COPD: All you need to know about the disease that is the second-highest killer of Indians

As per the Global Burden of Disease (GBD) report, Chronic Obstructive Pulmonary Disease (COPD) has emerged as the second most significant contributor to death and disability-adjusted life years in India, after heart disease. Owing to its fatal nature, this disease is highlighted annually on World COPD Day, observed every year on the third Wednesday of November.

The theme for this year, "Breathing is Life - Act Earlier," underscores the importance of preserving healthy lungs for overall well-being. The central idea is to stress the urgency of early intervention, particularly in light of the worsening air quality index in the burgeoning metropolises of India.

On this global healthcare observance, medical experts share insights to enhance understanding, prompt early detection and promote effective management strategies for individuals affected by this debilitating lung condition.

What is Chronic Obstructive Pulmonary Disease?

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition characterised by airflow limitation, making it difficult to breathe. It includes conditions such as chronic bronchitis and emphysema, both contributing to the overall limitation of airflow in the lungs, as explained by Dr Sanggita Checker, Consultant Chest Physician at Wockhardt Hospitals.

The core characteristic of COPD is the presence of airflow limitation, a consequence of inflammation and damage to the airways and alveoli within the lungs. This impairment leads to difficulties in breathing, progressively worsening over time. The chronic nature of the disease implies that it tends to advance gradually, impacting lung health and overall respiratory function.

Can Mumbai's worsening air quality enhance COPD symptoms?

The deteriorating air quality in Mumbai poses a significant threat to individuals with COPD, as the poor Air Quality Index (AQI) can intensify their symptoms, informs Dr Harish Chafle, pulmonology and critical care, Global Hospitals, Parel Mumbai.

The increased exposure to particulate matter such as PM 2.5, PM 10, ozone and other pollutants in the air exacerbates respiratory issues among individuals with COPD. These tiny particles, especially PM 2.5 and PM 10, can penetrate deep into the lungs, causing inflammation and aggravating pre-existing respiratory conditions.

The presence of elevated levels of pollutants in the air becomes particularly detrimental for those with COPD, as they are more susceptible to the adverse effects of air pollution. Individuals with COPD experience compromised lung function, and the heightened pollution levels in Mumbai contribute to a more challenging environment for them.

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The pollutants present in the air can trigger respiratory distress, worsen breathing difficulties and lead to increased frequency and severity of COPD symptoms. Therefore, the connection between Mumbai's deteriorating air quality and the exacerbation of COPD symptoms underscores the critical need for effective air quality management and respiratory care interventions to mitigate the impact on individuals with pre-existing respiratory conditions.

Leading factors that contribute to the disease

COPD has various causes, each contributing to the development and progression of this respiratory condition:

Tobacco smoking: The leading cause of COPD, tobacco smoke contains harmful chemicals that can damage the airways and alveoli in the lungs over time, leading to chronic inflammation and airflow limitation.

Second-hand smoke exposure: Constant exposure to the smoke emitted by others who are actively smoking is another significant contributor to COPD. Inhaling second-hand smoke can have similar detrimental effects on the respiratory system.

Occupational exposure: Inhaling toxic chemicals, fumes and dust in certain occupational settings can contribute to the development of COPD. Prolonged exposure to these substances can lead to chronic lung irritation and damage.

Childhood asthma: Acquiring asthma early in childhood can increase the risk of developing COPD later in life. Persistent inflammation and damage to the airways associated with asthma may contribute to the development of COPD over time.

Alpha-1 antitrypsin deficiency: A rare genetic condition known as alpha-1 antitrypsin deficiency can induce COPD in young individuals. This deficiency affects the body's ability to protect the lungs from damage, leading to the development of COPD at a younger age.

Indoor air quality: Living in homes with inadequate ventilation and inhaling fumes from the burning of coal and fuel for cooking and heating purposes can also increase the risk of COPD.

Know the key signs and symptoms of COPD

Chronic cough: A persistent cough is a prominent COPD symptom, lasting for an extended period. It arises from continuous irritation and inflammation in the airways, often accompanied by the production of mucus.

Shortness of breath: Individuals with COPD commonly experience breathlessness, especially during physical exertion. As the condition restricts the airflow in and out of the lungs, it impedes the body's ability to efficiently exchange oxygen and carbon dioxide.

