89 per cent people are unaware about Spirometry: Study

Spirometry is the only diagnostic tool that detects the health of our airways and our lungs. According to a questionnaire based survey conducted by Chest Research Foundation, Pune, in the major 24 cities of India across Maharashtra, Tamil Nadu, Kerala, West Bengal, Uttar Pradesh, Karnataka, Gujarat and Andhra Pradesh, 89 per cent of people had never heard of spirometry. In contrast almost 70 per cent of the respondents knew what an ECG is despite the fact that the number of patients suffering from chronic respiratory (Asthma and COPD) diseases, is much more that the number of patients of Diabetes, Heart Diseases and stroke all taken together, according to a report published in a leading medical journal in India.

According to a report published by the National Centre for Macroeconomics and Health, the estimated economic loss due to COPD in India is around Rs 35,000 crores. If managed according to guidelines, this cost should not have been more than 3500 crores.  Similarly with Asthma, India loses money to the tune of an estimated 10,000 crores which should ideally be just about 3000 crore if managed according to guidelines.

Spirometry, which is the gold standard diagnostic test, remains poorly utilised in clinical practice. In a nationwide survey conducted by Chest Research Foundation in the year 2005 to study the use of Spirometry for the diagnosis of obstructive airways diseases, it was found that 75 per cent of patients with OADs had never been subjected to Spirometry. Primary care practitioners asked for a Spirometry in only 9 to 11 per cent of cases. This leads to a large number of cases being undiagnosed and consequently untreated. Commenting on the issue, Dr Sundeep Salvi, Director, Chest Research Foundation said “Trying to control serious respiratory diseases without using a Spirometer is like trying to control a patient’s blood pressure without bothering to use a sphygmomanometer. It is unfair to the patient.”

In the above mentioned survey considering that nearly 26 per cent of these people were smokers, almost 16 per cent had chronic breathlessness and chronic cough, and 12 per cent had wheeze and those who were diagnosed of asthma or COPD only about 53 per cent had heard about spirometry.

“Spirometry is actually as easy to conduct and interpret as an ECG and sonography.” Dr Salvi affirmed. Dr. Monica Barne from Chest Research Foundation said, “Spirometry is poorly taught in medical colleges. Hence most doctors believe that it is not as essential a test. Doctors also continue to believe that spirometry is expensive, difficult to conduct and that its interpretation requires special expertise. Given the state of the nation’s respiratory health, we cannot afford such myths that play with the lives of millions. For the patient there can be no stronger evidence than a spirogram. It removes resistance to inhalation therapy, which is best for both asthma and COPD. And it also helps improve compliance as the graph shows the progress the patient has made.”

Spirometer is also a very useful tool to measure the true age of the lungs of a person who is a smoker and a major ally in helping smokers to quit. Sir John Hutchison, the inventor of the modern day spirometer had recommended the use of spirometry by all insurance companies to predict longevity.

CRF has been conducting regular training programmes in spirometry for doctors and laboratory technicians. It has also developed distance education programmes and a unique online quality assurance programme to promote the use of this diagnostic tool all over the country.