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Lung Health: Breathe Easier
Chronic Obstructive Pulmonary Disease (COPD)
Know the Facts
- Chronic Obstructive Pulmonary Disease (COPD) is characterized by obstruction to airflow from the lungs.
- COPD is the fourth leading cause of death in the United States and claims the lives of 117,522 Americans annually.
- Smoking causes approximately 80 to 90 percent of COPD cases; a smoker is 10 times more likely than a nonsmoker to die of COPD.
- Occupational exposure to certain industrial pollutants increases the odds for COPD. A recent study found that the fraction of COPD attributed to work was estimated as 19.2%.
- COPD limits a person's ability to:
- Work.
- Tolerate normal physical exertion.
- Do household chores.
- Participate in social activities.
- Sleep.
- COPD includes emphysema and chronic bronchitis, but does not include asthma. Emphysema and chronic bronchitis frequently coexist.
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Emphysema
Emphysema causes irreversible lung damage. The walls between the air sacs within the lungs lose their ability to stretch and recoil. They become weakened and break. Air can be trapped in the air sacs and this impairs the exchange of oxygen and carbon dioxide. Also, the support of the airways is lost, allowing for obstruction of airflow.- Prevalence and Incidence
Forty-three percent of emphysema sufferers are women and the incidence of this condition is increasing among women. - Symptoms
Symptoms of emphysema include cough, shortness of breath and a limited exercise tolerance. Diagnosis is made by pulmonary function tests, along with the patient's history, examination and other tests. - Hereditary Emphysema
Alpha1 antitrypsin deficiency-related (AAT) emphysema is caused by the inherited deficiency of a protein called alpha1-antitrypsin (AAT) or alpha1-protease inhibitor. AAT, produced by the liver, is a "lung protector." In the absence of AAT, emphysema is almost inevitable. It is responsible for 5% or less of the emphysema in the United States.
An estimated 50,000 to 100,000 Americans, primarily of northern European descent, have AAT deficiency emphysema.
The onset of AAT deficiency emphysema, between the 20's and 40's, is characterized by shortness of breath and decreased exercise capacity. Blood screening is used if the trait is suspected and can determine if a person is a carrier or AAT-deficient.
Smoking significantly increases the severity of emphysema in AAT-deficient individuals.
A recent study suggested that there are at least 116 million AAT carriers among all racial groups, worldwide.
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Chronic Bronchitis
Chronic bronchitis is defined by the presence of a mucus-producing cough most days of the month, three months of a year for two successive years without other underlying disease to explain the cough.Chronic bronchitis is an inflammation and eventual scarring of the lining of the bronchial tubes. These tubes connect the trachea (windpipe) with the lungs. When the bronchial tubes are inflamed and/or infected, less air is able to flow to and from the lungs and a heavy mucus or phlegm is coughed up. Chronic bronchitis may precede or accompany pulmonary emphysema.
- Prevalence and Incidence
Women develop chronic bronchitis at a significantly higher rate than men. In 2001, 3.7 million men had a diagnosis of chronic bronchitis compared to 7.5 million women. Chronic bronchitis affects people of all ages, but is higher in people over 45 years of age. - Symptoms
Symptoms of chronic bronchitis include chronic cough, increased mucus, frequent clearing of the throat and shortness of breath.Once the bronchial tubes have been irritated over a long period of time, excessive mucus is produced constantly, the lining of the bronchial tubes becomes thickened, an irritating cough develops, airflow may be hampered, and the lungs are endangered. The bronchial tubes then become an ideal breeding place for infections.
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Know Your Risk Factors
You are at risk for COPD if you:
- Currently smoke (or have smoked a lot and for a long time in the past); Cigarette smoking is by far the most common cause of chronic bronchitis and emphysema.
- Work in an area where there is a lot of dust and irritating fumes.
- Have been exposed to secondhand smoke in your home or work for extended periods of time.
- Have a productive cough (with phlegm or sputum) most days of the week.
- Feel short of breath with routine activities.
- Have shortness of breath with less and less activity.
- Have a family history of early COPD (before age 45).
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Manage Your Risk Factors
A good care plan for any person with COPD should include the following:
- Don't smoke! If you smoke and would like help with quitting, please speak with your doctor or call HIP's Quit For Life Quit Smoking Program at 1-866-QUIT-4-LIFE (784-8454) TDD: 1-877-777-6534.
- Avoid exposure to colds and influenza at home or in public.
- Avoid respiratory irritants such as secondhand smoke, dust, and other air pollutants.
- Follow a nutritious, well-balanced diet, and maintain your ideal body weight.
- Get regular exercise daily, to the extent that you are able to tolerate activity. (Consult your physician about your exercise tolerance.)
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Work with Your Doctor
Vaccination
Pneumonia and Influenza vaccines should be given to COPD patients. Ask your doctor about getting vaccinated against influenza and pneumococcal pneumonia.- Consultation
See your doctor or follow your doctor's instructions at the beginning of any cold or respiratory infection. - Medication
None of the existing medications for COPD has been shown to modify the long-term decline in lung function that is the hallmark of this disease, except oxygen for emphysema when it is necessary. Medication for COPD is used to decrease symptoms and/or complications. - Bronchodilator medications may be prescribed to help relax and open up the air passages in the lungs.
- Additional treatment includes antibodies, oxygen therapy, and systemic glucocorticosteroids. The efficacy of inhaled glucocorticosteroids is under study. Chronic treatment with steroids involves the risk of serious side effects.
- Oxygen
The quality of life for a person suffering from COPD diminishes as the disease progresses. At the onset, there is minimal shortness of breath. People with COPD may eventually require supplemental oxygen and may have to rely on mechanical respiratory assistance.
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