximately 37-42 weeks. When a baby is born before the completed 37 weeks of pregnancy, it is considered preterm. Those born before the 28th week of pregnancy are considered extremely preterm.

Severity of preterm birth Week of Pregnancy
Late preterm 34 – 36 weeks
Moderately preterm 32- 33 weeks
Very preterm 28 – 31 weeks
Extremely preterm Less than 28 weeks

75% of preterm births are born after 32 weeks, although the babies with the most severe health problems are seen within the ‘extremely preterm’ category.

Nearly 15 million babies worldwide and about 500,000 babies in Europe are born preterm each year, one in ten. In the light of these numbers, preterm infants represent Europe’s largest child patient group and preterm
birth has become the major cause of infant death and disabilities from birth in both developed and developing countries.

Are there any risk factors associated with preterm birth?

In about half of all cases of preterm birth, the exact cause of the early delivery remains unknown. However, a number of risk factors have been identified which are likely to increase the chances of preterm labour, such as maternal infections, very young or very old (aged under 17 or over 35) mothers, smoking and even passive smoking.

What health problems could affect babies born preterm?

Compared with full-term babies, preterm infants are at greater risk of developing health complications. The earlier the baby is born, the less developed its organs will be, and the higher the risk of medical complications later.

These include cerebral palsy, sensorial and motor disabilities, learning and behavioural disorders and, commonly, problems with the lungs.

How is preterm birth linked to lung disease?

The lungs are one of the last organs to develop as a baby is growing inside the womb. This means that when a baby is born prematurely his/her lungs are not fully developed which may lead to both short and long-term ‘health problems’.

Short term problems

Bronchopulmonary Dysplasia (BPD)

The most common lung disease affecting preterm babies is a condition known as Bronchopulmonary Dysplasia (BPD).

It is characterised by rapid breathing, shortness of breath and gasping and coughing to get more oxygen. The condition usually develops as a consequence of preterm babies being given mechanical ventilation. This is when ventilators breathe for the baby until the lungs can do it themselves. Although this process is often essential to the survival of the baby it can damage the baby’s lungs, causing inflammation leading to the development of BPD. BPD can be a temporary condition, but for some children, symptoms can persist into adulthood, increasing the risk of developing chronic lung disease such as chronic obstructive pulmonary disease (COPD).

Respiratory distress syndrome (RDS)

RDS is the leading cause of death in babies born prematurely. It occurs in babies whose lungs are not fully developed and is mainly caused by a lack of a protective substance called surfactant.

© EFCNI

This substance helps to keep a baby’s lungs inflated with air and when babies suffer a shortage of it, they need to be given oxygen through a tube and a substitute for surfactant. RDS can lead to a higher risk of developing BPD and severe respiratory infections in the first two years of life and an increased likelihood of asthma later in life.

Respiratory syncytial virus (RSV)

Nearly all babies will contract RSV by the time they are the age of two. For most babies who are born at full term, the symptoms of the virus are similar to a common cold. Full-term babies get antibodies from their mothers during pregnancy which help to fight RSV and other viruses. However, when a baby is born even only a few weeks early, they do not get enough of these antibodies before birth.

This lack of antibodies, combined with the fact that the lungs are not yet fully developed, means that prematurity is the greatest risk factor for severe RSV infection. The symptoms of the virus may include persistent coughing and wheezing, high fever and sudden gasping for breath. If your baby is showing these  symptoms, it is important you contact your doctor as soon as possible. Parents can help prevent their babies contracting the infection by prophylaxing their preterm baby against RSV and encouraging those in close contact with the baby to regularly wash their hands, especially before touching the baby, and by cleaning toys, bedding and play areas frequently. They should also prevent anyone smoking near their baby.

Long-term problems

Experts are currently unsure about the long-term effects of preterm birth. Medical advancements have led to more babies surviving longer, especially extremely pre-term babies who are now surviving.
As this has been a relatively recent development, researchers have not yet been able to assess the long-term impact of preterm birth on the lungs.

There has, however, been research into the effect of preterm birth on school-age children, which has shown that children born prematurely have a lower exercise capacity compared with other children their age born at full term, an increased risk of developing allergic asthma, general reduced lung function and more airway obstruction problems.

What is the impact of these health consequences?

When a baby is born prematurely, they will immediately be taken to a special care baby unit (Neonatal Intensive Care Unit), so that a specialised healthcare team can provide individualised care. This can be very distressing for parents as they are separated from their baby so soon after birth, in addition to their baby arriving unexpectedly early.

Parents may be sent home while their baby remains in hospital, or they may be able to return home with their baby and administer oxygen therapy or other treatments from the home. Families caring for a preterm baby often have to face psychological, financial and social costs linked to the long-term health problems of caring for their child.

The effects of preterm birth varies greatly between countries and over the last few decades the survival gap for babies born in high-income countries and babies born in the poorest countries has widened dramatically. Many preterm babies, especially those born before 28 weeks, experience related health problems into their adult life, which can be a great social and financial cost to the individual, their family and society.

What can be done to reduce the impact of problems associated with prematurity?

Follow-up plan of care and aftercare programme

A key area for improvement in care for preterm babies with lung problems is to carry out a structured follow-up plan and aftercare programme for treatment, documenting medical checks and aftercare.

This means when one aspect of the child’s illness has been dealt with, it is important for that doctor to pass on the relevant history of the baby’s illness to the next person to care for the baby. Healthcare professionals should also be able to assist parents at home, through training and education. Whilst this is done well in some countries, some other health care systems do not have an effective follow-up plan in place.

Monitoring for infections

Another important area for improvement is improving awareness of the risk of lung infections. If an infection
is identified early, it is much easier to manage them.

Better support for parents

Parents can often be left feeling helpless when their baby is seriously ill after birth. It is important for them to receive the best information possible and to be signposted to local parent support groups so they can hear experiences from others.

If parents and families feel supported they will be better able to manage the potential impact of having a preterm child. If you are faced with the pressure of caring for a baby who has been born prematurely. You may have many questions and it is important for you to feel supported during this time. There are parent organisations across Europe, who can provide support networks and information for parents relevant to your country.

The European Foundation for the Care of Newborn Infants (EFCNI) is the first pan-European organisation and interactive network to represent the interests of preterm and newborn infants and their families. It gathers together parents, healthcare professionals and stakeholders from different disciplines with the common goal of improving long-term health of preterm and newborn children by ensuring the best possible prevention, treatment, care and support.

This material was compiled with the help of Professor Gunilla Hedlin, Dr. Kajsa Bohlin, Katarina Eglin from Fruehgeborene and experts from the European Foundation for the Care of Newborn Infants (EFCNI).

 

Spain & Gibraltar

Air Europa

Air Europa does not provide oxygen on board their aircraft and does not permit the use of oxygen cylinders. However, they do allow you to take your own portable oxygen concentrators on board at no extra cost. Please let them know at the time of booking or at least 48 hours prior to your flight.

Portable oxygen concentrators allowed include:
– AirSep FreeStyle
– AirSep LifeStyle
– Delphi RS-00400
– Inogen One
– Invacare XPO2
– Respironics EverGo
– SeQual Eclipse.

Air Nostrum

Air Nostrum does not allow you to bring your own oxygen on board the aircraft but can supply oxygen at an additional cost of 180 euros. They provide flow rates of 2, 4 and 8 litres per minute. Iberia must be contacted at least 48 hours before departure to reserve this service and they must be provided with your requirements. A medical certificate confirming that oxygen is required for medical reasons must be produced at check-in.

Gestair

Gestair allow you to take your own oxygen on board at no extra charge. They will also provide oxygen at an additional cost of 150 euros per flight. They can provide flow rates of 2, 4 and 8 litres per minute. Please let them know during the time of booking or at least 48 hours before departure. A medical certificate confirming that oxygen is required for medical reasons must be produced at check-in.