Wheezing and chest tightness: Wheezing, characterised by a high-pitched whistling sound during breathing, signals airway constriction. Chest tightness reflects the inflammation and narrowing of the air passages, contributing to the overall respiratory distress in COPD.

Does early diagnosis help?

Early intervention is pivotal for the effective management of COPD as it allows for timely interventions to slow disease progression and improve the overall quality of life. Checker shares 3 ways early diagnosis can help patients suffering from COPD:

Smoking cessation: Early identification of COPD provides a crucial window of opportunity for individuals to cease smoking. Smoking cessation is the single most effective measure to slow the progression of COPD and alleviate symptoms. Early diagnosis facilitates targeted smoking cessation interventions, preventing further damage to the lungs and improving long-term outcomes.

Pulmonary rehabilitation: Identifying COPD in its early stages allows for prompt enrollment in pulmonary rehabilitation programs. Early participation in these structured interventions, which combine exercise, education and support, helps individuals manage their symptoms, improve lung function and enhance overall well-being.

The sooner individuals are diagnosed, the earlier they can benefit from pulmonary rehabilitation, optimising its impact on their physical and emotional health.

Medication: Early diagnosis enables healthcare professionals to initiate appropriate medication regimens promptly. Medications such as bronchodilators and anti-inflammatory drugs are integral to COPD management.

Administering these medications early on helps alleviate symptoms, control inflammation and maintain better respiratory function. Early intervention with medication can prevent the disease from advancing to more severe stages, promoting a more effective and sustainable long-term management strategy.

Treatment options available for COPD

The treatment landscape for COPD encompasses a range of options tailored to address the diverse needs of individuals. Checker shares 5 ways to tackle the fatal condition:

Bronchodilators: These medications work to relax and widen the airways, facilitating easier breathing. Short-acting bronchodilators provide immediate relief during exacerbations, while long-acting bronchodilators offer sustained improvement in lung function over an extended period.

Inhaled corticosteroids: In cases where inflammation is a prominent component of COPD, inhaled corticosteroids may be prescribed. These medications help reduce inflammation in the airways, mitigating symptoms and preventing exacerbations.

Pulmonary rehabilitation: A structured program combining exercise, education and support, pulmonary rehabilitation aims to enhance overall respiratory health. It assists individuals in managing symptoms, improving lung function and optimising their ability to lead an active life.

Oxygen therapy: In advanced stages of COPD where oxygen levels in the blood are significantly low, oxygen therapy may be recommended. This involves the use of supplemental oxygen to ensure the body receives adequate oxygen, alleviating symptoms and improving overall well-being.

Surgery: In severe cases of COPD, surgical interventions may be considered. Lung volume reduction surgery involves removing damaged tissue, allowing the healthier portions of the lungs to function more effectively. Lung transplantation may be an option for those with end-stage COPD.

Tailored treatment plans are essential in COPD management, considering the unique needs and circumstances of each individual, explains Chafle. Regular monitoring is crucial to evaluate the effectiveness of the chosen interventions and to make necessary adjustments as the disease progresses or if new symptoms emerge.

Lifestyle changes to improve the condition

Lifestyle choices play an imperative role in both the prevention and management of COPD. Experts emphasise that avoiding tobacco smoke is paramount, as it is the leading cause of COPD. By abstaining from smoking and steering clear of second-hand smoke, individuals can significantly reduce their risk of developing COPD.

In addition to avoiding tobacco, minimising exposure to occupational pollutants and environmental irritants is equally important. Occupational settings with toxic chemicals, dust and fumes pose a risk to respiratory health. Taking precautions, such as wearing protective gear and ensuring adequate ventilation, can mitigate these risks.

Similarly, reducing exposure to outdoor and indoor air pollutants, including particulate matter and environmental toxins, contributes to respiratory well-being. In areas with poor air quality, individuals can reduce COPD risk by staying indoors during high pollution periods, using air purifiers and wearing masks. Adequate ventilation at home and workplace is also important.

Regular exercise and maintaining a balanced diet are integral components of a healthy lifestyle that positively impact COPD prevention and management. A balanced diet rich in antioxidants, omega-3 fatty acids, and vitamins supports lung health. Staying hydrated and maintaining a healthy weight also contribute positively to respiratory function, shares Checker.