July 22, 2021

Chronic Obstructive Pulmonary Disease (COPD): What is it? Are you at risk?

Written by: Maki Palad, M.D.
Reviewed by: Mubashar Rehman, PHD

The Centers for Disease Control and Prevention (CDC) reports that COPD affects almost 16 million Americans, and it ranks fourth on the causes of mortality or deaths in 2018 [1,2]. The statistics could be higher as more than 50% of individuals with weak respiratory function did not know they had COPD [3]. So what is it that makes up this disease, and should you be concerned?

 

What is it?

COPD is caused by significant airway and alveolar changes due to exposure to harmful substances and gases [4]. In COPD, there is a chronic airway limitation characterized by respiratory symptoms such as cough, shortness of breath, and sputum production. It is, however, relatively common and can be prevented or treated. When there is constant and significant damage to the lungs, the chronic inflammation causes the airways to constrict and limit airflow, hence, the term chronic obstructive pulmonary disease.

 

What are the signs?

There are key indicators to consider the diagnosis of COPD, and these must be caught early in the course to prevent further damage. If you are over 40 years old and have any of these signs, you may want to ask your physician about it. Although having any of these indicators does not mean you have the disease, it increases the probability of having COPD. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), the following are the most common symptoms of COPD [4]:

Shortness of breath

Dyspnea, or shortness of breath, is a significant sign of COPD. It is mainly described as feeling short of breath most of the day or characteristically worse with exercise. Others can describe it as chest heaviness, air hunger, or a sense of increased effort to breathe. This symptom may also be progressive and can make daily tasks such as walking or doing household chores difficult.

Cough

Initially, cough can present on and off and progresses to daily and even throughout the day. It may be productive or nonproductive. You may find yourself with bouts of cough that won’t go away and eventually causes discomfort. Chronic bronchitis or cough that has been present for at least three months is a major component of COPD.

Sputum production

It is quite common for your cough to produce mucus or sputum that may be clear to yellow. Regular sputum production with your cough can be hard to tell apart from other conditions that may also present similarly. However, the presence of sputum with coughing, especially when it has been going on for several months without any other conditions that may explain it, should raise concern for a possible COPD diagnosis.

 

Are you at risk?

Exposure to smoke and harmful particles

There is significant evidence that your risk for developing COPD is from a history of cigarette smoking. Although it is a factor that causes most COPD cases, it is not the only risk factor that influences disease development. Smoke from biomass fuels, tobacco, and other harmful substances causes the lungs to be inflamed. This is a typical response of the lungs when exposed to harmful foreign particles. However, chronic exposure, such as in heavy smokers, leads to lung destruction and eventually disrupts function. Occupational exposure like organic dusts, and chemical fumes should also be given light. A UK-based study among sculptors, gardeners, and warehouse workers showed a higher association in developing COPD [5]. Indoor air pollution from poorly functioning stoves, coal, wood, and crop residues burned in open fires are also contributors to this disease. Increased levels of urban air pollution are also said to have detrimental health risks, especially to those with heart and lung conditions.

 

Asthma and underlying lung conditions

Other than cigarette smoking and exposure to particles, asthmatics and those with underlying lung pathology are at risk of developing COPD. Asthma and COPD are very much related in terms of symptoms, and oftentimes, these two are difficult to tell apart. One study showed that people who have asthma were 12 times more at risk of having COPD than those without asthma [6]. Because of the airway hyper-responsiveness in asthma, it puts the individual at risk of decreased lung function, leading to COPD.

COPD— A Summary:

Chronic Obstructive Pulmonary Disease is a disease that is found in many adults. It is characterized by chronic airway inflammation that leads to narrowing of the airway and limiting airflow. Some of the most common symptoms of COPD are shortness of breath, chronic cough, and sputum production. And the risk of developing this disease is highest in cigarette smokers and asthmatics! COPD can easily be prevented and there is a good amount of medications available to treat this disease.

 

References:

  1. Xu JQ, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2018. NCHS Data Brief,Number 355. Hyattsville, MD: National Center for Health Statistics; 2020.
  2. Wheaton AG, Cunningham TJ, Ford ES, Croft JB. Employment and activity limitations among adults with chronic obstructive pulmonary disease — United States, 2013. MMWR Morb Mortal Wkly Rep. 2015:64 (11):290–295.
  3. Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey 1988-1994. Arch Intern Med. 2000;160:1683–1689.
  4. GOLD (2021) Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. Available at: https://goldcopd.org/2021-gold-reports/
  5. De Matteis S, Consonni D, Bertazzi PA. Exposure to occupational carcinogens and lung cancer risk. Evolution of epidemiological estimates of attributable fraction. Acta Biomed. 2008;79 Suppl 1:34-42.
  6. Silva GE, Sherrill DL, Guerra S, Barbee RA. Asthma as a risk factor for COPD in a longitudinal study. Chest. 2004;126(1):59-65. doi:10.1378/chest.126.1.59
Article written by Maki Palad, M.D.
Maki is a medical doctor from Manila, Philippines.She also majored in Biology prior to pursuing a medical career. When she is not working, she does freelance writing for health blogs and websites. She also does volunteer work for telehealth consultations and onsite charity clinics. During her free time, she likes to spend it at home reading, binge-watching her favorite shows and working out.

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