 Iberia Airlines

Iberia does not allow you to take your own oxygen on board their aircraft. However, they will provide this at an additional fee. You must make a request and submit a medical form as soon as possible.

Spanair

 

Spanair does not provide oxygen on board their aircraft and does not allow you to carry your own oxygen on board.

Smaller Airlines

For the latest information on the smaller airlines please use the contact details below.

Poland

Airline Contact
Aerogryf

 

Aerogryf does not provide oxygen on board their aircraft and does not allow you to carry your own oxygen on board.

EuroLOT

EuroLOT will allow you to take your own oxygen and can also provide it on board. If you wish to use your own, the cylinder must be less than 1.5 litres. If you require continuous oxygen, oxygen must be ordered through the airline. There is an additional charge of 150 euros per flight on a short hauls and 250 euros per flight on long hauls. In-flight oxygen must be ordered at least 7 days in advance. A MEDIF form will also need to be submitted by fax.

LOT Polish Airlines

EuroLOT will allow you to take your own oxygen and can also provide it on board. If you wish to use your own, the cylinder must be less than 1.5 litres. If you require continuous oxygen, oxygen must be ordered through the airline. There is an additional charge of 150 euros per flight on a short hauls and 250 euros per flight on long hauls. In-flight oxygen must be ordered at least 7 days in advance. A MEDIF form will also need to be submitted by fax.

Wizz Air

Wizz Air does not provide additional oxygen on board their aircraft. You may carry your own oxygen, provided Wizz Air receives a medical confirmation that the you are fit to fly and you must be accompanied by an escort.

Belarus

Airline

Contact

Belavia

Belavia does not provide oxygen on board their aircraft but will allow you to take your own on board.
To book oxygen, you will need to fill out a number of forms that state the necessity for additional oxygen and that you are fit to fly.

 

Smaller Airlines

For the latest information on the smaller airlines please use the contact details below.

Gomelavia

 

Tel: +375 232 96 46 77

 

February

Scientific findings published in the ERJ in February.

 

  • COPD patients exercise less as their condition worsens
  • Antibiotics may improve COPD survival

COPD patients exercise less as their condition worsens

The amount of exercise that chronic obstructive pulmonary disease (COPD) patients are able to do, gives doctors an idea of how serious their disease may be. Patients with severe COPD can have limited activity but doctors do not yet know at what specific stage exercising becomes difficult.

Doctors use a system called GOLD to describe how serious someone’s COPD is. GOLD Stage 1 describes someone with mild COPD who does not show many symptoms and may not even know that their lungs are not working normally. Symptoms progress through GOLD stages 2 and 3 until Stage 4, which describes very severe COPD with restricted breathing and regular symptoms.

A German team studied 163 COPD patients and 29 patients with chronic bronchitis to compare how much exercise patients could do at different stages of COPD. Patients wore an armband that measured the number of steps they took each day and how much exercise they did for 5 days. The researchers tried to find out whether the amount of exercise completed was linked to how bad their conditions were, to decide whether exercise is a reliable measure of COPD stage.

Mild COPD patients and those who became breathless with exercise were less likely to walk any distance compared to patients with chronic bronchitis. Patients with severe and very severe COPD and those who became very short of breath with little exercise were most likely to be the least active when all the patients in the study were compared.

Exercise becomes more difficult for COPD patients when their condition is moderately severe and it is harder for them to breathe (GOLD stage 2). The amount of exercise completed by patients with severe COPD patients (GOLD stage 3) was significantly less compared with patients with mild COPD (GOLD stage 1).

However, characteristics used to consider how bad COPD is, do not always accurately match the amount of exercise that the patient is able to do. Peer-pressure and the weather may also influence exercise participation, so it might be useful to consider these things for future studies.

Antibiotics may improve COPD survival

Studies have shown that treating severe chronic obstructive pulmonary disease (COPD) with corticosteroids and/ or antibiotics – greatly improves recovery at times when a patient experiences worsening symptoms (this is called an exacerbation). A team of scientists in the Netherlands has studied the long-term risk of regular exacerbations in primary care COPD patients who received oral corticosteroids with and without antibiotics. All of the patients who took part in the study were on maintenance respiratory drugs, were at least 50 years old, and had been treated for worsening symptoms.

Of the 842 patients studied, just under half were treated with corticosteroids after the first sign that symptoms were getting worse and just over half were treated with corticosteroids and antibiotics (using an antibiotic called doxycyclin in half of the cases).

A total of 595 patients had a second exacerbation and 450 patients had a third exacerbation during the study.

The amount of time that passed between exacerbations was recorded. Time between the first and second occasions of worsening symptoms was similar amongst the two patient groups. However, the time taken between the second and third occasions of worsening symptoms was significantly shorter in patients who did not receive antibiotics and so these patients were likely to deteriorate more quickly than patients who were taking antibiotics with corticosteroids. Analysing all exacerbations, the risk of a subsequent exacerbation was lower after treatment with antibiotics added to corticosteroids.

Furthermore, a survival benefit was shown in the patient group treated with oral corticosteroids and antibiotics at first exacerbation during follow-up.
The use of antibiotics prescribed without a course of oral corticosteroids, irrespective of the indication, almost halved the risk of a subsequent exacerbation.

Exacerbations can occur when bacteria are present. Antibiotics kill these bacteria so exacerbations may occur less often. Patients with severe COPD are likely to have a lot of bacteria present in their lungs. If the time between exacerbations can be increased, a patient’s health will not deteriorate as quickly and they will have a better quality of life.

If future studies confirm that antibiotics delay worsening symptoms and increase the lifetime of some COPD patients, there may be many changes to how doctors treat COPD patients when they have exacerbations.

Methods of preventing respiratory infections

Personal hygiene, such as washing your hands with soap and plenty of water, remains the most effective way to prevent this.

Other recommendations:

  • use a handkerchief or disposable napkin if you sneeze. The symptoms will not go away, but it can prevent the infection from spreading;
  • avoid touching the face, especially the eyes and mouth, to prevent germs from entering the body;
  • avoiding communities-work, kindergarten, school, crowded, enclosed spaces;
  • increase the intake of vitamins in the diet, especially vitamin C-necessary to strengthen the immune system;
  • elimination of nicotine and alcohol consumption;
  • administration of bee products (in case of food tolerance and absence of allergy to these products).

Types of infections of the lower respiratory tract

  • Influenza (may affect both the upper and lower respiratory tract);
  • Bronchitis (respiratory tract infection-causative agent adenovirus);
  • pneumonia (lung infection – adenovirus, pneumococcal);
  • bronchitis (infection of the small airways that affects infants and children under two years of age-the causative agent of rhinovirus, respiratory syncytial virus);
  • Tuberculosis (persistent bacterial infection of the lungs). Cough is a major symptom of lower respiratory disease and can usually be accompanied by mucus. Other possible symptoms include tightness in the chest, shortness of breath, shortness of breath (feeling short of breath), wheezing.

Treatment of respiratory infections

Most respiratory infections do not require treatment. Symptoms can be treated with symptoms (OTC): paracetamol, ibuprofen, plenty of fluids and rest at home. Apifitotherapy (tincture of propolis, pasture, Acacia, pine, fir, honey from alfalfa, beehive aerosols) is recommended.

Hot teas will be consumed: sea urchin, field horsetail, lanceolate, chamomile, to which you can add lemon to get additional vitamin C. in most diseases of the respiratory system, antibiotics are not recommended, they work only if the infection is caused by bacteria or as a result of secondary infection. Symptoms of upper respiratory disease usually resolve after a week or two.

Dirty air indoors and your lungs

All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

In English

Auf Deutsch

En Francais

En Espanol

In Italiano

По-русски

Po polsku

στα Ελληνικά

Dirty air indoors and your lungs

Author
This information was written and compiled by the European Respiratory Society (ERS) Environment and Health Commitee.
Co-funding and production and content support for this publication has been provided by the Health and Environment Alliance (HEAL), through DG Environment, European Commission.

