November marks COPD Awareness Month, a time dedicated to spreading awareness about Chronic Obstructive Pulmonary Disease (COPD). COPD is a common lung disease causing restricted airflow and breathing problems. In people with COPD, the lungs can get damaged or clogged with phlegm. Symptoms include cough, sometimes with phlegm, difficulty breathing, wheezing, and tiredness. COPD is not curable but symptoms can improve if one adopts its control measures such as avoiding smoking and exposure to air pollution and getting vaccines to prevent infections. It can also be managed with medicines, oxygen, and pulmonary rehabilitation. 

In this blog, we’ll explore the burden of COPD, its symptoms, risk factors, and prevention strategies, and debunk some common myths surrounding this condition.

The Burden of COPD

COPD is a progressive lung disease characterized by obstructed airflow, making it difficult to breathe. It encompasses conditions such as chronic bronchitis and emphysema, and its prevalence has been steadily rising.

According to the World Health Organization (WHO), COPD is the third leading cause of death worldwide, causing 3.23 million deaths in 2019 worldwide. Nearly 90% of COPD deaths in those under 70 years of age occur in low- and middle-income countries (LMIC). 

According to a new study, Nepal had the world’s highest age-standardised death rates for COPD in  2019 i.e 182.5 per 100,000 population.

Population-based Prevalence of Selected Chronic Non-communicable Diseases in Nepal study carried out by Nepal Health Research Council (NHRC) said in Madhes province, 16.4 percent of the total population i.e one in every six people; In Sudurpaschim Province, 14.3 percent of total population ie.e one in every seven people; in Bagmati province 11.7 percent of total population i.e one in every nine peopl; in Lumbini province, 9.5 percent i.e one in every 10 people,in Koshi province 6.2 percent of total population i.e one in every 16 people and in Gandaki province 6 percent of total population i.e one in every 16 people suffers from COPD. The study showed that over three million people across the country suffer from respiratory problems, but only three percent receive proper treatment.

The burden of COPD extends beyond mortality rates, affecting individuals’ quality of life and placing a substantial economic burden on healthcare systems. The symptoms of COPD can be debilitating, leading to decreased mobility, increased healthcare utilization, and a significant impact on mental health.

Risk Factors 

Understanding the risk factors for COPD is essential for prevention and early intervention. 

According to WHO, Tobacco smoking accounts for over 70% of COPD cases in high-income countries. In LMIC tobacco smoking accounts for 30–40% of COPD cases, and household air pollution is a major risk factor.

Some major risk factors include:

• Tobacco: exposure from active smoking or passive exposure to second-hand smoke;
• Work-related pollution: occupational exposure to dust, fumes, or chemicals;
• Indoor air pollution: smoke exposure from biomass fuel (wood, animal dung, crop residue) or coal 
• Underdeveloped lungs: early life events such as poor lung growth
• Lack of a balanced diet
• Athma in childhood; and
• Genetic: a rare genetic condition called alpha-1 antitrypsin deficiency, which can cause COPD at a young age.

Symptoms of COPD:

Recognizing the symptoms of COPD is crucial for early diagnosis and effective management. Common signs and symptoms include:

• Shortness of breath, especially during physical activities.
• Persistent cough with mucus production.
• Wheezing and chest tightness.
• Fatigue and frequent respiratory infections.

Diagnosis:

COPD is confirmed by a breathing test called spirometry, which measures how the lungs are working. In low- and middle-income countries, spirometry is often not available and so the diagnosis may be missed. 

Prevention Strategies:

Preventing COPD involves adopting lifestyle changes and minimizing exposure to risk factors. Here are some key strategies:

• Quit Smoking: The most effective way to prevent COPD is to quit smoking. Smoking cessation programs and support groups can be valuable resources.

• Avoid Environmental Pollutants: Minimize exposure to air pollutants, workplace toxins, and indoor pollutants.

• Vaccinations: Regular vaccinations, including influenza and pneumonia vaccines, can help prevent respiratory infections that may contribute to COPD.

• Healthy Lifestyle: Maintain a healthy lifestyle with regular exercise, a balanced diet, and proper hydration to support overall respiratory health.

Myths and Facts:

Dispelling myths about COPD is crucial for its clear understanding. Let’s debunk some common myths along with its facts:

Myth: COPD is a man’s disease.

Fact: All genders can develop COPD.

Myth: You can’t exercise with COPD.

Fact: Regular exercise helps improve lung function. It can make a patient feel better physically and mentally.

Myth: COPD only affects the lungs.

Fact: COPD coexists with many comorbidities, including heart disease, lung cancer, hypertension, osteoporosis, and diabetes.

Myth: Only older adults develop COPD.

Fact: COPD is certainly more common in older adults than in younger people, but younger people are not immune to the condition.

Myth: Only smokers develop COPD.

Fact: While smoking is a leading cause of COPD, other risk factors are air pollution, work-related pollution, infection, and some forms of asthma.

COPD Awareness Month serves as a reminder of the need for education, early detection, and prevention strategies to tackle this silent but formidable respiratory condition. By understanding the burden, recognizing symptoms, addressing risk factors, and dispelling myths, we can work towards a healthier future for individuals living with COPD and reduce the global impact of this disease. The theme of this year COPD awareness month is “Healthy Lungs for Life”. 

References: 

“Chronic obstructive pulmonary disease (COPD).” https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd) (accessed Nov. 30, 2023).

“Nepal has ‘world’s highest’ lung disease death rate – Asia & Pacific.” https://www.scidev.net/asia-pacific/news/nepal-has-worlds-highest-lung-disease-death-rate/ (accessed Nov. 30, 2023)

POPULATION-BASED PREVALENCE OF SELECTED NON-COMMUNICABLE DISEASES IN NEPAL, https://nhrc.gov.np/wp-content/uploads/2019/07/CKD-Report-pdf-resize.pdf