COPD: The Quiet Epidemic

The lung disease affects one in four adults
lungs
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The name COPD may not be familiar to you, but it's likely the symptoms are. Someone you know is beginning to show signs that his or her lungs aren't working right -- except the symptoms can be so subtle you may not realize that's what's going on. Or -- even scarier -- it might be you, and you may have no symptoms at all, and yet your lungs have already suffered irreparable damage. Known as chronic obstructive pulmonary disease (COPD) for the progressive nature of the damage and the fact that it prevents air from reaching all the airways in the lungs, COPD is one of the most under-recognized diseases around.

Why are doctors and researchers suddenly so concerned that people don't know about COPD? Because the latest numbers are terrifying. According to a study in the September 10, 2011, issue of The Lancet, COPD will strike one in four adults over the age of 35, a much higher percentage than previously reported. According to Andrea Gershon, the researcher who led the study, the average woman in her mid-30s is more than three times as likely to develop COPD, a progressive and potentially fatal lung disease, as breast cancer. And a man in his 30s is more than three times as likely to develop COPD as prostate cancer. Here's what we all need to know about COPD to protect ourselves.

Why COPD can be considered an epidemic

COPD may not spread from person to person as an infectious disease, but its numbers are rising, and the number of people dying from it is higher every year. Another problem is that COPD is underreported, and the disease often goes unrecognized until people are very ill. Consider these scary facts:

  • COPD is now the third-leading cause of death in America, claiming the lives of 124,000 Americans a year, according to the American Lung Association.

  • Mortality from COPD has increased 22 percent in the last decade.

  • According to the latest estimates, there may be as many as 16 million people in the United States currently diagnosed with COPD.

  • An additional 14 million or more people in the U.S. may have COPD but haven't been diagnosed because they have few symptoms and haven't sought health care yet. (Many smokers delay seeking treatment for "smoker's cough" because they dread receiving bad news.)

Who gets COPD

Best known as a smoker's disease, COPD does strike smokers and people who smoked when they were younger at much higher rates than nonsmokers. But lung damage from smoking only accounts for a portion of COPD cases, and experts are still trying to sort it all out. For example, women die from COPD in higher numbers than men, yet fewer women smoke. Other factors associated with COPD include exposure to workplace chemicals, secondhand smoke, asthma, a history of childhood respiratory disease, and other lung diseases that cause lung damage. The latest study followed, for 14 years, 13 million adults in the Canadian health registry who were in their mid-30s and older. Here's what it tells us about who gets COPD:

  • Men: 30 percent of all men will get COPD in their lifetime, and 60,000 men will die from COPD, according to the Canadian study.

  • Women: 25 percent of all women will get COPD in their lifetime, and 64,000 women a year will die from COPD. Note that although the percentage of women with COPD is lower, more women die of the disease.

  • People in rural areas: 32 percent of people who live in rural areas get COPD.

  • People in urban areas: While at lower risk than those in rural areas, 26.7 percent of urban dwellers nevertheless get COPD.

COPD risks and precautions

What causes COPD -- and how to protect yourself

Smoking is by far the highest risk factor for COPD, but it's not the only one. Here are the top six ways your lungs can get damaged, and what to do:

1. Smoking

The prevalence of COPD among smokers is still under study, but recent research has put it as high as 50 percent. That means that eventually half of all smokers will develop the disease. So what to do? If you smoke, quit now, using these ten great tips to help you stop.

2. Working in a hazardous environment

Those exposed regularly to dust, chemical fumes, and other respiratory irritants or toxins in the workplace have a higher incidence of COPD. If you work around toxins, talk to your supervisor about air quality and what can be done to improve it. Wearing a respirator mask, using air filters, and other technologies can make a big difference.

3. Suffering from asthma

This is an area where researchers are still trying to sort out a chicken-and-egg cycle, but there's no question that asthmatics develop COPD at higher rates. One recent study in Australia found that more than 40 percent of adults who had severe childhood asthma developed COPD by the age of 50 -- a 32-fold higher risk compared to the risk for those without asthma. If you have asthma, make sure you're getting good medical care and controlling your asthma aggressively, using medications and avoiding triggers to protect your lungs from damage.

4. Respiratory infections

Studies have found that people who had a history of childhood respiratory infections or who suffer repeated bouts of bronchitis and pneumonia are at risk for COPD. While you can't change your medical history, you can make sure from now on that when you develop a respiratory infection, it's adequately treated to prevent lung damage. See a doctor for coughs and breathing problems that don't go away after a few days or if you feel phlegm or pressure in your chest.

5. Secondhand smoke

According to the World Health Organization (WHO), passive smoking is associated with a 10 to 43 percent increase in risk of developing COPD. The more exposure you have, the worse the damage. So while you don't need to worry so much about an occasional smoky bar, you do need to worry if a family member, coworker, or friend is regularly smoking near you in a closed car or room. Start being vigilant about asking people not to smoke near you, and when all else fails, go stand near an open window for the sake of your lungs.

6. Smog, smoke, and air pollution

One study found that people who live near coal-burning power plants have a higher incidence of COPD; another study found that women who cooked over wood fires had high rates of COPD. Pay attention to the air quality where you live and work, and look for ways to improve it. Don't burn wood fires in enclosed spaces, and don't burn green or wet wood, which is smokier. Use fans and open your windows when cooking, and don't be afraid to demand more stringent pollution controls from your local government if there's a violator in your area.


Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio