Ahead of World Lung Day on Sunday September 25,
Lung Health Coalition Calls on Health Service to Urgently Combat Delays in Breathing Test Diagnostics
– Survey shows widespread staff vacancies, with many patients having to wait months, even years, for simple diagnostic breathing tests –
“At the moment, we are being left to make an educated best guess,
which is like seeing a diabetes patient, without knowing their blood sugar levels”
– Consultant Respiratory Physician
Strict embargo: Monday September 19 at 6am
The Irish Lung Health Alliance, a coalition of charities working to promote healthy lungs, has today called on the Health Service Executive to urgently address delays in the provision of breathing tests, or pulmonary function tests, crucial in the diagnosis of a range of lung diseases.
The call comes ahead of World Lung Day on Sunday September 25th, and a survey of 19 pulmonary function laboratories showing widespread staff vacancies and many patients having to wait months, even years, for pulmonary function tests.
As part of its lung health awareness campaign, the Alliance is urging the public to adopt its “Top Five Steps to Love your Lungs” by availing of ‘flu, pneumonia and COVID-19 vaccines, by quitting smoking, by limiting exposure to air pollution, by eating a balanced diet, and by being physically active.
Members of the Irish Lung Health Alliance include: the Alpha-1 Foundation Ireland, the Asthma Society of Ireland, the Chartered Physiotherapists in Respiratory Care, COPD Support Ireland, Cystic Fibrosis Ireland, the Irish Association of Respiratory Nurses (ANAIL), the Irish Cancer Society, the Irish Institute of Clinical Measurement Physiologists, the Irish Lung Fibrosis Association, the Irish Sleep Society, the Irish Thoracic Society, and the Tobacco Free Research Institute.
Laboratory Survey
The survey of pulmonary function laboratories located across Ireland took place during August 2022, with 19 laboratories responding of a total of 33 invited to participate. Key findings were:
- Vacancies: two-thirds (68%) of the laboratories who responded had vacancies for respiratory physiologists, with the majority of these having multiple vacancies
- Pulmonary function tests: when it comes to this vital diagnostic breathing test, nine laboratories noted their waiting list was now 18 months or more, with four of these indicating a waiting period of three years or more
- Sleep studies: needed to diagnose serious conditions such as sleep apnoea and narcolepsy, nine laboratories now have a waiting list of a year or more for sleep studies, with patients of six laboratories waiting two years or more
- Breathing challenge tests: seven laboratories now have a waiting list of a year or more for this test which diagnoses asthma. Clearly, any delay in offering this key diagnostic tool has implications for patient treatment and would be a significant cause of concern
- Workload: almost 85 per cent of laboratories (16 of 19 laboratories) who responded noted that their workload had increased since before COVID. Five laboratories indicated that their workload had increased by 25%, five laboratories by 50%, and two laboratories by 100%
Under-resourced
For Dr Marcus Butler, consultant respiratory physician and member of the Irish Lung Health Alliance, not having prompt access to pulmonary function tests is akin to working blindfolded:
“Pulmonary function tests (PFTs), or breathing tests, are crucial in making an accurate diagnosis of lung disease. However, the pandemic has exposed that this service is majorly under-resourced and it has been severely curtailed. PFTs are crucial in making an accurate diagnosis of conditions such as asthma and Chronic Obstructive Pulmonary Disease (COPD), and to determine the severity of practically every other lung disease. This is a test that should be available as quickly as possible based on often urgent clinical need – for urgent cases, ideally on the same day. At the moment, we are being left to make an educated best guess, which is like seeing a diabetes patient, without knowing their blood sugar levels. We really are working blindfolded.
“Latest figures from the Central Statistics Office show that of the 33,055 people who sadly passed away in 2021, almost a quarter of these died as a result of a lung-related illness, including COVID-19. Yet, there are lung function tools available that can help us to reduce lung health mortality and morbidity, but we need to have access to them. Our health service can, and must, do better.”
Playing Havoc
Ann Marie O’Connell, Senior Respiratory Physiologist and President of the Irish Institute of Clinical Measurement Physiologists, commented:
“Pulmonary function tests are not only vital in diagnosing new patients but also in the ongoing treatment and care of patients who may be undergoing surgery, chemotherapy, and even bone marrow transplants. Unfortunately, too many laboratories that carry out these tests are now seeing waiting times of anywhere between 18 months and three years and indeed longer. The precautions required for COVID have meant that we are seeing a lot less patients each day due to hygiene requirements. It has played havoc with the scheduling of appointments and has meant our waiting lists getting longer and waiting times being pushed further out.
“We also know from our survey that two-thirds of laboratories who responded have vacancies. We urgently need to put in place additional training places for respiratory physiologists so that we can not only start to reduce the numbers on waiting lists but also plan for a growing population which is going to create even bigger pressures on our services. Additionally, we need to ensure greater consistency among hospitals when it comes to the availability of hygiene equipment and facilities, whether that be air sterilisers, HEPA-filtration, screens or negative pressure rooms.”
World Lung Day is co-ordinated by the Forum of International Respiratory Societies and the European Lung Foundation. For more information on the work of the Irish Lung Health Alliance or to download the “Top Five Steps to Love Your Lungs” factsheet, visit www.lunghealth.ie. Follow on social media using hashtag #WorldLungDay
ENDS
Issued on behalf of the Irish Lung Health Alliance by:
Don Delaney, director, d2 communications, tel.: 01 910 8987 / 087 793 3249
Lung Diseases
Latest statistics from the Department of Health’s National Healthcare Quality Reporting System (annual report 2020) show the following:
- Asthma – Ireland has one of the highest rates of asthma prevalence in the world, with approximately 450,000 people with doctor-diagnosed asthma, of whom approximately 240,000 are estimated to have uncontrolled asthma. Evidence suggests that the prevalence of asthma within the population is rising.
- COPD or Chronic Obstructive Pulmonary Disease – also known as bronchitis or emphysema, it is estimated that 380,000 people are living with COPD in Ireland, yet only 110,000 are diagnosed. Sadly, at least 1,500 people die of COPD each year.
- Lung cancer – this is the leading cause of cancer death in both men and women in Ireland, with over 2,700 people diagnosed with the disease each year. Incidence rates of lung cancer in our most deprived areas are more than twice as high as those in our least deprived areas, reflecting the strong association with smoking.
Other lung diseases which have a significant impact on the health and well-being of people in Ireland include:
- Obstructive sleep apnoea – where the upper airways are obstructed during sleep, this is currently estimated to affect 600,000 people in Ireland with prevalence on the rise due to ageing and obesity.
- Alpha-1 antitrypsin deficiency (or Alpha-1) – a genetic condition that can cause lung, liver, and skin disease, and which often leads to COPD, is estimated to affect 250,000 people on the island of Ireland.
- Cystic fibrosis – Ireland has the highest incidence of cystic fibrosis per capita in the world among its indigenous population and some of the most severe forms of the disease.
- Lung fibrosis – with 400 people diagnosed with this condition each year, it can affect both smokers and non-smokers, and is known to develop in family members.
About the Irish Lung Health Alliance
The Irish Lung Health Alliance is a coalition of Irish charities that have joined forces to promote healthy lungs. Lung disease incorporates a range of diseases and conditions such as asthma, lung cancer, cystic fibrosis, tuberculosis, sleep apnoea, lung fibrosis, sarcoidosis, alpha-1 antitrypsin deficiency, and chronic obstructive pulmonary disease, also known as COPD, bronchitis or emphysema. For more information, visit www.lunghealth.ie