Glossary

Age-standardization - A technique used to remove as far as possible the effects of differences in age when comparing two or more populations. In this report, rates were applied to five-year age groups in the 1991 Canadian population (the standard population) in order to obtain the overall rate for each year.

Allograft – Tissue or organ transplanted from one person to another.

Alpha 1 antitrypsin (A1AT) deficiency - An inherited disorder associated with retention of the liver-produced protein A1AT in the liver and low levels of A1AT in the serum. In the most severe form of A1AT deficiency, the clinical features consist of early-onset emphysema, neonatal hepatitis, chronic hepatitis, and cirrhosis. However, phenotypic expression throughout life is extremely variable.

Antenatal steroid – Steroid administered before birth with the intention of helping the lungs of a premature fetus to mature.
Asbestosis (ICD 9 code 501; ICD 10 code J61) – An irreversible condition caused by inhaled asbestos fibres, featuring scarring of the lungs. Can lead to COPD.

Asthma (ICD 9 code 493, ICD 10 code J45-J46) - A chronic disorder characterized by symptoms of cough, shortness of breath, chest tightness and wheeze. Prevalence estimates in this report are based on responses to the following questions: For children 5-11 “Has he/she ever had asthma that was diagnosed by a health professional?”; for 12+ “Now I’d like to ask about certain chronic health conditions which you may have. We are interested in long-term conditions which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional . . . Do you have asthma?”

Bronchiectasis – Chronic abnormal dilation of the bronchi associated with recurrent respiratory infections.
Bronchiolitis (ICD 9 code 466.1, ICD 10 code J21) - Inflammation of the smaller airways in the lung, usually caused by bacterial or viral infection.

Bronchiolitis obliterans (BO) - Chronic progressive allograft dysfunction with airflow limitation as a result of obstruction of the small airways, thought to be a manifestation of chronic rejection. While uncommon in the first year following transplant, BO incidence increases steadily thereafter. It is present in at least half of long-term lung transplant survivors and is the predominant cause of death after the first year following transplant.

Bronchopulmonary dysplasia - Changes to a baby’s lungs following severe respiratory distress in preterm infants who have been treated with oxygen and mechanical ventilation.
Chronic obstructive pulmonary disease (COPD) (ICD 9 code 490-492, 496; ICD 10 code J40-44) - A chronic disease with shortness of breath, cough and sputum production, also referred to as chronic bronchitis and emphysema. Prevalence estimates in this report were derived by combining responses to the following questions: “Now I’d like to ask about certain chronic health conditions which you may have. We are interested in long-term conditions which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional” “. . . chronic bronchitis,” “ . . . emphysema,” “ . . . chronic obstructive pulmonary disease (COPD).”

COPD projections (hospitalization and mortality) – Simple projections created using the trendline feature in spreadsheet software. Available data were fit to a curve using linear or polynomial regression as indicated and the trend was projected to 2010.

Co-morbidity – Co-existence of two or more diseases or conditions.

Continuous positive airway pressure (CPAP) – The delivery of slightly pressurized air through a mask to increase the amount of air breathed without increasing the effort of breathing. Used in the treatment of obstructive sleep apnea and COPD.

Current smoker - includes daily smokers and non-daily smokers (also known as occasional smokers). Determined from the response to the question "At the present time do you smoke cigarettes every day, occasionally, or not at all?"

Cystic fibrosis (ICD 9 code 277.0, ICD 10 code E84) - A chronic genetic disease that causes individuals to produce abnormal mucous in the lungs that interferes with breathing and affects the ability of the pancreas to produce sufficient enzymes needed for the digestion of food.

Daily smoker - refers to those who respond "every day" to the question "At the present time do you smoke cigarettes every day, occasionally or not at all?"

Dyspnea – Shortness of breath, difficulty or laboured breathing.
Emphysema – A chronic respiratory disease featuring overinflation of air sacs (alveoli) in the lungs causing a decrease in lung function. (See also Chronic obstructive pulmonary disease.)

Exacerbation – An increase or worsening of the severity of symptoms.

High sampling variability – Population surveys include only a sample of the population. This sample may or may not be representative of the population as a whole. If the number of people who answer a question is very small, then the estimate of what is happening in the population based on this number may not be accurate. A measure of the degree of accuracy is the co-efficient of variance. When the co-efficient of variance exceeds a certain level, interpretation requires caution because the actual value could vary considerably from the estimate obtained in the survey. In this report, the following values were used to define high sampling variability:

• 0 – 16.5% = reliable estimate
• 16.5% – 25.0% = high sampling variability of estimate
• > 25.1% = estimate not used for this report

Hospitalization diagnosis – Each time an individual leaves hospital (discharge, transfer or death) a record is completed listing one or more diagnoses that contributed to the hospital stay. The condition responsible for the length of stay in hospital is listed as the most responsible diagnosis. Up to 15 other conditions may also be listed. This report uses the most responsible diagnosis for all analyses unless otherwise indicated.
Hypersensitivity pneumonitis (extrinsic allergic alveolitis) – (ICD 9 495; ICD10 J67) - An inflammation of the lung caused by the body's immune reaction to small airborne particles such as bacteria, mould, or fungi.

