Lexington, KY (Aug. 31, 2007) ¾ Two worldwide studies published in this week's edition of The Lancet observe the alarming growth rate of chronic obstructive pulmonary disease (COPD). The only U.S. site in the International Burden of Lung Disease (BOLD) Study was located in Eastern Kentucky, and was found to have some of the highest rates of COPD in the world. In fact, it had the second highest rate among women and fourth highest among men. Smoking is a primary risk factor for the disease, although it is heavily influenced by exposures to dusty working environments, air pollution, diet, and genetic factors.Dr. David M. Mannino, a faculty member in the University of Kentucky College of Public Health and UK College of Medicine Division of Pulmonary, Critical Care and Sleep Medicine, is co-author of the studies. "Global burden of COPD: risk factors, prevalence, and future trends," concluded that higher levels and more advanced stages of COPD occur worldwide than previously thought. Furthermore, this burden will increase as the world's population continues to age. "International variation in the prevalence of chronic obstructive pulmonary disease (The BOLD Study): a population-based prevalence study," looked at risk factors, prevalence and future trends of COPD. The World Health Organization (WHO) estimates that in high-income countries, 73 percent of COPD mortality is related to smoking, with 40 percent related to smoking in nations with low and middle income populations. "Worldwide, tobacco smoke remains the most important cause of COPD," Mannino said. "Furthermore, smoking during pregnancy can negatively affect fetal lung growth and result in development of lung disease. We can not, however, ignore other factors important in COPD such as air pollution, diet, and occupational exposures. In addition, we see many patients in whom disease progresses years after they have stopped smoking, suggesting that we need new strategies to deal with this devastating disease."