The high mortality rate in Poland for bronchitis, emphysema, and asthma in 1970 and 1971 decreased in the subsequent years. There was, however, some upward trend of mortality observed in the first half the 1980s in both sexes aged 45-64 and 65 years and older (Fig 1). In infants there has been a noticeable decline of the mortality rates for chronic airways disease. However, because this trend was not accompanied by similar changes in the hospital morbidity rates, one may suspect that it reflects improvement of treatment rather than decrease of prevalence of the disease.
Disaggregation of the mortality data by individual causes reveals substantial differences in the patterns of change in the rates over time (Tables 3 and 4). Considerable increase of mortality has been observed for chronic bronchitis in both men and women, whereas an opposite change has occurred for emphysema. The magnitude of change of mortality rates for bronchitis between 1980 and 1986 was similar to that observed in hospital morbidity. However, the pattern for emphysema was different in that almost unchanged discharge rates were accompanied by a decline in mortality. Morbidity and mortality rates for chronic bronchitis, emphysema, and asthma in Poland were consistently higher in rural than in urban inhabitants in the 1980s (Table 5), whereas overall morbidity and mortality rates showed the opposite trend, being higher in urban than in rural areas. there
Prevalence and Dynamics in an Open Population
The only longitudinal study on the prevalence and dynamics of COPD in an adult general population in Poland was carried out in the city of Cracow from 1968 to 1981. The sample studied in a cross-sectional survey in 1968 comprised 4,355 inhabitants aged 19-70 years, of whom 2,959 (67.9%) were interviewed in 2 subsequent follow-up studies in 1973 and 1981. The questionnaire used in the field study was based on that developed by the Medical Research Council of Great Britain.
Figure 1. Death rates for bronchitis, emphysema, and asthma according to sex and selected age groups, Poland, 1970-86.
Table 3—Death Rates far Chronic Bronchitis, Emphysema, and Asthma Among Persons 45-64 Years of Age by Sex in Poland, Selected Years 1972-1986 (per 100,000 Population)
Table 4—Death Rates far Chronic Bronchitis, Emphysema, and Asthma Among Persons 65 Years and Over by Sex in Poland, Selected Years 1972-1986 (per 100,000 Population)
Table 5—Death Bates for Chronic Bronchitis Emphysema, and Asthma Among Persons 45-64 Years of Age and 65 Years and Over by Place qfBesidence in Poland 1980 and 1986 (per 100,000 Population)
|45-64||65 +||45-64||65 +|