Drawing attention to the importance of prevention of lung diseases through education, environmental protection, behavioural changes and improved air quality. We support Europe in formulating ambitious goals around prevention and will help to improve respiratory health.
Our approach to healthcare should pivot towards preventing disease. Increased screening, particularly for rare respiratory diseases and lung cancer, and educating people on how to live with and manage their disease should become a normal part of the healthcare cycle. Exposure to environmental pollution should be in front of mind, influencing consumer, work, and policy decisions. Policy revisions should consider prevention measures in all specific disease scenarios to deliver best responses. In addition, Eurobarometer data should be used to inform prevention approaches.
Normalised prevention approaches
The EU sets indoor and outdoor air quality standards: By 2030, everyone in Europe should be able to enjoy clean air. The 1996 Air Quality Framework Directive is the foundational EU law that established a common strategy to assess and manage ambient air quality across EU member states. There is also no specific, binding EU-level legislation that sets harmonized pollutant limits for indoor air quality. However, the Directive’s objectives are not well implemented and a framework to address the issues of indoor and outdoor pollution and pollen should be needs to be developed and well implemented, filtering through to national policy. Various policies that range form tobacco, to construction products, chemicals, climate change, that have implications for air quality but not the issue at its core. These EU frameworks should would follow the updated of the WHO air quality guidelines and set the air quality standards for the EU.
The average European resident could live about 6 months longer if particulate air pollution (PM2.5) were reduced to the WHO guideline level.
Air pollution costs over €1,000 per person per year . Air standards would be no longer fragmented and neglected at the national level. They should be coherently addressed in one holistic framework which clearly lays out expectations, accountability and empowers lung patients and professionals for action through information. Air quality enforcement should be effective, including tackling individual choices such as wood burning. A tangible reduction in exposure to respiratory environmental risks must be seen.
Air pollution shortens the average life expectancy of Europeans by about two years.
A recent achievement by the EU has been the 2024 revision of the EU Council Recommendation on Smoke free environments, which looks at the effects of second-hand smoke and aerosols. It recommends that Member States extend smoke-free environment policies to key outdoor areas, to better protect people in the EU, particularly children and young people. This is one step closer to protecting patients from the damages from tobacco.
Tobacco regulation becomes a higher EU ambition: further reduction in tobacco usage leads to an overall health improvement for all respiratory diseases and helps reduce lung cancer and COPD incidence. The WHO Framework Convention on Tobacco Control is an overarching binding law which all EU Member States are obligated to follow, This should be the minimum standard implemented in all EU Member States, including better regulation to protect against second-hand smoke exposure. The current revision of the EU tobacco framework, is aimed at bringing newer products within the EU’s regulation including all nicotine products, with the goal of making regulation of these new products as stringent as traditional tobacco products (e. g. plain packaging and flavours and gimmicks aimed at children). The ELHG supports the EU setting aligned policies on the commercialisation, taxation and norms regulating tobacco and newer smoking products. Ultimately the sale of tobacco and its use should be banned in Europe.
In Europe, tobacco consumption is the leading preventable cause of death, responsible for around 15.4% of male deaths and 4.7% of female deaths in adults over 30 years old.
Secondary prevention measures become routine: Measures such as screening, lung health checks, self-management, and pulmonary rehabilitation, which will be key for COVID-19 survivors with longer term lung damage, should be available to all to reduce and prevent deterioration, exacerbations or further illness for people living with respiratory disease. This will enhance quality of life and lead to longer lives. A programme of early screening should be established across Europe, recognising that respiratory diseases also lead to other chronic diseases.
Lung cancer becomes a less deadly chronic disease: Lung cancer is the biggest cancer killer in Europe, with over 20% of cancer deaths. A very large benefit can be gained from better treatment and early interventions, such as screening rolled out across Europe. With more effective treatment and smoking cessation, lung cancer would become a chronic disease.
Abnormal lung growth is associated with 15-20% of deaths of newborns.
The COPD curve is flattened: With greater awareness and earlier diagnosis the deterioration typically seen in COPD can be reduced before rapid deterioration begins, dramatically improving the lives of patients living with COPD.
The European Region misses 1 in 5 tuberculosis cases – a critical gap in detection and care.
Vaccines to address infectious lung diseases are improved and championed: Significant improvements in vaccines and their availability will tackle the situation we have today with 1 million people being hospitalised with pneumonia per year , while new vaccines are developed which address existing risk factors in tuberculosis. Vaccine hesitancy should also be reduced by championing vaccination to protect vulnerable people, building on the public attention received during the COVID-19 pandemic. Respiratory patients need to have the information on vaccinations to be able to adhere to vaccination plans. The WHO European Immunisation Agenda 2030 aims to leave no-one behind and should be fully supported by all health agencies in Europe.