Australian Institute of Health and Welfare (2020) Chronic obstructive pulmonary disease (COPD), AIHW, Australian Government, accessed 25 September 2022.
Australian Institute of Health and Welfare. (2020). Chronic obstructive pulmonary disease (COPD). Retrieved from https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd
Chronic obstructive pulmonary disease (COPD). Australian Institute of Health and Welfare, 25 August 2020, https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd
Australian Institute of Health and Welfare. Chronic obstructive pulmonary disease (COPD) [Internet]. Canberra: Australian Institute of Health and Welfare, 2020 [cited 2022 Sep. 25]. Available from: https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd
Australian Institute of Health and Welfare (AIHW) 2020, Chronic obstructive pulmonary disease (COPD), viewed 25 September 2022, https://www.aihw.gov.au/reports/chronic-respiratory-conditions/copd
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Chronic obstructive pulmonary disease (COPD) is a preventable and treatable lung disease characterised by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible. The symptoms of COPD include cough, sputum production, and dyspnoea (difficult or laboured breathing). COPD symptoms often don't appear until significant lung damage has occurred, which usually worsens over time (WHO 2020).
It is worth noting that it can be difficult to distinguish COPD from asthma because the symptoms of both conditions can be similar—both have obstruction to the airways, both are chronic inflammatory diseases that involve the small airways (Buist 2003). Although the current definitions of asthma and COPD overlap, there are some important features that distinguish typical COPD from typical asthma. For more information, see Asthma.
Additionally, COPD and bronchiectasis share common symptoms of cough with sputum production and susceptibility to recurrent exacerbations (Hurst et al. 2015). Although these two diseases present several common characteristics, they have different clinical outcomes. Therefore, it is very important to differentiate them at early stages of diagnosis, so appropriate therapeutic measures can be adopted (Athanazio 2012). For more information, see Bronchiectasis.
COPD results from a complex interaction between genes and the environment. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), there are many causes of COPD, which may include:
The development of COPD occurs over many years and therefore affects mainly middle aged and older people while asthma affects people of all ages. The prevalence of COPD increases with age, mostly occurring in people aged 45 and over.
In the 2017–18 ABS National Health Survey (NHS), the prevalence of COPD (captured here as self-reported emphysema and/or bronchitis) in Australians aged 45 and over was 4.8%, or an estimated 464,000 people (ABS 2018). Overall, the prevalence did not differ significantly between men and women (4.5% and 5.1% respectively), however for those aged 55–64, COPD was more prevalent in women compared with men (6.2% and 3.6%, respectively) (Figure 1).
However, it should be noted that the prevalence of COPD is difficult to determine from routine health surveys. This is because COPD is formally defined in terms of an abnormality of lung function and clinical testing is required to accurately estimate the prevalence of the disease.
In a large international study called the Burden of Obstructive Lung Disease (BOLD) study, the lung function of nearly 10,000 people were tested (Buist et al. 2007). The BOLD study estimated the prevalence of COPD using spirometry testing in addition to questionnaires about respiratory symptoms, health status, and exposure to COPD risk factors. BOLD estimated the overall prevalence of COPD in 12 countries (including Australia, China, Turkey, Iceland, Germany, USA and Canada) to be 10% for people aged 40 and over. In a later study conducted in Australia using a protocol that closely followed that used in the global BOLD study, the prevalence of COPD was estimated to be 7.5% for people aged 40 years and over and 30% for people aged 75 and over (Toelle et al. 2013).
Source: ABS 2019 (Data table).
Based on self-reported data, in 2018–19, 10% of Aboriginal and Torres Strait Islander people aged 45 and over had COPD (an estimated 17,800 people), with a higher rate among females (13%) compared with males (6.7%). The prevalence of COPD among Indigenous Australian was 2.3 times as high as non-Indigenous Australians, after adjusting for difference in age structure (ABS 2020a; ABS 2020b).
The prevalence of COPD among Australians did not differ significantly according to remoteness area.
However, the prevalence of COPD was higher in the lowest socioeconomic area compared with those in the highest area (men: 7.5% and 3.1%, respectively; women: 6.6% and 4.0%, respectively) (Figure 2).
COPD can interrupt daily activities, sleep patterns and the ability to exercise. People with COPD rate their health worse than people without the condition. In 2017–18, 1 in 5 (20%) of those aged 45 years and over with COPD rated their health as poor, compared with 5.4% of those aged 45 years and over without it. At the same time, 17% of those with COPD rated their health as very good and 4.9% as excellent compared with 34% and 17% (respectively) of those without COPD (Figure 3).
Source: ABS 2019 (Data table).
In 2017–18, people with COPD were more likely to report high (19%) and very high (17%) levels of psychological distress compared to people without COPD (8.3% and 4.0%, respectively) (Figure 4).
Source: ABS 2019 (Data table).
In 2017–18, people with COPD were more likely to report moderate (36%) and severe (22%) bodily pain compared to people without COPD (23% and 7.8%, respectively) (Figure 5).
People with COPD often have other chronic diseases and long term chronic conditions. For more information, see COPD, associated comorbidities and risk factors.
Athanazio R et al. 2012. Airway disease: similarities and differences between asthma, COPD and bronchiectasis. Clinics 67 (11): 1335.
Australian Bureau of Statistics (ABS) 2018. National Health Survey: First Results, 2017–18. ABS Cat no. 4364.0.55.001. Canberra: ABS.
ABS 2019. Microdata: National Health Survey, 2017–18, detailed microdata, DataLab. ABS cat no. 4324.0.55.001. Canberra: ABS. Findings based on AIHW analysis of ABS microdata.
ABS 2020a. National Aboriginal and Torres Strait Islander Health Survey, 2018–19. ABS Customised report. Canberra: ABS.
ABS 2020b. National Health Survey, 2017–18. ABS Customised report. Canberra: ABS.
Buist S, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM et al. 2007. International variation in the prevalence of COPD (The BOLD study): a population-based prevalence study. Lancet 370: 741-50.
Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2018 Report).
Hurst JR, Elborn JS, Soyza AD 2015. COPD—Bronchiectasis Overlap Syndrome. European Respiratory Journal 45: 310-313.
Lange P, Celli B, Agusti A, Jensen GB, Divo M, Faner R et al. 2015. Lung-function trajectories leading to chronic obstructive pulmonary disease. The New England Journal of Medicine 373(2): 111-22.
Toelle BG, Xuan W, Bird TE, Abramson MJ, Atkinson DN, Burton DL et al. 2013. Respiratory symptoms and illness in older Australians: the Burden of Obstructive Lung Disease (BOLD) study. Medical Journal of Australia 198:144–8.
World Health Organisation (WHO) 2020. COPD: Definition. Viewed 20 February 2020.
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