Respiratory diseases represent today the third cause of death, following cardiovascular diseases and neoplasms. Their distribution in the population is considerably changed in the last century in association with the general increase of the chronic degenerative diseases which affect particularly older age. More than 50% of mortality for respiratory diseases is due to the chronic obstructive pulmonary disease (COPD) which includes chronic bronchitis and pulmonary enphysema. COPD represents a chronic progressive disease, with high morbility and mortality. The prevalence of COPD is continuously increasing over the years. Smoking habit, followed by some occupational exposures, and poor socio-economic conditions are the main risk factors for the development of COPD. Mortality for COPD is high, representing more than 5% of all causes of death. In Europe, Italy is at the seventh place for mortality for COPD in males. Furthermore, COPD represents one of the diseases with highest social costs. Severity of the disease in the more advanced stages causes a relevant limitation in the daily life and in the working activities of the patients. Costs of the disease are high both considering the indirect costs (loss of working days by the patients or by the patient relatives, limitation in the daily activities, reduction in quality of life) and the costs directly related to the consumption of health resources. Despite some progress in the epidemiological and clinical research, many problems on pathophysiology and treatment of COPD remain to be resolved. Mechanisms of the chronic damage and of the progression of the disease are not known; except for smoking cessation, there are no effective treatments able to prevent the progressive decline in the pulmonary function. The Congress to be held in Florence, February 5-6, 1999, may represent an important meeting where dedicated international researchers will discuss and develop the major topics related to the mechanisms and the therapeutic strategies of COPD. A better comprehension of all aspects of this disease (epidemiology, pathophysiology, diagnosis) will be particularly useful for a better prevention and treatment of COPD.
Prof. Carlo Giuntini President of the Meeting