Chronic obstructive pulmonary disease (COPD) is a group of progressive lung diseases that obstruct airflow. Symptoms develop slowly. Over time, COPD can make it hard to perform routine tasks. It’s a major cause of disability and death in the United States.
The most common cause of COPD is smoking. COPD is not contagious. Most of the time, treatment can ease symptoms and slow progression. There are a variety of oral medications and inhalers to help improve breathing. Depending on your particular situation, treatment may include medical therapies or surgery.
COPD Types and Frequency
The two main types of COPD are chronic bronchitis and emphysema.
Bronchitis is inflammation of the bronchi, the air pathways to the lungs. According to the American Lung Association (ALA), more than 10 million Americans had chronic bronchitis in 2011. Seventy percent of those cases involved people over age 45. The risk of chronic bronchitis increases with age. Among people over 65 years old, the rate is 64.2 per 1,000 persons. Among 18- to 44-year-olds, the rate was 28.6 per 1,000 persons.
Women have chronic bronchitis at double the rate of men. In 2011, 6.8 million women had chronic bronchitis, while 3.3 million men had it. There are some differences among races, too. Figures from 2011 show that 7.5 million non-Hispanic whites had chronic bronchitis. For non-Hispanic blacks, the figure was 1.3 million. Among Hispanics, 943,000 had chronic bronchitis.
Emphysema causes damage to the alveoli, the air sacs in your lungs. About 4.7 million Americans had emphysema in 2011, according to the ALA. More than 90 percent of cases involve people over age 45.
Over the years, the incidence of emphysema has risen in women while it declined in men. By 2011, 2.5 million women and 2.1 million men had emphysema. It is estimated that 3.8 million non-Hispanic whites had emphysema, while 489,000 non-Hispanic blacks and 232,000 Hispanics had it.
About 64 million people around the world had COPD in 2004, according to the World Health Organization. In the United States, 12.7 to 14.7 million adults have COPD. However, that may be an underestimate. The ALA thinks there may be as many as 24 million adults with COPD. Rates of COPD are highest in Southeast and Midwest states. In 2011, the rate was under 4 percent in Washington and Minnesota. In Alabama and Kentucky, it was above 9 percent.
You can get it at any age, but middle-aged and older adults are most likely to be diagnosed with COPD. Worldwide, COPD affects men and women equally.
Most COPD is caused by smoking. Another cause is exposure to chemical fumes. One study found that about 19.2 percent of COPD could be linked to industrial pollutants on the job. The figure is 31.1 percent for workers who never smoked. In poor countries, COPD may be a result of cooking fuels in poorly ventilated homes.
Rarely, COPD is caused by something called alpha-1-antitrypsin (AAt) deficiency. It’s a genetic condition that causes low levels of the AAt protein, which helps to protect the lungs. According to the Mayo Clinic, it’s the cause of about 1 percent of COPD cases. Genetics, air pollution, and recurrent respiratory infections may be contributing factors.
Early symptoms include shortness of breath or tiring easily, and are easy to ignore. Later, you may develop a cough. The cough may produce mucus, phlegm, or spots of blood. Fatigue and tightness in the chest can become a problem. Physical exertion like climbing a flight of stairs may leave you wheezing or gasping for air.
As COPD progresses, there may be swelling in the legs and feet. Low oxygen levels in your bloodstream may result gray or blue discoloration of your lips and fingernails. You may experience increased weight loss.
Treatment can often successfully manage symptoms of COPD, but it’s a serious condition. If you have COPD, you’re more vulnerable to the common cold, influenza, and pneumonia. COPD also increases the risk of developing pulmonary hypertension, which is high blood pressure in the arteries that serve the lungs.
Other complications from COPD include heart disease and depression. If you’re a smoker who has chronic bronchitis, you’re at increased risk of developing lung cancer.
The WHO reported that 3 million people died of COPD in 2005. That represents 5 percent of all deaths worldwide. Ninety percent of those deaths take place in low or middle-income regions. It is the third leading cause of death in the United States. In 2010, COPD claimed 134,676 American lives.
According to the ALA, smoking is linked to about 80 percent of all COPD deaths. In women, smokers are 13 times more likely to die from COPD than non-smoking women. For men, smokers are 12 times more likely to die from COPD than their non-smoking counterparts.
The lowest death rate is among Hispanics. Almost 80 percent of COPD-related deaths are among non-Hispanic whites.
COPD is costly, and results in a high rate of hospitalizations for people over age 65. A survey of COPD patients shows that as many as 51 percent are limited in their ability to function at work. Seventy percent say it limits physical activity. Fifty-six percent say household chores are a problem and 50 percent have trouble sleeping. Fifty-three percent feel limited in social activities and 46 percent feel it interferes with family activities. According to the ALA, COPD cost the United States $49.9 billion in 2010. Of that, $29.5 billion was spent on direct healthcare costs. $8.0 billion represented indirect morbidity costs and $12.4 were indirect mortality costs.