Respiratory deaths in Europe
In the WHO European Region, the four most commonly fatal lung diseases accounted for one-tenth of all deaths and 7% of the DALYs lost in 2008 (tables 1 and 2). The proportion of deaths due to respiratory disease was higher among the 28 countries of the European Union (EU28) -12.5% (661 000 deaths annually) - than among the remainder of the WHO European countries, where it was 7.5% (292 000 deaths annually).
The proportion of all deaths due to lung diseases is influenced by the age of the population, and the age-specific death rates from respiratory and nonrespiratory causes. If we concentrate solely on respiratory deaths (including lung cancer and pulmonary vascular disease) and adjust each country & mortality rates to the European Standard Population, then the age-standardised death rates are similar for EU28 and non-EU28 countries. However, within each of these groups of countries there is considerable international variation (figures 1 and figure 2).
Figure 1 maps the age-standardised death rates for respiratory causes in each European country in recent years. The same information is shown as a bar chart in figure 2. The highest rates tend to occur in parts of north-western Europe (Belgium, Denmark, Ireland, and the UK), central Europe (Hungary, Romania and Moldova) and some central Asian republics (Kazakhstan and Kyrgyzstan).
The specific respiratory conditions contributing to the toll of respiratory mortality in selected EU28 countries are illustrated in figure 3. The pattern is similar in the remaining EU28 countries. Over half of the respiratory deaths are due to lung cancer or COPD, conditions that are mainly caused by tobacco smoking. Smoking is also a risk factor for pneumonia and pulmonary vascular disease, conditions which also contributed substantial fatalities.