The disease we now call COPD, chronic obstructive pulmonary disease, is actually made up of two respiratory illnesses, emphysema and chronic bronchitis. They tend to occur together as a result of long-term exposure to irritants. In emphysema, the tiny air sacs in the lungs weaken and stiffen, losing their ability to exhale properly and expel carbon dioxide. With chronic bronchitis, the muscles that line the airways tighten and become inflamed, making it harder for air to get through. The inflammation may lead to overproduction of mucus, which is why one of the first signs of COPD is often a chronic phlegmy cough that won't go away.
How to prevent this damage from occurring? Smoking is certainly a primary risk factor for COPD, but nonsmokers need to be on the alert as well. With COPD now the third-leading cause of death in the U.S., it's important to know how to protect yourself. Here are the top seven ways to prevent COPD.
1. Stop smoking.
There's no way around it: The majority of cases of COPD are caused by smoking, and quitting is by far the most effective thing you can do to halt the damage. Inhaling cigarette smoke (and, to some extent, other types of smoke, including pot smoke) damages the elastic fibers that allow the tiny air sacs in the lungs to expand and contract. Somewhere between one in five and one in two smokers will develop COPD; one 2003 study tested older smokers for COPD and found that 50 percent of them had the condition, but many didn't know it yet.
Byron Thomashow, professor at Columbia University Medical School and chairman of the board of the COPD Foundation, says he finds himself wishing he could fast-forward the clock "just temporarily, like in a sci-fi movie" and let smokers experience what it's going to feel like once their lungs begin exhibiting symptoms and they have irreversible damage from COPD. "I believe they'd quit immediately if they knew what was in store."
Take steps to quit and the healing begins almost immediately. Research has shown that quitting smoking halts the progressive lung damage that leads to COPD. And if you quit early enough, studies show that your lung function can stabilize and eventually resemble that of a nonsmoker of the same age.
2. Don't stop exercising, even if you can't catch your breath.
According to Thomashow, the biggest mistake he sees people make is to cut back on exercise when it's difficult for any reason, when in fact they should do just the opposite. "It's counterintuitive; you feel like you should rest and not push yourself because it's not comfortable," he says. "But it turns out that exerting yourself and getting the air into the lungs is the best thing you can do."
If you have any physical issues such as excess weight or asthma, or if you're concerned about your breathing because you're a smoker or former smoker, it's that much more important to exercise to keep your lungs strong and healthy. If you notice that you're having trouble climbing hills or increasing your speed, pay attention to those trouble spots and work up to them gradually. If you suffer from asthma, talk to your doctor about using a "rescue" inhaler just prior to or during exercise to make it easier. Over time, continuing to exercise will help you build tolerance and lung strength.
3. Be proactive about workplace safety.
While smoking gets most of the attention as the cause of COPD, other lung irritants play a significant role as well. One study found that occupational exposure to workplace dust and chemical fumes may be responsible for as many as 20 percent of all COPD cases. Lung irritants known to put someone at risk for COPD include coal dust, fibrous dust from cotton and grain, concrete dust, chemical fumes, and mineral dust associated with mining, such as cadmium and gold. Most states have strict regulations regarding air quality and workplace protection, but they aren't always enforced. Demand protection for yourself, family members, and coworkers in the form of respirators, masks, filters, and other protective equipment.
More ways to protect yourself from COPD
4. Step away from the smokers.
One night in a smoky bar probably won't put you at risk, but long-term exposure to secondhand smoke primes your lungs for COPD. In fact, the World Health Organization has estimated that 10 percent of all smoking-related deaths are due to secondhand smoke. Several convincing studies have shown that people who were exposed to secondhand smoke as children are more likely to get emphysema, one of the conditions that makes up COPD. Other studies have shown that people who are exposed to secondhand smoke over a long period of time have a higher risk of all respiratory illnesses.
Ask smokers to smoke outside the home and don't permit smoking in the car. At work, avoid lunch breaks with smoking coworkers, and if designated smoking areas aren't at an effective distance from your workspace, bring the issue up anonymously with your supervisor.
5. Spare your lungs on spare-the-air days.
Exposure to air pollution and smog have been linked with COPD. Try not to go outside any more than necessary when air pollution levels are high (designated "spare-the-air" days in some areas), and don't exercise outdoors on smoggy days. Also, avoid driving with the windows open; one study of California commuters found that they received almost half of their daily exposure to air pollution just while driving to work in the morning, even though that constituted just 6 percent of their day.
Indoor air pollution is an issue, too. Beware of smoke from fireplaces (clean flues and chimneys, and avoid burning smoky wood); the World Health Organization has documented a rising incidence in COPD among women who cook over wood-fired or otherwise smoky indoor fires. Avoid, too, breathing the fumes from paint thinner, hair spray, insecticides, and other products labeled with warnings about lung irritation.
6. Do deep-breathing exercises.
When it comes to the lungs, there's definitely a "use them or lose them" component, experts say. Do breathing exercises to help keep the air sacs in your lungs elastic and to keep airways clear. There are two types of breathing exercises recommended for COPD patients, and they can benefit those at risk as well.
The first is called pursed-lips breathing. Take a normal breath, preferably through your nose, then puff out your cheeks, purse your lips, and blow the air out slowly. Your exhale should be four times longer than your inhale, so count one while you inhale, four while you exhale.
The second type of breathing, diaphragm breathing, is easiest to practice lying on your back with your knees bent. Put one hand on your abdomen, the other on your upper chest. Inhale through your nose, feeling your abdomen move outward, then exhale while feeling it fall inward. The goal is to feel your abdomen move while your upper chest stays still.
7. Boost your intake of fish and fish oil.
Several recent studies have shown that fish oil, which is high in omega-3 fatty acids, may be valuable in healing the lung damage that leads to COPD. The most conclusive research, conducted in Japan, found that people who ate a diet enriched in omega-3s from fish and fish oil had a significant drop in lung inflammation and were able to walk further than a control group, as measured by a six-minute walking test. On the basis of this study, many pulmonologists now recommend that patients with asthma or a history of frequent respiratory illnesses eat fish several times a week or take a fish oil supplement.