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If you breathe, then the Year of the Lung is for you.
That is the message the Forum of International Respiratory Societies (FIRS) wants to spread to the world in 2010 and begin a social movement for greater public awareness, policy action, and resources to combat all forms of lung disease.
"It doesn't matter if it's someone with sarcoidosis, a critical patient with ARDS, or whether it's somebody with COPD struggling to catch their breath," said James P. Kiley, PhD, director of the National Heart, Lung and Blood Institute, Bethesda, Md. "It's gut-wrenching and really difficult to see. It gives you reason to push even harder to get answers to questions that lead to these events."
Too often, such patients are overlooked because lung health is not high on the public agenda. Consider how frequently you have seen the pink ribbon as the symbol for breast cancer awareness. It is undeniably a disease worthy of attention. Yet how many of your patients would be surprised to learn that lung cancer kills 160,000 people each year in the U.S., more than breast, colon, and prostate cancers combined?
A brainstorm in Mexico City
International leaders in respiratory care and pulmonology pondered the lack of widespread support for lung health, as they sat in a conference room in sunny Mexico City during the FIRS' 2008 meeting. FIRS consists of representatives from the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), the Asociación Latinoamericana del Tórax (ALAT), the Asia Pacific Society of Respirology (APSR), the European Respiratory Society (ERS), the International Union Against Tuberculosis and Lung Disease (The Union), and the Pan African Thoracic Society (PATS) who gather yearly in different locales throughout the world to build alliances and identify global opportunities to promote respiratory health. 
Kalpalatha K. Guntupalli, MD, professor of medicine and chief of the pulmonary, critical care, and sleep medicine section at Baylor College of Medicine, Houston, was among this elite group of public health experts when they had a brainstorm: Build solidarity for lung health awareness by naming 2010 the Year of the Lung.
"Everybody caught on, and the idea got buy-in immediately," said Dr. Guntupalli, who also is president of the ACCP. "Each organization is slightly different but what they have in common is a passion to help people with lung disease. Each organization is coming up with things to do."
They created a website www.yearofthelung.org as the main hub of activity. The ambitious project's official launch took place with a signing of the Year of the Lung Declaration at the 40th Union World Conference on Lung Health in Cancún, Mexico, Dec. 6. It has five main goals:
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to offer widespread support to the more than 160 nations that have ratified the first-ever international public health treaty - the WHO Framework Convention on Tobacco Control - and call upon the remaining countries to do so
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to demand increased research funding to develop tools and treatments ranging from new diagnostics to new vaccines and medicines
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to strengthen health systems and work toward the fair and equitable distribution of these health care resources to all who need them
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to lobby for improved legislation protecting the quality of the air we all breathe
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to ensure that every health worker, parent, child, teacher, employer, religious leader, community leader, media representative, and government official understands the risks and symptoms of lung diseases and how to keep lungs healthy, because lung health is essential to breath and life.
Grim Stats the World Should Know
As respiratory care professionals, all of us are aware of the grim statistics below.
The Year of the Lung gives us a chance to focus on lung health, raise public awareness, and draw the attention of governments and policymakers to do what is needed to amend the situation.
Lung disease accounts for 19 percent of total deaths and 15 percent of disability-adjusted life-years in the world. Tobacco-related diseases kill 5 million people worldwide and 1.5 million from lung cancer each year.
Despite the staggering numbers of 9 million new cases in 2007 and 1.7 million deaths a year from tuberculosis, no major new drugs have been developed for TB since the 1970s, and the only vaccine available is a century old.
Pneumonia kills 2 million children under 5 years of age annually.
More than 250,000 asthma deaths per year are attributable to lack of treatment.
COPD will become the third most common cause of death worldwide in the near future, yet half the people with COPD go undiagnosed. Early lung disease detection methods, such as spirometry, are either not readily available or not utilized.
Each year, 250,000 to 500,000 people die of seasonal flu in the world; and when new strains strike, the morbidity and mortality can be extremely high.
Nearly half of the world's population breathes polluted air. Policies to regulate air quality are lagging.
-Compiled by Kalpalatha K. Guntupalli, MD, Baylor College of Medicine, Houston
Global change
What makes the Year of the Lung campaign unique is that it is the first coordinated international endeavor to champion all aspects of lung health, said Dean E. Schraufnagel, MD, who chaired FIRS during the development of the plan. As president-elect of ATS, he has had the opportunity to travel and raise awareness for the Year of the Lung. On a trip to India, he realized how much work needs to be done.
"I went to a major conference of lung disease physicians, and noticed a hookah in their meeting," said Dr. Schraufnagel, professor of medicine and pathology in the section of pulmonary, critical care, sleep, and allergy at the University of Illinois at Chicago. "They had all different flavors, and mothers and fathers - some of whom were chest physicians - were telling their kids to try it. It's as if you had turned the clock back to 1950 America where we had advertisements saying, 'More doctors recommend Camels than any other cigarettes.' This emphasizes the importance of awareness."
The experience underscored for him why the Year of the Lung's efforts are urgently needed. "We want more knowledgeable people and government agencies to not let down their guard on lung and respiratory disease," Dr. Schraufnagel said.
For its part, ATS has about 20 activities planned in honor of the Year of the Lung. The organization presented advocacy briefings on Capitol Hill March 4-6 that focused on lung health research. A book is in the works about the impact of lung disease on society, its economic burden, and what is being done to resolve the problems. The ATS' Year of the Lung committee also is creating a list of steps for the public to follow to improve their personal lung health, from smoking cessation, to hand-washing, to getting better sleep.
Dozens of sessions at ATS' annual meeting being held in New Orleans this May will feature world lung health problems. A Year of the Lung proclamation will be posted for attendees to sign, similar to the kickoff in Mexico. And Year of the Lung awards will be given to people who have recognized the importance of lung health in their professional lives and communities.
From prevention to intervention
The ACCP's motto for the Year of the Lung is "from prevention to intervention." Their core initiatives will concentrate on tobacco prevention as well as the diagnosis and management of COPD and lung cancer. Dr. Guntupalli has long been interested in combating the tobacco addiction epidemic around the world.
She fondly remembered a high-spirited patient who was a wonderful woman with lots of positive energy but could not quit smoking. The patient died around the time the Year of the Lung launched.
"In the intensive care unit, I see the end results of long-standing smoking: heart attacks, lung cancer, respiratory failure, and COPD," Dr. Guntupalli said. "You feel kind of helpless to watch the life sucked away due to a very preventable risk factor."
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