Lung infections could be detected by breath test

Researchers have found that different types of lung bacteria can be identified from breath tests.

A new study, published in the Journal of Breath Research, analysed exhaled breath samples from mice infected with different types of bacteria that cause lung infections.

The researchers were looking for particles in the breath known as volatile organic compounds (VOCs) given off by different bacteria.  They were able to detect the mice with the bacteria and those that were uninfected.

The results could lead to a successful, non-invasive way of identifying lung infections.

A child’s risk of early asthma affected by pollen exposure during pregnancy

A woman’s exposure to high pollen levels in late pregnancy increases the risk of early asthma in the child, according to a new study.

A number of studies have previously shown that there is an association with being born during a pollen season and an increased risk of allergies.

The new research, published in the Allergy, Asthma and Clinical Immunology Journal, involved 110,000 pregnancies in Stockholm, Sweden, to look at the significance of actual pollen content in different time periods before and after birth and its impact on asthma risk in children.

The study found that high levels of pollen exposure during the last 12 weeks of pregnancy resulted in a significantly increased risk of hospitalisation for asthma symptoms in the first year of the child’s life.

Respiratory infections

Respiratory infections are the most common disease in cold seasons and can be fatal for some people. In our article you will learn what you can do to stay healthy. The key words are: hygiene, avoiding congestion, increasing the intake of vitamins.

Respiratory infections affect the sinuses, throat, Airways and lungs. They are usually caused by viruses, but can also be caused by bacteria. This type of disease occurs most often in transition periods, especially in cold seasons.

What are respiratory infections and who are they affecting?

There are two categories of respiratory infections:

  • upper respiratory tract infections: affects the nose, sinuses and throat.
  • lower respiratory tract infections: affects the airways and lungs.

Children are more susceptible to upper respiratory disease than adults because their immune systems are underdeveloped. This condition is widespread throughout the world. Acute respiratory infections can get worse in a very short time in children, the elderly and people with reduced immunity. In this case, specialist treatment is required. According to the World Health Organization (who), acute respiratory infections kill an average of 2.6 million children worldwide each year.

How are respiratory infections transmitted?

Respiratory infections can be transmitted in several ways:

  • small airborne particles of pathogenic fluid transmitted by coughing or sneezing (viruses);
  • indirect contact: an infected person may pass the infection through the eye or nasal secretions to another person who will later use the same object (touching the eyes or nose before using common objects-a keyboard, a handle, a stick in the middle of transport).

Types of upper respiratory tract infections

  • Cold / cold (the causative agent is adenovirus);
  • Tonsillitis;
  • sinusitis;
  • laryngitis;
  • Flu.

Cough is the most common symptom of these conditions. In addition, other possible symptoms include nasal congestion, headache, nasal congestion and runny nose, sore throat, sneezing and muscle pain.

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First suspected person to person transmission of new bird flu virus in China

The first case of person to person transmission of the new avian influenza, the A (H7N9) virus, was reported in Eastern China in a study published this week.
The authors of the new study, published in the British Medical Journal, stressed that H7N9 is still not able to spread efficiently between humans.

Avian influenza A (H7N9) virus was recently identified in Eastern China. As of 30 June 2013, 133 cases have been reported worldwide, resulting in 43 deaths.

Most people who contracted the virus appear to have visited live poultry markets or had close contact with live poultry 7-10 days before they start to feel unwell.

The study includes analysis from two patients with the virus. The first patient – a 60 year old man – regularly visited a live poultry market. The second patient, his healthy 32 year old daughter, had no known exposure to live poultry before becoming sick. However, she provided direct and unprotected bedside care for her father in the hospital before his admission to intensive care.

The findings provide the strongest evidence yet of H7N9 transmission between humans, but the authors stress that its ability to transmit itself is “limited and non-sustainable.”

Asthma in the news

04/05/2011 WHO report shows deaths from non-infectious diseases on the rise

Diseases such as cancer, chronic lung disease, and heart disease now cause more deaths than all other diseases combined, according to a report from the World Health Organisation (WHO).

03/05/2011 UK doctors need more training to treat asthma

Doctors in the UK do not receive enough training in treating asthma, according to a new study released on World Asthma Day.

12/04/2011 New inhaler helps monitor cause of asthma attacks

People with asthma are set to benefit from a novel way of monitoring and treating their disease, thanks to a researcher in the USA.

01/04/2011 New vaccine could bring cure to asthma caused by dust mites

A vaccine that could completely cure asthma caused by house dust mite allergies is being developed by Australian researchers.

28/03/2011 Children with asthma need more help with inhalers

Fewer than one in 10 children with asthma use inhalers correctly, according to new research.

23/03/2011 Study finds that protein IL-13 stimulates fibroblast cells to invade the airway of asthma sufferers

According to researchers in the USA, changes that occur in the airways of people with asthma are, in part, caused by the naturally occurring protein interleukin-13 (IL-13).

21/03/2011 Gender influences lung defects in children

Differences in lung defects have been linked to gender in a new study carried out by researchers in the USA.

18/03/2011 Anti-asthma drug could limit seasonal attacks

Children and young adults with allergic asthma could benefit from new anti-asthma medication, according to the latest research.

03/03/2011 Environmental tobacco smoke education could benefit children with asthma

Children who have a high risk of asthma exacerbations may benefit from receiving education about environmental tobacco smoke from their carers, according to new research.

16/02/2011 Mild asthma might not need to be treated daily

Mild asthma might not need to be treated every day according to new research.

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New 3D computer lung model develops understanding of unknown lung region

Research published this week in the online early edition of the Proceedings of the National Academy of Sciences will enable scientists to simulate the pathway of drug treatments with inhalers in a poorly understood area of the lung.

The airways of all mammals include an area known as the pulmonary acinus, which looks like a bunch of grapes attached to a stem (acinus means “berry” in Latin). Scientists have struggled to understand what exactly happens in this microscopic, maze-like area of the lung system.

A research team led by the University of Iowa in the USA has created a detailed, three-dimensional rendering of the pulmonary acinus. The computerised model developed from mice, which have a very similar respiratory system to humans, is an accurate model of every twist and turn in this region, including the length, direction and angles of the respiratory branches that lead to the air sacs called alveoli.The model is important, because it can help scientists understand where and how lung diseases emerge as well as the role the pulmonary acinus plays in the delivery of drugs, such as those commonly administered with inhalers.

“These methods allow us to understand where in the lung periphery disease begins and how it progresses,” says Eric Hoffman, professor in the departments of radiology, medicine and biomedical engineering at the University of Iowa and co-author on the paper. “How do gases and inhaled substances get there and do they accumulate in one or another acinus? How do they swirl around and clear out? We just don’t have a complete understanding how that happens.”

Hoffman and Dragos Vasilescu, first author of the research paper, say that the model could be used to determine how smoking-induced chronic obstructive pulmonary disease originates and improve understanding of the region leading to more effective treatment of chronic obstructive pulmonary disease.

Previous models could replicate the structure of the lung in real life but could not convey how various parts act together as a whole. Advances in imaging and computation have enabled researchers to more fully explore how gases and other inhaled substances act in areas of the lung that were previously too complex to model.

The researchers’ next aim is to use the model to more fully understand how gases interact with the bloodstream within the acini and the alveoli.

Spirometry events

The ELF holds an annual public lung function testing event in the city where ERS holds its annual conference.

What?

ELF/ERS Spirometry event: test your lungs

When?

03/10/2008 13:00 – 22:00
04/10/2008 10:00 – 20:00
05/10/2008 10:00 – 18:00

Where?

Straße des 17. Juni, Berlin, Germany

 

Spirometry testing event, Berlin 2008

This year’s European Lung Foundation (ELF)/ European Respiratory Society (ERS) spirometry event will take place in Berlin, Germany at the ERS Congress. The ELF would like to express its sincere thanks to Boehringer Ingelheim for its financial support, without which the event would not be possible.

