“Diseases of the respiratory system are particularly frequent, only bronchial asthma and chronic obstructive bronchitis affect about 12% of the Italian population. Not only that: pulmonary infections (pneumonia) and pulmonary neoplasms remain a reason for frequent hospitalization, which today represent the leading cause of mortality among men in the field of neoplasms. All interstitial lung diseases and sleep apnea syndrome follow. COPD is the third cause of death in Italy and in the world. To influence the quality of the air, therefore atmospheric pollution, and above all the smoke. Well, as far as COPD is concerned, the battle we have not yet won is the one against smoking”. This was stated to Adnkronos Salute by Claudio Micheletto, director of the Complex Operational Unit of Pneumology of the University Hospital of Verona, rattling off data on the protagonist respiratory diseases, together with the health policy issues linked to the implementation of the Pnrr and post-Covid pulmonology, of the XXIV national congress of Italian pulmonology scheduled at the Fiera del Levante in Bari, from 9 to 11 June.
In Italy the number of smokers is stable at around “23% – recalls Micheletto – still a very high percentage, if we think that the main cause of chronic obstructive bronchitis is tobacco. But the number of smokers among young people is also worrying because smoking at a young age, especially continuous, predisposes towards COPD. Air pollution also acts as a trigger, air quality is crucial for respiratory health. The tracheobronchial apparatus moves liters and liters of air every day and therefore our bronchi are in contact with the environment”. Not only fine dust is under accusation “but also ultra-fine dust capable of reaching the alveoli and going into the bloodstream, therefore they also represent a risk factor for cardiovascular diseases”.
Spirometry and pulmonologist consultancy are provided in the Health Homes
And the expert has no doubts about the pulmonology of the future: “It is also being redesigned in the context of a new organization of the NHS – he points out – The positive lesson that we can draw from the pandemic concerns the home monitoring of many patients – in particular for the more serious ones who need oxygen therapy or non-invasive mechanical ventilation. Telemedicine has proven to be fundamental and can allow for careful monitoring of patients’ conditions while avoiding unnecessary access to hospital facilities”.
Furthermore, as “specialists” we are “building a new relationship with the territory, given that the legislation establishing the Health Homes provides that in the hub centers (one for every 50,000 inhabitants) there should be a spirometer among the technological equipment and the possible consultation of the pulmonologist specialist. This would allow, in particular for less complex cases – he explains – territorial management with adequate tools. The access of specialists for respiratory diseases will also be foreseen in the Health Homes: cardiologist, pulmonologist and diabetologist. The goal is to leave the walls of our hospitals and ensure that the patient can also find in the area – concludes Micheletto – an adequate method of diagnosis, control and monitoring”.