Chronic Obstructive Pulmonary Disease (COPD) rates in women skyrocket

The death rate for one of the most lethal diseases in North America has skyrocketed for women in the last 20 years, and a team of researchers from the University of British Columbia and the B.C. Centre of Excellence for Women's Health wants to find out why.

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in North America, with about 10,000 Canadians dying from the disease annually. Historically, COPD has affected more men than women, but death and hospitalization rates for the disease are climbing dramatically among women. Researchers predict that by 2010 more women than men will die of the disease.

An interdisciplinary team that is unique in Canada has launched a five-year, $1.5-million study to investigate the role that biological, social and cultural differences play in COPD. The team is led by Prof. Susan Kennedy of UBC's School of Occupational and Environmental Hygiene and Dr. Don Sin, Canada Research Chair in Chronic Obstructive Lung Disease, of the iCAPTURE Centre at St Paul's Hospital.

The study is funded by the Canadian Institutes of Health Research (CIHR) Institute of Gender and Health (IGH) and Institute of Circulatory and Respiratory Health (ICRH).

“We will be looking at the disease from all angles to understand why women have an extraordinary vulnerability and to help develop better diagnosis, treatment and even prevention,” says Kennedy, who also directs UBC's Centre for Health and Environment Research. “Even at apparently equal exposures, women are more likely than men to develop the disease at an early age and to experience more serious symptoms. Sex and gender differences must be part of the explanation.”

COPD death rates in Canada increased by 61 per cent in women and decreased by 15 per cent in men between 1984 and 2000, according to figures from the Public Health Agency of Canada. Today, approximately one million Canadians have the disease.

Factors that may account for the difference in rates of death and disability range from lung size to working conditions. For example, female cleaners often engage in small scale or domestic cleaning where safety procedures concerning pollutants may not be followed.

A lung disorder that causes airways to become partially obstructed, COPD can take 20-30 years to cause symptoms of breathing difficulties. It is a progressive and incurable disease that leads to severe disability and death. The most common causes of COPD are smoking, exposure to second-hand smoke and other pollutants such as dusts and fumes, especially those found in workplaces.

The only such research team in Canada to engage experts in respiratory medicine, gender studies, exposure assessment, and health promotion, the group includes PhD student and respiratory physiotherapist Pat Camp, who originated the study.

“COPD has long been considered a man's disease -- similar to the view once held about heart disease -- so women were often misdiagnosed,” says Camp. “Now we need to take the next step and look at both biological and environmental factors to really understand how this disease affects women.”

The team will analyze large databases of lung health information on hospital patients and workers at risk of COPD, using methods specifically designed to better understand sex and gender factors.

The team, called ICEBERGS (Interdisciplinary Capacity Enhancement: Bridging Excellence in Respiratory Disease and Gender Studies), is funded by CIHR and includes researchers from the UBC School of Occupational and Environmental Hygiene; UBC iCAPTURE Centre at St. Paul's Hospital; UBC departments of Medicine, and Health Care and Epidemiology, the UBC School of Nursing; and the B.C. Centre of Excellence for Women's Health.

“CIHR is proud to support this research, which will illuminate the impact of gender influences and sex differences on health through the study of this prevalent condition” said Dr. Miriam Stewart, Scientific Director of CIHR's Institute of Gender and Health.

“The research conducted by Dr. Kennedy and her team will help strengthen our knowledge and understanding of how gender and sex play a role in the development, care and prevention of COPD”, added Dr. Bruce McManus, Scientific Director of CIHR's Institute of Circulatory and Respiratory Health.

The research is also supported by the Heart and Stroke Foundation of Canada and the BC Lung Association.

CIHR is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to close to 10,000 health researchers and trainees across Canada.

British Columbia Centre of Excellence for Women's Health, funded by Health Canada and BC Women's Hospital and Health Centre, improves the health of women by fostering collaboration on multidisciplinary research projects.

The James Hogg iCAPTURE ( Imaging, Cell Analysis, and Phenotyping Toward Understanding Responsive, Reparative, Remodelling, and Recombinant Events) Centre for Cardiovascular and Pulmonary Research examines the role of genes and environment in inflammatory heart, blood vessel and lung disease.

The Canada Research Chairs program, designed to build Canada's research capacity, represents a Government of Canada investment of $900 million to establish 2,000 research professorships in universities across the country.