Spirometry is a test of how well you can breathe and can help in the diagnosis of different lung diseases. The test is painless and usually takes less than 10 minutes, but requires some hard blowing. You breathe into a small device called a spirometer, which measures the amount of air you can blow out of your lungs and how fast this can be done.

If you choose to have your lungs tested, you will be seen by a nurse or doctor in an individual booth. They will explain and demonstrate the test before you are asked to blow into the spirometer as hard as you can.

This public lung function testing event will be held on Straße des 17. Juni, between the Brandenburg Gate and the Victory Column. It will be run by the ELF in collaboration with the Deutsch Gesellschaft für Pneumologie (DGP), Deutsch Atemwegsliga (AWL) and the Deutsche Lungenstiftung (DLS). The event aims to encourage people to think about the health of their lungs and to raise awareness of chronic obstructive lung disease (COPD).

The spirometry event coincides with the celebrations of the Day of German Unity so if you are visiting the area, why not come along and test the strength of your lungs? Testing starts at 13:00 on Friday 3 October and finishes on Sunday 5 October at 18:00.

We very much hope to smash last year’s record of 2,882 people tested so please pay us a visit and help us achieve our goal!

Spirometry testing event, Stockholm 2007

This year’s European Lung Foundation (ELF)/ European Respiratory Society (ERS) spirometry event took place in Stockholm’s central railway station during the 17th Annual Congress in Sweden, which attracted over 15,000 respiratory professionals to Stockholm.

The main aim of the event was to raise awareness of lung health among local citizens.

The excellent central location encouraged commuters and shoppers of Stockholm to find out about lung health and disease and to learn about chronic obstructive lung disease (COPD).

The event was open for a total of 24 hours over 2 days, in an attempt to beat last year’s record of 2042 individuals, tested in Munich, Germany. Members of the public who had decided to have their lungs tested were seen by a volunteer nurse, in 1 of 18 individual booths. Individuals were asked to blow as hard as they could for 6 seconds into a hand held spirometer. Several doctors and representatives from smoking cessation groups were available on site for individuals to speak to if they wanted any further advice or information.

3 blows were taken from each person to produce an accurate average FEV1 reading. FEV1 is an indication of how much air can be forced out of your lungs in 1 second after taking a deep breath, to provide an important measure of pulmonary function.

The event proved to be hugely popular and attracted passers by and local workers who were happy to visit during lunch breaks and wait, despite the queues. The final number of individuals tested was 2882, 85.5% of whom showed acceptable FEV1 measurements.

Members of the general public who were found to have restricted airways were given guidance from doctors and advised to visit their own GP with the information produced from their lung test

Thank-you to all the taskforce whose hard work and support made this year’s event a record success. Our aim of beating last year’s total was easily achieved and has raised the standard for next year in Berlin!

Sincere thanks to the following partners:

• The Stockholm Task Force, including the Congress Chairs, and Inger Kull and Anne Renström,
• All volunteer nurses and doctors for pledging their valuable time.
• The generous financial support of Boehringer Ingelheim GmbH, without which the event would not be possible.
• The generous contribution of equipment and professional support from ndd Medizintechnik AG.
• The collaboration of Järnhusen AB and JC Decaux, for allowing the event to take place in the Central station.
• Dohrns exhibitions and Mix PR for their hard work on the project.
• Swedish patient interest groups and lung foundations for contributing to the local lung health awareness campaign.

Spirometry testing event, Munich 2006

Munich “blows” for healthy lungs: This was the slogan for the 2006 European Lung Foundation (ELF)/ERS spirometry event, which took place in Munich city centre on the Odeonsplatz on Friday and Saturday, September 1 and 2, 2006.

The event aimed to raise public awareness of lung disease in general and COPD in particular, as part of the ELF’s mission to promote lung diseases to the public on behalf of the ERS.

Record results

The final number tested was over 2,000 – a new record for this event. For the first time, the results from all the tests are going to be combined with the questionnaires completed by each participant.

Copenhagen 2005

In Copenhagen in 2005, the Spirometry Tent was set up in the Town Hall Square in the centre of the city.

Over 1000 members of the public had their lungs tested and 1 in 4 of those who took the test discovered they had some kind of airway obstruction.

Movies

Movies are shown here that were produced using several different techniques, including CT scanning. They show different aspects of the chest, lungs and airways.

The chest without the lungs

chest without the lungsThis movie shows the rib cage, the heart and all the major blood vessels of the lungs.
The lungs have been removed to show this more clearly.

The lungs

the lungsThis movie show the lungs that were removed for the movie above.

The contours of the lungs can be seen around 360 degrees.

The lungs and the airways

lungs and the airways This movie shows the same lungs as above.

However, the airways can be seen more clearly in this movie.

Fly through the airways

virtual bronchoscopy

This movie shows a virtual inspection or virtual bronchoscopy of the airways of the lungs.

CT scan of the chest

CT scan of the chest This movie shows a computed tomography (CT) scan. It shows slices through the chest from top to bottom. The airways of the lungs, the blood vessels of the lungs and the parenchyma can be seen.

2010

ERS Congress 2010 – Barcelona, Spain

The 20th ERS Congress was held in Barcelona, Spain at the outstanding FIRA Barcelona Exhibition centre.

 

 

The Congress attracted a record-breaking attendance of well over 22,220 delegates, who visited from all over the world to attend a comprehensive programme of scientific sessions from expert respiratory speakers.

The 2010 European Lung Foundation Award was presented to MEP Catherine Stihler, on behalf of the 35 MEPs who have signed the Tobacco Free Europe pledge, which reaffirms the right of all people to the highest standards of health.

Testimonies

These pages are provided for people to post their experiences or queries on any aspect of lung health or lung diseases. We hope that you can provide inspiration and information for each other on these pages.

Asthma testimonies

COPD Testimonies

Lung cancer testimonies

Pneumonia testimonies

Tubercolosis testimonies

Cystic fibrosis testimonies
Interstitial Lung Diseases testimonies

 

ERS School

The ERS School is composed of ERS Assembly secretaries who are responsible for the educational activities of the ERS.

Visit the ERS website to see the current members of the School Committee.

Pakistan introduces pneumonia vaccine to help cut child deaths

Pakistan is set to become the first country in south Asia to introduce the pneumococcal vaccine to protect children against pneumonia, one of the biggest killers of children aged under five years in the developing world.

The latest UN estimates indicate that pneumococcal disease accounts for 18% of child mortality; the primary cause of death among young children globally.

The new pneumococcal vaccine is expected to prevent a significant proportion of pneumonia cases, and has the potential to save tens of thousands of lives.

For the first three months, the pneumococcal vaccine is due to be rolled out in the Punjab province, where half of Pakistan’s population lives.

The pneumococcal vaccine has been administered in 16 developing countries to date, most of them in Africa. Bangladesh is set to implement the vaccination programme next year.

ERJ

Scientific findings published in the ERJ in March 2011

Reducing the side-effects of CPAP treatment for sleep apnoea

People with obstructive sleep apnoea use continuous positive airway pressure (CPAP) to help them breathe normally whilst they are asleep. CPAP generates a continuous airstream to keep the airways open and provides many benefits, including an improved quality of life and cardiovascular health.

However, side effects such as a blocked, dry or runny nose can occur as a result of using the treatment and can counteract the benefits it provides.

Greek researchers have uncovered the cause of adverse side-effects in the nose linked with using CPAP to treat sleep apnoea. The researchers demonstrated that the warming and moistening of air inhaled through CPAP can help to reduce these side-effects. Although previous research has shown that warming the CPAP airstream can benefit people with sleep apnoea, this is the first study that has examined how the heated air can improve symptoms.

A total of 20 people with sleep apnoea, who were already using CPAP treatment, were split into two groups: one group received 3 weeks of CPAP with a heated airstream, and the other group received normal CPAP, with no heating. The groups’ treatments were then swapped. The participants completed questionnaires to explain whether they experienced a runny nose, sneezing, an impaired sense of smell and/or a blocked nose. The researchers also measured resistance in the nose to the airflow from CPAP and analysed tissue taken from the nose.

