A joint publication by the European Lung Foundation and European Respiratory Society provides detailed statistics on lung health in Europe. 1 in 8 deaths in the EU are as a result of respiratory disease and 6 million people are admitted to hospital each year. It is estimated for several diseases that this represents the “tip of the iceberg”, as many disease deaths are improperly recorded (report). Lung disease is often complicated by fungal infection.
The report concludes that there are almost 10 million people under the age of 45 living with asthma in Europe, of which approximately 1 million have severe asthma which difficult to manage clinically. It is thought that around 50% of patients with severe asthma have sensitisation to various fungi (SAFS), of which Aspergillus fumigatus is the most common.
Moderate or severe COPD is present in 5-10% of the European population (25-50 million people). This results in around 300,000 deaths in Europe every year. The majority of this burden comes from lifelong cigarette smokers, of which 40-50% will develop COPD in their lifetime. Invasive aspergillosis in COPD is thought to affect about 1.2% of the 3,600,000 people admitted to hospital each year; about 34,000 people. It carries an 85% mortality. Chronic pulmonary aspergillosis also affects COPD patients.
Previously the prevalence of cystic fibrosis in the EU was estimated at around 37,000 cases. Allergic bronchopulmonary aspergillosis (ABPA) affects about 15% of teenagers and adults with cystic fibrosis. The report summarises that 15% of these patients are hospitalised at least once per year. Approximately 200 people with CF will undergo a lung transplant every year, although this figure is rising.
Interstitial lung diseases (ILD) are a collection of over 300 diseases, but mostly made up of idiopathic pulmonary fibrosis and sarcoidosis. Together they account for 50% of all ILDs in Europe, with hospitalisation and death rates peaking at 40 and 2.5 per 100,000 respectively. Aspergillosis is a common complication of fibrosing sarcoidosis, with a predicted prevalence of almost 166,000 people in Europe.
The total economic burden of respiratory disease was estimated at €379.6 billion, with COPD and asthma causing over €200 billion of this.