Lung ill­ness nearly dou­bles as flu and pol­lu­tion take toll

As air qual­ity wors­ens, lack of res­pi­ra­tory spe­cial­ists adds to pres­sure on A&Es

The Observer - - News - Jamie Doward

Ac­ci­dent and emer­gency de­part­ments have seen at­ten­dances due to lun­gre­lated ill­nesses al­most dou­ble in un­der a decade as vir­u­lent flu strains and air pol­lu­tion take their toll.

A short­age of lung spe­cial­ists means ser­vices can be patchy, how­ever. The huge in­crease is ad­ding to the pres­sures on hos­pi­tals and has prompted calls for a new na­tional strat­egy to tackle the prob­lem that the Bri­tish Lung Foun­da­tion es­ti­mates costs the UK econ­omy £11bn a year. A data re­view, shared with the

Ob­server by the Bri­tish Tho­racic So­ci­ety (BTS), re­veals that last year there were 913,646 at­ten­dances at A&E de­part­ments in Eng­land for lung ill­nesses – in­clud­ing pneu­mo­nia, flu, chronic ob­struc­tive pul­monary dis­ease (COPD) and asthma – a near dou­bling since 2011.

The rise has seen a cor­re­spond­ing in­crease in hos­pi­tal ad­mis­sions. In De­cem­ber 2016 the BTS data shows there were 32,492 ad­mis­sions re­sult­ing from A&E at­ten­dances for res­pi­ra­tory dis­ease – more than three times the av­er­age for any of the 20 most com­mon com­plaints that reg­u­larly trig­ger an ad­mis­sion.

The find­ings will re­in­force con­cerns about the threat to pub­lic health posed by flu out­breaks this com­ing win­ter. They show that, in the 12 months to April 2017, 62% more peo­ple died from a res­pi­ra­tory con­di­tion in the win­ter than in other seasons.

“Nearly ev­ery win­ter the NHS strug­gles to cope with a surge of peo­ple with lung dis­ease be­ing ad­mit­ted to hos­pi­tal through A&E,” said Dr Jonathan Ben­nett, in­com­ing chair of the BTS board. “This surge is pre­dictable, as cold weather can weaken the im­mune sys­tem and make us more prone to viruses that cir­cu­late.”

How­ever, he said that, al­though the NHS knew the surge was com­ing, not enough was be­ing done to tackle it.

“If you think of win­ter pres­sures, there’s a dou­bling of the acute and emer­gency ad­mis­sions, but there’s not a dou­bling of the res­pi­ra­tory physi­cians to man­age them. We’re not geared up to run the peaks.”

Lung spe­cial­ists iden­tify sev­eral fac­tors be­hind the rise in lung-re­lated A&E ad­mis­sions. These in­clude an in­crease in the num­ber of older peo­ple who may be frail be­cause of lung dis­ease or other health prob­lems, the con­tri­bu­tion of air pol­lu­tion to lung dis­ease flare-ups, and the po­tency of flu strains and other viruses in win­ter.

In ad­di­tion, the BTS claims a lack of in­vest­ment in treat­ments that could pre­vent peo­ple with pre-ex­ist­ing lung dis­ease need­ing hos­pi­tal ad­mis­sion, such as stop smok­ing sup­port, is tak­ing its toll. The so­ci­ety has called for fur­ther in­creases in flu vac­ci­na­tion.

It also wants a na­tional plan to di­ag­nose lung dis­ease ear­lier and for pa­tients dis­charged from hos­pi­tal with res­pi­ra­tory dis­eases such as pneu­mo­nia and COPD to have thor­ough as­sess­ments to pro­mote bet­ter self-man­age­ment of their con­di­tion.

A short­age of fund­ing and ex­perts is also a fac­tor, says the BTS. It claims that only 2% of all med­i­cal re­search spend­ing by char­i­ties goes on res­pi­ra­tory dis­ease.

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