The study found that heating the CPAP airstream can decrease the amount of inflammation in the nose and associated symptoms, as well as reducing any resistance to the airflow. These results also support a previous study which provided evidence that congestion and other symptoms in the nose are caused by the inflammatory effect of CPAP on nasal mucus.

The findings suggest that anti-inflammatory drugs might be used alongside CPAP in the future to help ease adverse symptoms, but further studies will be needed to investigate this.

ELF Reception, 27 September 2011

During the ERS Amsterdam Congress, patient organisations were invited to an ELF Reception, which was an informal opportunity for them to meet and discuss potential collaborations with other patient organisations, how to influence the future ERS agenda and meet the ERS leadership.

Some of the patient organisations gave presentations about the work that they are currently carrying out in their individual countries and explained how these projects may be useful to other European organisations.

The presentations can be downloaded below for further information.

1. Romanian TB Patients’ Association (ARB-TB)

During the ELF Reception at this year’s ERS Congress, we had the chance to initiate a debate regarding one of our ongoing projects – “Living together, breathing together”, which is an educational project of multidisciplinary care, related to the ACSM & IEK activities (WHO Stop TB Partnership). It involves TB patients supporting groups (education between peers) and advisory experts (from pneumology, psychology, sociology, anthropology, biology, social sciences, pharmaco-economy). The idea of this project came to us due to the fact that Romania has the highest incidence of TB, MDR-TB and TB-HIV co-infection across all the European Union countries, and because we believe that through the migration phenomenon, TB can affect even the countries with a low incidence rate. Therefore, we hope that countries of the European Union will address TB more as a global problem rather than a national one.

2. Lovexair Foundation
The project is working to develop a viable model for chronic disease management, in an attempt to overcome high healthcare costs and productivity issues. The model should also be easily reproduced for other conditions in other countries. The project aims to create an ongoing personalised education programme for patients and carers, to include: physical exercise, educational materials and workshops. The programme will be delivered through a trained educator network either in small groups or on a one-to-one basis. The development of an e-health platform will allow patient progress to be monitored and evaluated to enable personalised therapies to be developed in the future.

 

3. Apneuverening

The Dutch Sleep Apnoea Association is the first patient organisation to classify sleep centres and award those with the best performance. In September 2011, 41 out of 78 sleep centres in Holland received 1 to 5 Stars and these were awarded by patients with obstructive sleep apnoea syndrome.

The research, which has been carried out since 2004, has asked sleep apnoea patients how ill they feel, whether they experience any co-morbidity, how long it lasted before going to the doctors, if they got the right referral, how they rated their assessment at the sleep centre, did they get enough information and guidance on using CPAP, what CPAP and mask were they were given to use, do they use it every night, all night etc. The study shows that sleep centres are very eager to receive our star rating. The importance of our findings on patient experience is boosted because the insurance companies take our information into consideration when contracting sleep centres and CPAP delivering companies, which has strengthened the position of our patient organisation.

10 principles for clean air

Air pollution has been linked with a number of health problems including chronic cough, phlegm, lung infections, lung cancer, heart disease and heart attack. Daily concentrations of air pollution in most of Europe are still higher than European Union (EU) target values, causing harm to millions of people across the continent.

Experts from the European Respiratory Society (ERS) have released 10 principles for clean air to help guide Europe’s policy makers to take action to protect people from health risks caused by poor air quality.

The call to action comes ahead of an upcoming review of major EU outdoor air quality legislation.

The 10 principles for clean air:

Guiding principles:

1) Citizens are entitled to clean air, just like clean water and safe food.

Although this principle seems obvious, the reality is that millions of Europeans live in areas where it is unsafe to breathe the air around them.

2) Outdoor air pollution is one of the biggest environmental health threats in Europe today, leading to significant reductions of life expectancy and productivity.

The effect of outdoor air pollution should not be underestimated. It can reduce people’s lifespan, cause serious heart and lung disease and reduce the amount of work people are able to do.

Causes of poor air quality:

3. Fine particles and ozone are the most serious pollutants. There is an urgent need to reduce their concentrations significantly.

  • Fine particles come from burning fuel, such as diesel in vehicles. They are also formed in the air by chemical reactions involving sulphur and nitrogen oxides.
  • Ground-level ozone is created by chemical reactions between nitrogen oxides (NOx) and volatile organic compounds (VOC) – emitted by cars, power plants, industrial boilers, refineries, chemical plants and other sources – in the presence of sunlight

4. Roadside pollution poses serious health threats that cannot be adequately addressed by regulating fine particle mass or ozone. Other metrics such as ultrafine particles and black carbon need to be considered in future research and so inform further regulation.

There are some pollutants that are less known than fine particles and ozone, which should be considered in future research. Two examples of these that often exist in the air around the roadside close to where people live and commute, are black carbon and ultrafine particles.

  • Black carbon, also known as soot, is generated by the burning of fossil fuels. There is increasing evidence that inhalation of black carbon particles is associated with a wide range of health effects – including heart attacks and reduced lung function.
  • Ultrafine particles, which come from car exhausts, are much smaller than other particles in the air. They can enter the blood stream and can trigger inflammation.

5. Non-tailpipe emissions (from brakes, tires and road surfaces, etc.) pose a health threat for road users and subjects living close to busy roads.

Damaging particles in the air don’t always come from cars’ exhausts, they can also come from the erosion of materials, such as tarmac on the roads and the wear of brakes or tyres from a car.

6. Real-world emissions of nitrogen dioxide from modern diesel engines are much higher than anticipated. This may expose many road users, and subjects living on busy roads, to short-term peak concentrations during rush hours and periods of stagnating weather that may impact on health, although to what extent requires further research.

Modern diesel engines produce more nitrogen dioxide in the real world than when tested in the laboratory. Experts believe that long-term exposure to this gas can cause problems with the lungs. As emissions of this gas seen in recent years are much higher than predicted it could be putting people at risk, particularly those living close to busy roads and those who commute during rush hours. Further research is needed to understand more about this risk.

7. Global warming will lead to more heatwaves, during which air pollution concentrations are also elevated and during which hot temperatures and air pollutants act in synergy to produce more serious health effects than expected from heat or pollution alone.

Hot weather and air pollution together lead to more serious health effects – something that will become increasingly important in the face of global warming.

8. Combustion of biomass fuel produces toxic pollutants. This is true for controlled fires, such as in fireplaces, woodstoves and agricultural burning, as well as for uncontrolled wildfires. There is a need to assess the real health impacts of air pollution from these sources in many areas in Europe to inform on the need for better control.

Biomass includes things such as plants or dead trees. These are burnt across the globe in fireplaces and woodstoves and also during wildfires. This principle suggests experts should focus research on how biomass burning affects our health to help decide how levels can be controlled.

Action needed:

9. Compliance with current limit values for major air pollutants in Europe confers no protection for public health. In fact, very serious health effects occur at concentrations well below current limit values, especially those for fine particles.

Legislation on air pollution in Europe urges governments to reduce concentrations of pollutants to a specific limited value. However, serious health effects can still occur from concentration levels far below the values stated in current legislation, particularly for fine particles.

10. EU policies to reduce air pollution are needed that ultimately lead to air that is clean and no longer associated with significant adverse effects on the health of European citizens. The benefits of such policies outweigh the costs by a large amount.

The final principle highlights the need for EU policies to reduce air pollution so that that the air we breathe is clean and does not damage our health. The benefits of this would far outweigh the costs.

Round-up of respiratory news

The ELF would like to wish all our readers a Happy New Year.

