Chronic obstructive pulmonary disease (COPD) is a term referring to two lung diseases: chronic bronchitis and emphysema. Both conditions cause obstruction of airflow that interferes with normal breathing. Both frequently exist together, so physicians prefer the term COPD. COPD is preventable and treatable. This definition of COPD does not include other obstructive diseases such as asthma, although uncontrolled asthma over a lifetime can result in damage and COPD.
Chronic bronchitis is the inflammation and eventual scarring of the lining of the bronchial tubes. When the bronchi are inflamed and/or infected, less air is able to flow to and from the lungs. The inflammation eventually leads to scarring of the lining of the bronchial tubes and excessive mucus production. As the lining of the bronchial tubes becomes thickened, a cough develops and airflow may be impeded. Symptoms of chronic bronchitis include chronic cough, increased mucus, frequent clearing of the throat and shortness of breath.
Emphysema starts with the destruction of air sacs (alveoli) in the lungs where oxygen from the air is exchanged for carbon dioxide in the blood. The walls of the air sacs are thin and fragile in individuals with emphysema. Damage to the air sacs is irreversible and results in permanent damage to the tissue of the lower lungs. As these air sacs are destroyed, the lungs deliver less oxygen to the bloodstream, causing shortness of breath. Symptoms of emphysema include cough, shortness of breath and a limited tolerance for exercise.
Who gets COPD?
COPD is one of the most common respiratory conditions of adults and is the fourth leading cause of death in the United States. COPD most often occurs in people age 40 and older with a history of smoking (either current or former smokers), although as many as 1 out of 6 people with COPD never smoked. It is estimated that 24 million Americans are affected by COPD. Additionally, 127,000 deaths and 721,000 hospitalizations were caused by COPD in 2005. In Kentucky, COPD is also the fourth leading cause of death. Among African Americans, COPD is one of the top 10 causes of death and accounts for more than 3 percent of all deaths in African-Americans.
What causes COPD?
Most cases of COPD develop after long-term exposure to lung irritants. Tobacco use is a major cause of the development and progression of COPD. Approximately 80 to 90 percent of COPD deaths are caused by smoking. Men and women smokers are nearly 12 and 13 times as likely to die from COPD, respectively, compared to those who have never smoked. COPD can also occur in people who have had long-term exposure to chemicals, dust, or fumes in the workplace. Heavy or long-term exposure to secondhand smoke or other air pollutants may also contribute to COPD. In rare cases, a genetic condition called alpha-1 antitrypsin (AAT) deficiency may also cause COPD. A low level AAT can lead to lung damage and COPD if the person is exposed to smoke or other irritants.
What are the symptoms of COPD?
Symptoms of COPD include:
- Chest tightness
Constant coughing spells, sometimes called smokers cough
Coughs that produce phlegm or mucus
Shortness of breath with normal activity
Not being able to take a deep breath
When COPD is severe, shortness of breath and other symptoms can get in the way of doing even the most basic tasks, such as doing light housework, taking a walk, even bathing and getting dressed.
COPD develops slowly, and can worsen over time, so be sure to report any symptoms you might have to your doctor as soon as possible, no matter how mild they may seem.
How is COPD diagnosed and managed?
While there is no cure for COPD, early detection is important to improve treatment and the outcomes associated with the disease. To detect COPD, there is a test called spirometry. Spirometry can detect COPD before symptoms become severe. It is a simple, non-invasive breathing test that measures the amount of air a person can blow out of the lungs and how fast he or she can blow it out. Based on this test, your doctor can tell if you have COPD, and if so, how severe it is. The lung damage caused by COPD is irreversible but there are many treatments that can improve the patient’s quality of life. Treatment with medication can improve and prevent COPD symptoms and reduce the frequency and severity of exacerbations. The best way to reduce the risk of developing COPD and slowing the progression is to stop smoking.
National COPD Action Plan
The federal Department of Health and Human Services has released the first-ever Chronic Obstructive Pulmonary Disease National Action Plan. Its development has been a true collaborative effort among federal and nonfederal partners and the COPD community at large.
On May 22, 2017, the plan was released publicly during the American Thoracic Society annual conference in Washington, D.C. A panel discussion to formally announce the plan featured presenters from the National Heart, Lung and Blood Institute, the COPD Foundation and Alpha-1 Foundation. The COPD National Action Plan is a framework created by and for the entire COPD community.
Kentucky will use the action plan as a framework moving forward to develop strategies for addressing COPD. In late 2016 the Department for Public Health collaborated with state partners to create a Kentucky COPD Advisory Board. The board meets quarterly to address COPD issues in the state.
For more information about the board and meeting times, please contact the Kentucky COPD Program at (502) 564-7996.