Immunosuppression - Suppression of the body's natural defence system; usually necessary to prevent organ transplant rejection.

Incidence (or incidence rate) - The number of new cases that occur in the population at risk during a specific time period. (Incidence rate is the number of new cases divided by number of at risk individuals in the population, commonly during a one-year period and is typically expressed per 100,000 population.

Influenza (ICD 9 code 487, ICD 10 code J10-J11) – Infection by the influenza virus, causing mild to severe respiratory symptoms.

International Classification of Disease (ICD) - The global standard to report and categorize diseases, health-related conditions and external causes of disease and injury in order to compile useful health information related to deaths, illness and injury (mortality and morbidity). The 9th revision of the ICD (ICD 9) was used after 1979 until the 10th revision, which was phased in from 1999 to 2001.

• ICD Codes for complications of pregnancy (ICD9 code 630-676; ICD 10 code O00-O99)
• ICD Codes for reproductive causes ICD-9, V20-V39, ICD-10 Z30-Z39

Isocyanates - Petrochemical-based precursors for the manufacture of flexible and rigid polyurethane (PUR) foams, a family of polymers.

Low birthweight – Live births weighing less than 2500g.

Lung cancer (ICD 9 code 162, ICD 10 code C33-C34) – A malignant tumour with abnormal growth of lung tissue.

Mesothelioma - A malignant tumour affecting the lining of the chest or abdomen.

Mortality diagnosis – For the purpose of this report, the diagnosis most responsible for death according to the death certificate.

Neonatal – Pertaining to age from birth to 28 days.

Occasional smoker - also referred to as non-daily smoker, refers to those who respond "Occasionally" to the question "At the present time do you smoke cigarettes every day, occasionally or not at all?"

Oximetry – Non-invasive test to measure the amount of oxygen in the blood.

Polysomnography – A sleep study to assess quality of sleep and air flow to the nose and mouth; used to diagnose sleep apnea.

Pneumonia (ICD 9 code 480-486, ICD 10 code J12-J18) - Inflammation of lung, usually caused by bacterial or viral infection.

Pneumoconiosis (ICD 9 code 011.4,495, 500-505; ICD 10 code J60-J66) - Includes silicosis, coal workers’ pneumoconiosis, and asbestosis, as well as historically less common diseases such as talc-related lung disease, siderosis, stannosis, bauxite lung (from aluminum), graphite lung and lung disease from beryllium.

Pulmonary Fibrosis - Chronic lung inflammation with progressive scarring of the alveolar walls.

Pulmonary Hypertension - Elevated blood pressure in the pulmonary arteries from constriction; causes problems with the blood flow in the lungs and makes the heart work harder.

Preterm birth rate - The proportion of live births with a gestational age at birth of less than 37 completed weeks (259 days or less) in a specific place and time.

Prevalence (point prevalence) - The proportion of the population who report a behaviour or have a health problem at a particular time.

Quality adjusted life year (QALY) – A measure of the value of health. A year of life is adjusted for its quality or its value. A year in perfect health is considered equal to 1.0 QALY. The value of a year in ill health would be discounted.

Respiratory distress syndrome (RDS) (ICD 9 code 769; ICD 10 code P22.0) – A condition of newborns, also known as hyaline membrane disease, that results in breathing difficulties due to a deficiency of lung surfactant, which coats the alveoli (airs sacs) to prevent them for collapsing as the baby exhales.

Respiratory syncytial virus (RSV) – A virus that causes both upper and lower respiratory symptoms. It is the underlying cause of most cases of bronchiolitis and pneumonia in children under 2 years of age.

Second-hand smoke is what smokers exhale and the smoke that rises from a burning cigarette.

Silicosis and Anthracosilicosis – ICD 9 500, 502; ICD 10 J60, J62 – Pneumoconiosis caused by carbon dust or silica dust.

Silicotuberculosis – ICD 9 011.4; ICD 10 J65 – Pneumoconiosis associated with tuberculosis.

Sleep apnea (ICD 10 code G47.3) - A disorder in which a person stops breathing during sleep, at least five times per hour, usually for periods of 10 seconds or longer.

Spirometry – A test of the air capacity of the lungs; lung function testing.

Surfactant – Substance secreted naturally in the lungs to reduce the surface tension of fluids coating the lungs, preventing the lungs from collapsing; the lack of surfactant causes respiratory difficulties in preterm infants.

Tuberculosis (TB) (ICD 9 code 010-018, 137; ICD 10 code A15-A19, B90) – A disease caused by a bacterium called Mycobacterium tuberculosis. TB usually attacks the lungs, but it can also affect other parts of the body such as the lymph nodes. The disease is spread when an infected individual coughs, sending TB bacteria into the air.

Xenotransplantation - Transfer of organs or tissue from one species to another species, such as from animals to humans.