Here is a round-up of the respiratory news you may have missed over the Christmas period:

Italian Health Agency rejects use of e-cigarettes

The Italian Health Agency (Istituto Superiore di Sanità) has issued a new report rejecting the use of e-cigarettes as a smoking cessation tool. The new report recognises that e-cigarettes could reduce the harm caused by second-hand smoke but concludes that people who use e-cigarettes could be encouraged to pick up the habit of smoking, particularly young people or those who have already quit.

The report also states that there is no scientific evidence sufficient to establish the safety and effectiveness of the products as a method for smoking cessation.

ERS Congress press releases

The ELF is responsible for press activities at the European Respiratory Society annual Congress.

All media alerts and news releases for the annual ERS Congress are posted on the online media centre of the Congress as soon they are made publicly available. Accredited members of the press can register for embargoed press updates and to attend the Congress by visiting the website:

ERS Congress 2013: Barcelona

To view past press releases from the ERS Congresses, visit the websites below:

ERS Congress 2012: Vienna

ERS Congress 2011: Amsterdam

London TB rates are highest in Western Europe

London was declared the European capital of tuberculosis today with almost 3,500 new cases last year.

If trends of infection continue, within two years Britain is likely to have more new cases of TB each year than the United States, according to a report from the government’s health agency, Public Health England (PHE).

More than 8,750 TB cases were reported in Britain in 2012, which is around 14 per 100,000 of the population.

According to the PHE report, London had the main burden of TB infections in Britain in 2012 with 3,426 cases, almost 40% of the national total.

Almost three-quarters of people diagnosed with TB were migrants from areas of the world where TB is common, such as South Asia and sub-Saharan Africa. Although the proportion of TB cases that were resistant to one of several drugs was under 2%, drug-resistant TB “remains a problem”, the report added.

Cyprus

Airlines Contact
Cyprus AirwaysWEB_CHEMIN_4565_1192009267

 

Cyprus Airways does not allow you to take your own oxygen on board their aircraft. However, they will provide it at an additional fee of 85 euros per flight. Your oxygen can be reserved when making a booking or at least 72 hours before your flight. Oxygen can be administered at 2 or 4 litres per minute and you will be required to fill out a medical certificate.

 

Eurocypria Airlines

Eurocypria Airlines provide oxygen and allow you to take your own provisiosns on board their aircraft. Oxygen can be reserved when making a booking or by requesting it at least 48 hours before your flight. There is an additional fee if you choose to use their oxygen supplies, which is calculated depending on the length of your flight. In both cases you must complete a medical form and present it at check-in.

Bird flu

Bird flu (avian influenza) has been an important topic in the news since it was first seen in humans. Although there have been lots of reports about the illness, do you know what causes it, how it spreads to humans and whether we are at risk?

What is flu?

“Flu”, or influenza, is caused by the influenza virus. Outbreaks occur in humans every winter. It is spread by breathing in droplets of water in the air containing the virus that have been coughed or sneezed out by another person. The usual symptoms in adults are fever, muscle aches and cough, and are usually bad enough to make you stay in bed for 2 or 3 days.

What are the different types of flu?

There are many flu viruses, which can be type A, B or C. Within these three types, there are many different subtypes depending on what is on the surface of the virus. The things found on the surface are proteins, and these can be a protein called haemagglutinin (H) or a type called neuraminidase (N). Different types of H and N are given different numbers, and these numbers are what give the types of flu their names (e.g. H5N1).

What is bird flu?

Many animals can get the flu. The illness caused in birds, “bird flu”, is also called “avian influenza”. While all birds can be infected with bird flu, many wild birds can have a virus without any signs of being ill. Other birds, including chickens, ducks and geese, become sick when infected with the same bird flu viruses. In poultry, bird flu viruses can cause two different types of disease. One is fairly common and is a mild illness, and the other is rare and deadly.

Can humans catch bird flu?

Flu viruses normally only infect one species and do not cause infection in other species. However, human cases of bird flu have now been seen. Out of the very many different types of bird flu, only four have infected humans. These are called H5N1, H7N3, H7N7 and H9N2.

What is the H5N1 virus?

The H5N1 virus is the one you hear most about on the news. This is because:

  • It is causing a worldwide outbreak in birds at the moment.
  • It has infected humans on many occasions in recent years.
  • It has caused more than 200 human cases of very severe disease and more than 100 deaths.
  • When people catch H5N1 virus there is a high chance that they will die.

How can the H5NI virus pass from birds to humans?

From what has been seen so far, it is difficult for humans to catch the H5N1 virus. Although tens of millions of poultry over huge areas have been infected since 2003, fewer than 300 human cases have been confirmed. As far as we know, the way that humans get infected with the H5N1 bird flu virus is only by very close contact with dead or sick birds (for example butchering and preparation of infected birds for eating, or playing in an area with waste from freeranging poultry). Most cases of human bird flu have occurred in rural households where small flocks of poultry are kept and very few cases have been detected in the groups thought to be at high risk (for example commercial poultry workers and vets). No direct human to human spread has been confirmed. Many scientists are now doing research into the factors that might increase the chances of humans being infected.

What are the signs and symptoms of H5N1 bird flu in humans?

In many patients, the disease caused by the H5N1 virus makes the patient ill very rapidly. Initial symptoms include:

  • high fever (usually higher than 38°C)
  • severe aches and pains all over the body

And possibly:

  • breathlessness
  • diarrhoea
  • vomiting
  • abdominal pain
  • chest pain

Almost all patients eventually develop pneumonia and many of their organs may stop working properly. There may be more symptoms than those listed and not all patients have the symptoms above.

What can be done to prevent or treat H5N1 bird flu?

Unfortunately, the current flu vaccine that many people take each year does not protect against bird flu and there is no vaccine currently available for bird flu. Anti-viral drugs can be used for bird flu, for example oseltamivir (known as Tamiflu®). Anti-virals may be given to help prevent infection with bird flu if taken before a person is infected or to help improve survival from bird flu if given within 48 hours of the first symptoms. In the absence of a vaccine, anti-virals are the only medical intervention for prevention and treatment.

Why is bird flu such a worry?

Scientists fear that the H5N1 bird flu virus could change into a form that can easily infect and spread between people, which would result in an extremely contagious and lethal disease. If this were to happen, the resulting virus would probably be something humans have never been exposed to before. With no immune defences, the infection could cause terrible illness, such as occurred in the 1918–1919 Spanish flu pandemic, which killed an estimated 40–50 million people worldwide.

What is a pandemic?

A pandemic is an outbreak of an infectious disease that spreads worldwide, or at least across a large region. Looking at our history, flu pandemics can be expected to occur three to four times each century, when new virus types emerge and are easily passed from person to person. However, the occurrence of flu pandemics is unpredictable and when the next one does occur it may be nothing to do with the current H5N1 bird flu virus.

How can we prevent a pandemic?

H5N1 avian flu in humans is still a rare disease, but actions must to be taken to try and prevent it from being capable of producing a pandemic. However, as a pandemic is likely to happen at some point in the future it is essential that people are prepared. The following actions should be taken:

  • Scientists must closely watch and study bird flu viruses to learn more about them.
  • Wild bird populations need to be monitored.
  • Organisations such as the World Health Organization (WHO), the Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (OIE) need to work together to help the world to prepare for a possible pandemic.
  • The European Union and its Member States need to work together on research and preparedness plans, as flu viruses will pass all borders.
  • All countries and all their citizens need to be involved.

Author

This factsheet was compiled by the ELF office, using the sources below, with the help of ERS expert Mark Woodhead. The material was reviewed and approved by the ERS Advisory Board.

Information sources

The following sources were used as background information in the compilation of this document:

World Health Organisation bird flu pages

Centers for Disease Control bird flu pages

Yuen KY, Chan PK, Peiris M, et al. Clinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus. Lancet 1998 14; 351: 460-461.

Interesting links

Read about the 2006 ELF Award winner, Albert Osterhaus, who conducted ground-breaking research into the viruses responsible for bird flu and severe acute respiratory syndrome (SARS).

Reduced lung function linked with cognitive decline

Lung function may be linked to brain functions relating to problem-solving and processing speed, according to a new study.

