Lucknow: “COPD is on the rise – deteriorating air quality is turning it into a global epidemic. Act now to reverse the trend.”
“Knowing your lung function is the first step to protecting your breathing.” Prof. (Dr.) Ved Prakash
Key facts
ऽ Global prevalence – Globally, an estimated 480 million people are living with COPD by 2023. The prevalence is expected to increase by 23% by 2050, potentially reaching 600 million people. This increase will be greater in low- and middle-income countries and may particularly affect women more than men.
ऽ Global burden – COPD is the third leading cause of death worldwide, contributing significantly to non-communicable disease mortality.
ऽ Projected Ranking- By 2030, COPD is expected to remain the third leading cause of death globally due to aging population, increasing tobacco use and exposure to environmental pollutants.
ऽ Mortality Rate- Estimates- In 2019, approximately 3.2 million deaths occurred worldwide due to COPD.
ऽ Age Distribution- COPD can affect people of all ages, but it is more prevalent in the elderly population, particularly in those aged 60 years and above.
ऽ More than 55 million people in India suffer from COPD.
ऽ Major risk factors include smoking, which accounts for approximately 40% of cases in India. Use of biomass fuels for cooking and heating aggravates COPD. Indoor air pollution from cow dung cakes, especially in rural homes, makes COPD a major indoor disease.
ऽ Global risk factors: Worldwide, approximately one-third of COPD cases occur in non-smokers, often associated with occupational exposures such as air pollution and other environmental factors.
ऽ Economic impact: In the United States alone, direct medical costs associated with COPD exceed ₹2.65 lakh crore annually, highlighting the economic burden of the disease.
ऽ Undiagnosed cases: A significant portion of COPD cases are undiagnosed cases, leading to underestimation of its prevalence. This hinders early management and increases the burden of advanced disease.
ऽ COPD often co-exists with other chronic diseases, such as cardiovascular conditions, diabetes, and mental health disorders, complicating overall health outcomes and proper management of the disease.
What is COPD?
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that makes breathing difficult. This includes conditions such as chronic bronchitis and emphysema. People with COPD often experience symptoms such as chronic cough, shortness of breath, wheezing, and chest tightness. The disease can widely affect daily life and lead to serious complications if not properly managed.
World COPD Day, which will be observed on 20 November 2024 this year, is organised by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in collaboration with healthcare professionals and COPD patient groups worldwide. The theme of World COPD Day 2024 is “Know your lung function”. The theme aims to highlight the importance of measuring lung function, also known as spirometry. Spirometry is a simple and basic test that measures how much air you can breathe in and breathe out. This test is important for diagnosing COPD and other lung conditions.
Effects of COPD:
Common symptoms of COPD include:
Chronic cough
Shortness of breath
Wheezing
Chest tightness
Fatigue
Frequent respiratory infections
Unexpected weight loss
Difficulty carrying out daily activities.
As COPD progresses, people often have more difficulty carrying out their normal daily activities due to shortness of breath, which can be a significant financial burden due to the cost of medical treatment.
During a COPD attack they may need to receive additional treatment at home or be admitted to hospital for emergency care. Severe attacks can be life threatening.
Causes of COPD:
Tobacco smoking: Cigarettes or bidis are the primary cause. ऽ Secondhand smoke: Even non-smokers are at risk of developing COPD from exposure to secondhand smoke.
ऽ Occupational pollution: Long-term exposure to workplace pollutants and irritants such as dust, chemicals and smoke can increase the risk of developing COPD.
ऽ Indoor air pollution: Use of biomass fuels (cow dung cakes, coal, wood) for burning can cause indoor air pollution, which may increase the risk of COPD.
ऽ Genetic causes: Alpha-1 antitrypsin deficiency is a rare genetic condition that can cause early-onset COPD.
ऽ Frequent respiratory infections: Frequent respiratory infections, especially during childhood, may increase the risk of developing COPD later in life.
ऽ Poor socio-economic conditions: health problems
Limited access to care, and inadequate nutrition can contribute to the development and progression of COPD.
Pre-existing respiratory conditions: People with pre-existing respiratory conditions such as asthma may be at increased risk of developing COPD.
Treatment of COPD:
- Bronchodilators
- Inhaled corticosteroids
- Pulmonary rehabilitation
- Oxygen therapy
- Surgery
Knowing your lung function is important for several reasons.
Early detection – Regular lung function tests can help catch COPD at an early stage, when it is most manageable. Early detection allows for timely and appropriate treatment, which can improve quality of life and slow disease progression.
Monitoring disease progression – For people already diagnosed with COPD, regular spirometry tests can help monitor disease progression and the effectiveness of treatment. This information helps to make appropriate decisions about care.
Adopting good lifestyle habits can help improve your lung function. If your lung function is declining, it may motivate you to quit smoking, engage in pulmonary rehabilitation, or adopt healthy habits that support lung health.
Adequate advice from healthcare providers can help improve your lung function.
Effect of air pollution on COPD
Continuous exposure to air pollutants such as particulate matter (PM2.5 and PM10), nitrogen dioxide (NO₂), and sulfur dioxide (SO₂) can cause inflammation and damage to the lungs, increasing the risk of exacerbations.
Exacerbation of symptoms- Poor air quality can promote a severe form of COPD, worsening symptoms such as breathlessness, cough, and wheezing and increasing the number of hospitalizations.
Disease progression- Long-term exposure to air pollutants leads to a rapid decline in lung function in COPD patients, making the disease more severe over time.
Increased mortality- Studies have shown that mortality rates are higher among COPD patients in areas with significant air pollution, particularly during smog.
Poor quality of life- Air pollution worsens respiratory symptoms, restricts physical activity, and affects mental health, leading to poor quality of life for individuals with COPD.
Biomass fuel exposure- In many low- and middle-income countries, indoor air pollution from the use of biomass fuels (e.g., wood, charcoal, and dung) for cooking and heating is a major contributor to the prevalence of COPD.
Role of Department of Pulmonary and Critical Care Medicine in providing excellence in COPD care:
At our centre, the diagnosis and stage of the disease is accurately assessed by conducting a complete physical examination of patients with symptoms of COPD. For this, state-of-the-art facilities like spirometry, body-plethysmography diffusion study, forced oscillometry (FOT), high resolution CT scan are available which help in early diagnosis of the disease. Our centre has an excellent Critical Care Unit (ICU) equipped with modern ventilators, senior specialist doctors and trained nursing staff. Which is capable of providing immediate emergency treatment of severe attacks of COPD. We have been able to reduce the risk of ventilator-associated pneumonia (VAP) by more than 10% by following stringent infection control protocols and ICU hygiene practices, which is an excellent figure.
On the occasion of World COPD Day, the Department of Pulmonary and Critical Care Medicine, King George’s Medical University (KGMU) organized a press interaction to raise awareness about the need for prevention, treatment and early diagnosis of COPD. The event was attended by eminent faculty members including Professor (Dr) Ved Prakash, Head of Pulmonary and Critical Care Medicine, Professor (Dr) Rajendra Prasad, Former Head of Department of Respiratory Medicine, Professor (Dr) Anil Gupta, Department of PMR, and Prof RAS Kushwaha, Department of Respiratory Medicine. Dr Sachin Kumar, Dr Mohammad Arif and Dr Atul Tiwari from the Department of Pulmonary and Critical Care Medicine were also present. The discussion focused on KGMU’s initiatives in COPD management, importance of vaccination and prevention of COPD. The event underlined the department’s commitment to tackle COPD through clinical excellence, community outreach and public health education.
