Chronic airways disease (CAD) has been of interest to epidemiologists in different countries for more than 30 years. Although several comparative studies have been done thus far, more are expected because the magnitude of the problem and its changes over time are not identical in different countries. Our aim is to present recent trends in the hospital morbidity and general mortality due to chronic bronchitis, emphysema and asthma in Poland. We also describe the prevalence and dynamics of nonspecific respiratory diseases based on the longitudinal observations of a sample of the adult population in the city of Cracow. We present available data on the trends in some basic risk factors, though not much is known in this respect. The data on mortality, air pollution, and supply of cigarettes in the general population have been obtained from the Central Statistical Office in Warsaw and taken from the Statistical Yearbooks published by the Office. further
Hospital morbidity data are based on the 10% sample of discharges from each hospital conducted by the Ministry of Health and Social Welfare and the Ministry of Transportation. A few hospitals under the control of other ministries are excluded. The analyzed data for CAD present a situation in Poland only in the 1980s, because data for earlier years were collected in a different way than at present and are incomplete for respiratory diseases.
Approximately 350 persons/100,000 population were hospitalized yearly due to bronchitis, emphysema, and asthma, which was 3.3% of all cases, and the overall rates were similar in 1980 and 1986. Men have been hospitalized 1.6 times more often than women, and this ratio has not fluctuated much over time, although it has been strongly related to age. Whereas women aged 15-44 years were hospitalized more often than men due to slightly higher hospitalization for asthma, in younger and even more so in older patients, discharge rates were much higher in men than women (almost 3 times above 65 years of age).
When the discharge rates are analyzed by individual diagnosis (Tables 1 and 2), the distinctions between age and sex groups become even more visible; however, the patterns and levels of hospitalization were similar in 1980 and in 1986. Some increase in hospital morbidity due to chronic bronchitis is seen, particularly in the infants (by 75%) and individuals aged 65 years and older (by 43% and 31% in men and women, respectively). The overall rate of discharge for chronic airways disease in Poland was similar to the rate observed in the US. However, differences exist for more detailed diagnosis, and while patients with bronchitis and emphysema were hospitalized twice as often in Poland as in the US, the reverse was true for asthma. It may partly reflect existing diagnostic differences between the countries, and caution is advised in making comparative inferences.
Table 1—Hospital Discharge Bates for Chronic Bronchitis, Emphysema, and Asthma Among Men by Age in Poland, 1980 and 1986 (per 10,000 Population)
Table 2—Hospital Discharge Rates for Chronic Bronchitis, Emphysema, and Asthma Among Women by Age in Poland, 1980 and 1986 (per 10,000 Population)