These two types of brain function were associated with reduced lung function; however poor lung health did not appear to be linked to memory problems or issues with stored knowledge.

The research, published in the journal Psychological Science, used data from a study of ageing in Sweden that monitored participants’ health for almost two decades.

The analysis of this data identified different patterns showing that loss of lung function can lead to cognitive losses. The researchers believe the results can offer insights into the processes of human ageing.

Although this study does not explain what a loss of pulmonary function does to the brain, the researchers speculated that reduced lung health could lower the availability of oxygen in the blood that could in turn affect chemicals that transmit signals between brain cells.

Bulgaria

Airline

Contact

Bulgaria Air

Bulgaria Air does not provide oxygen on board their aircraft and does not allow you to carry your own oxygen on board.

Bulgarian Air Charter

Bulgarian Air Charter provides oxygen free of charge on board their aircraft. You will be required to fill out a medical form with your doctor to state the flow rates that you will require during the flight.

Smaller Airlines

For the latest information on the smaller airlines please use the contact details below.

Air ViaWEB_CHEMIN_5671_1193143030

 

Tel: + 359 52 573 405

 

BH Air

 

BH AIR does not provide oxygen on board their aircraft and does not allow you to carry your own oxygen on board.

Tel: +359 2 981 0 189

 

Scorpion Air

 

Tel: +359 2 9694411

 

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Air pollution
01.02.10 Effects of air pollutants on lung function
01.06.09 Vehicle exhaust fumes and the development of asthma in adults
01.03.09 Air pollution during pregnancy and how it affects babies’ lungs
01.06.08 Air pollution in urban areas causes inflammation in the airways
01.05.07 Breathing in traffic pollution affects childrens’ respiratory health
01.04.07 Traffic air pollution causes asthma
01.02.12 Warning over cost of asthma caused by traffic-related air pollution
Allergy
01.09.08 Pregnant mothers who live on farms may be protecting their children from asthma and allergies
01.10.08 Swimming in chlorinated outdoor pools may increase the risk of asthma and allergies
01.05.08 A dog in the home may reduce the likelihood of allergy in children
01.03.07 Both your genes and your environment influence allergy and asthma
Alpha-1-antitrypsin deficiency (AATD)
01.06.09 Lung function deterioration in alpha 1-antitrypsin deficient patients
Asthma
01.06.11 Stressful life events and asthma development
01.01.11 Mass of muscles and organs better predicts asthma in females
01.05.10 Parents’ workplace exposure may increase asthma risk in their children.
01.12.09 Can regular swimming increase asthma risk in children?
01.01.09 Healthy eating may help to prevent asthma attacks
01.06.09 Vehicle exhaust fumes and the development of asthma in adults
01.04.09 Asthma in the workplace
01.12.08 New asthma guidelines may improve patient health
01.10.08 Swimming in chlorinated outdoor pools may increase the risk of asthma and allergies
01.09.08 Pregnant mothers who live on farms may be protecting their children from asthma and allergies
01.08.08 What causes continuing respiratory illnesses in infants?
01.04.08 Advice from pharmacists may improve asthma control
01.03.08 Household cleaning products may trigger wheezing in children
01.10.07 The influence of leisure activities and smoking on teenage asthma
01.10.07 Asthma patients need new alternative treatment to overcome the side-effects of current therapies
01.06.07 Apple juice could protect children against asthma
01.04.07 Swimming pool air damages the lungs
01.04.07 Traffic air pollution causes asthma
01.04.07 Overweight girls increase risk of adult asthma
01.03.07 Smoking mothers increase asthma risk in children
01.03.07 Both your genes and your environment influence allergy and asthma
Bronchiectasis
01.03.07 Self-management in bronchiectasis
Bronchiolitis
01.07.10 Can swimming pool chemicals damage your child’s lungs?
Chronic cough
01.10.09 Online cough clinic could pave the way to better healthcare
Chronic obstructive pulmonary disease (COPD)
01.03.12 Cured meat consumption and lung problems
01.02.11 Variability of symptoms in patients with severe COPD
01.11.10 Rehabilitation can improve quality of life for COPD patients despite other existing problems
01.08.10 Eating a sensible diet may help prevent COPD
01.03.10 Panic attacks and anxiety in COPD patients
01.02.10 Patients on home ventilation benefit from regular support
01.08.09 Smokers with COPD may have an increased risk of lung cancer
01.07.09 Genes may be responsible for worsening COPD
01.03.09 COPD: who survives for longer, men or women?
01.02.09 COPD patients exercise less as their condition worsens
01.02.09 Antibiotics may improve COPD survival
01.10.08 Patients who have chronic obstructive pulmonary disease (COPD) are also at risk from diabetes or heart disease
01.07.08 Chronic obstructive lung disease (COPD) may not only be a disease of the lungs
01.07.08 Chronic obstructive pulmonary disease (COPD) patients may become easily depressed if they are not regularly monitored
01.06.08 Undiagnosed obstructed airways can lead to work loss and reduced quality of life
01.04.08 Chronic obstructive pulmonary disease (COPD) needs to be better understood
01.03.08 The 6-minute walk test is useful to assess the levels of fitness in patients with chronic obstructive pulmonary disease (COPD)
01.12.07 Relatives of COPD patients have an increased risk of COPD
01.06.07 Inhaled steroids may protect hearts of COPD patients
01.05.07 COPD patients with low levels of red blood cells struggle to breathe and find it harder to exercise
01.08.11 Talking about end-of-life care
Cystic fibrosis
01.01.08 Data collection from cystic fibrosis centres may help improve the standard of care
01.03.07 Cystic fibrosis sufferers living longer due to modern disease management
Emphysema
01.12.08 Emphysema patients’ lives improved by a valve
Influenza
01.12.07 Should all individuals be offered the influenza vaccine?
Lung cancer
01.01.10 Lung function predicts lung cancer risk in smokers
01.08.09 Smokers with COPD may have an increased risk of lung cancer
01.04.09 Improving lung cancer diagnosis
01.02.08 Cannabis smokers may have a greater risk of lung cancer than tobacco smokers
01.07.07 Can your risk of lung cancer be influenced by your blood group?
01.07.07 Differences in how lung cancer cells spread to the lymph nodes may affect your chances of survival
01.06.07 A new technique detects lung cancer during its early stages
Lung disease
01.05.09 Rheumatoid arthritis and lung disease
01.09.08 Khat leaves may offer new benefits for lung diseases
01.12.07 Is it safe to fly if you have a lung disease?
Lung infections
01.05.07 A new tool will help doctors to treat elderly patients with lung infections
Lung injury
01.11.08 Treatment to slow deterioration in brain function may also prevent lung injury
Lung transplants
01.12.09 Are metallic stents really safe?
01.01.08 The use of a natural growth factor may make lung transplants more successful
Obesity
01.08.07 Breathing problems in overweight patients may be linked to a particular protein in the body
01.04.07 Overweight girls increase risk of adult asthma
Pneumonia
01.10.10 Early recognition of community-acquired pneumonia may improve survival
01.03.10 Antibiotics used to treat community-acquired pneumonia may hide tuberculosis
01.06.08 Avoid catching pneumonia in the community
01.03.08 Statins reduce the number of Pneumonia deaths
01.11.07 The addition of steroids to standard antibiotic treatment may benefit patients with community-acquired pneumonia
01.05.2012
How does pneumonia differ in different age groups?
Premature babies
01.08.08 Premature babies may suffer lung problems as adults
01.05.11 Study sheds light on lung health of premature babies
01.11.11 Life support for babies: the long-term effects on ability to exercise
Primary ciliary dyskinesia (PCD)
01.04.10 Quality of life in patients with primary ciliary dyskinesia (PCD)
01.06.12 European audit of primary ciliary dyskinesia (PCD) care for children
Pulmonary arterial hypertension (PAH)
01.04.09 A new drug may improve high blood pressure
01.08.07 Bosentan is safe to treat pulmonary arterial hypertension (PAH)
01.11.07 Long-term treatment with Sidenafil may help patients with pulmonary embolism
Sarcoidosis
01.06.10 Techniques in succession can aid the diagnosis of sarcoidosis
Sleep apnoea
01.11.12 Electronic nose could be used to detect sleep apnoea
01.03.11 Reducing the side-effects of CPAP treatment for sleep apnoea
01.10.09 If your partner snores, you may not sleep any better when alone.
01.09.09 Sibutramine – a potential sleep apnoea treatment?
01.05.09 Sleep apnoea patients may still feel tired despite treatment
01.12.08 Job loss may be caused by sleep apnoea
01.08.08 Inflamed airways may worsen the condition of sleep apnoea patients
01.05.08 Patients with severe sleep apnoea may be at risk of diabetes
01.02.08 10% of children are thought to snore regularly
01.09.07 Problems with hormone levels could explain why sleep apnoea patients feel sleepy during the day
01.06.07 Patients with heart failure may have problems breathing whilst asleep
Smoking
01.01.10 Cannabis and tobacco affect the lungs in different ways
01.08.09 Smokers with COPD may have an increased risk of lung cancer
01.02.08 Cannabis smokers may have a greater risk of lung cancer than tobacco smokers
01.10.07 The influence of leisure activities and smoking on teenage asthma
01.09.07 The effects of tobacco smoking may damage your lungs even after you stop
01.03.07 Smoking mothers increase asthma risk in children
01.07.11 High levels of smoking among people with suspected TB in South Africa
Treatment
01.02.10 Patients on home ventilation benefit from regular support
01.07.07 Who decides when your treatment should stop if you have a terminal illness?
Tuberculosis
01.03.10 Antibiotics used to treat community-acquired pneumonia may hide tuberculosis
01.01.09 How has the number of people with TB been reduced in Romania?
01.08.09 Linezolid may help patients with extremely drug-resistant tuberculosis (XDR-TB)
01.10.07 A wider choice of treatment for tuberculosis patients may improve their state of health
01.11.07 French study highlights the importance of monitoring tuberculosis
01.07.11 High levels of smoking among people with suspected TB in South Africa
01.09.11 New guidelines on drug-resistant tuberculosis
01.04.12 New guidelines on tuberculosis care in Europe
01.07.12 How cost-effective is treating multi-drug resistant TB?
01.10.12
A new TB drug shows hope for difficult-to-treat cases
Viral infection
01.08.08 What causes continuing respiratory illnesses in infants?
Work related
01.03.11 New guidelines released on work-related asthma
01.12.11 Cement production workers and lung diseases
01.04.11 Farmers at higher risk of poor lung health
01.04.09 Asthma in the workplace
01.07.08 Wood smoke exposure can cause inflammation in the lungs of fire-fighters
01.04.08 Regular exposure to milk powder can affect your breathing
01.02.08 Female workers are more susceptible to wood dust than male workers
01.09.07 Firefighters are at a greater risk of lung disease

Areas for action

Areas for action

The World Health Organisation (WHO) has a global agenda for Influenza surveillance which provides guidance and support about the control of Influenza. It aims to reduce death rates from influenza epidemics and to raise awareness and be prepared for the next pandemic.
Many people in developing countries have no access to flu vaccines and are not aware of its benefits. The WHO hopes to change this by increasing the amount of flu vaccines used.
WHO experts believe that the world is now closer to another influenza pandemic than at any time since 1968, when the last pandemic occurred (‘Hong Kong flu’). A series of six phases of pandemic alert are used to inform the world of the seriousness of the next pandemic influenza threat. The world is presently in phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans.

The present widespread travels in all parts of the world increase the risk of spread of human influenza markedly.

Planning may help to reduce transmission of the pandemic virus strain, to decrease cases, hospitalisations and deaths, to maintain essential services and to reduce the economic and social impact of a pandemic. The level of preparedness will also influence the final death toll. However, even in one of the more conservative scenarios, it has been calculated that the world will face up to 233 million outpatient visits, 5.2 million hospital admissions and 7.4 million deaths globally, within a very short period

The European Scientific Working group on Influenza (ESWI) is a partnership organization of influenza stakeholders who aim to reduce the burden of influenza in Europe.

It is ESWI’s task to raise awareness on the impact of influenza and its control measures amongst government representatives, the European Union, opinion leaders in public health, health care workers, international organizations and the pharmaceutical industry.

In May this year, ESWI will bring together leading organizations and institutes in the field of influenza in a one-day meeting to provide them with an informal platform to discuss ways to better protect the European population against influenza.
The ESWI Flu Summit will be an action-oriented event with participants including healthcare professionals, public health officials, organizations of at-risk patients and senior citizens, and other public and private organizations that have an interest in addressing and resolving influenza issues.

 

Indoor air pollution

Indoor air pollution
All of our factsheets have been reviewed by members of the European Respiratory Society (ERS) who are experts in the field. These are freely available to download in a range of European languages.

In English

Auf Deutsch

En Francais

En Espanol

In Italiano

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Po polsku

στα Ελληνικά

Author
This factsheet was compiled by the ERS Environment and Health Committee. The factsheet was reviewed and approved by the ERS Advisory Board.

Co-funding, and production and content support for this publication has been provided by the Health and Environment Alliance (HEAL;
.

Information sources
Scientific references:

Other sources:

Please see below for the full range of expert approved factsheets.

Bird flu The normal lung
Pulmonary arterial hypertension Sleep apnoea
Diet and the lungs Indoor air pollution
Outdoor air pollution Dirty air and the lungs
Pneumonia Work-related lung diseases
Asbestos-related lung diseases Alpha 1-anti trypsin deficiency
Dirty air indoors and your lungs Spirometry
Rare and ‘orphan’ lung diseases Allergic rhinitis or “hayfever”
Climate change and the lungs Tuberculosis
Smoking and the lungs Living well with COPD
Asthma and infection Acute Bronchitis
MDR-TB Asthma in elite athletes
Sarcoidosis CPAP
Living an active life with COPD Asthma and pregnancy

Belgium

Brussels Airlines

 

Brussels Airlines supply oxygen on board their aircraft at an additional charge per bottle. Maximum flow rate is 8 litres per minute. To book oxygen, please contact the Medical assistance Coordination Service on + 32 2 7233703. You will also need to fill out a MEDIF form.

If you have sleep apnoea, you can use a CPAP machine on board their aircraft providing it is battery powered. The equipment cannot be used during take off and landing.

 

 

CityJet

 

Cityjet does not allow you to take oxygen on board their aircraft. However, they will allow you to take your own portable oxygen concentrators on board. These include INOGEN One and EVERGO model 900. To order oxygen, please call one of the numbers below at least 72 hours before your flight.

– Ireland: 01 8700 170
– UK: 0871 666 50 50
– Belgium: 03 287 80 80
– France: 3654
– Luxembourg: 493395
– Netherlands: 0900 4 50 50 50
– For all other countries: +32 (0)3 287 80 80

 

 

 

 

Jetairfly

Jetairfly does not allow you to use your own oxygen on board their aircraft. However, they can provide it at an additional cost. To order oxygen, you must send a request to Flight Specials at least 7 days before your flight.

Online Contact Form

Thomas Cook Airlines

 

Thomas Cook Airlines does not allow you to take your own oxygen on board their aircraft. However, they provide oxygen at an additional cost of £100 per flight. This has to be arranged at least 21 days before your flight. Please call 0844 855 0515 prior to booking your holiday to discuss your specific requirements.

 

Bosnia & Herzegovina

Airline

Contact

B&H Airlines

B&H airlines only have oxygen on board their aircraft for emergencies. However, you are allowed to take your own provisions on board. You will be required to complete a number of forms and obtain a letter from your doctor stating that you require supplementary oxygen. You may need to be accompanied by a friend who will be res