According to the Centers of Disease Control and Prevention (CDC), chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. This disease kills more than 120,000 Americans annually—the equivalent of one death every four minutes, and the numbers are increasing.
As of 2011, 12 million people in the United States were diagnosed with COPD. It may be as much as 16 million currently. Another 12 million people may have the disease without knowing it.
COPD develops slowly and usually worsens over time. In the early stages, the disease may have no symptoms. Early prevention and treatment can help avoid serious lung damage, respiratory problems, and even heart failure. The first step is to recognize your personal risk factors for developing this disease.
The main risk factor for COPD is smoking, which causes up to 90 percent of COPD deaths, according to the American Lung Association (ALA). Smokers are approximately 13 times more likely to die from the disease than those who have never smoked. Long-term exposure to tobacco smoke is particularly dangerous. The more years and the more packs you smoke, the greater your risk. Pipe smokers and cigar smokers are all at risk. Exposure to secondhand smoke also increases your risk. Secondhand smoke includes both the smoke from burning tobacco and smoke exhaled by a smoker.
While smoking is by far the principal risk factor for COPD, it isn’t the only one. Indoor and outdoor pollutants can also cause the condition when exposure is intense or prolonged. Indoor air pollution includes particulate matter from the smoke of solid fuel used for cooking and heating. Examples include poorly ventilated wood stoves, burning biomass or coal, or cooking with fire. Exposure to heavy amounts of environmental pollution is another risk factor. Indoor air quality plays a large role in the progression of COPD in developing countries. But urban air pollution—such as traffic and combustion-related pollution—poses a greater health risk worldwide.
Long-term exposure to industrial dust, chemicals, and gases can irritate and inflame the airways and lungs, increasing your chance of COPD. People in professions that deal with frequent exposure to dust and chemical vapors, such as coal miners, grain handlers, and metal molders, have a greater likelihood of developing the disease. One study in the American Journal of Epidemiology found that the fraction of COPD attributed to work was estimated at 19.2 percent overall and 31.1 percent among those who had never smoked.
In rare cases, genetic factors can cause people who have never smoked or had long-term particulate exposure to develop COPD. The genetic disorder results in a lack of the protein α1-antitrypsin (AAT). An estimated 100,000 Americans have AAT deficiency, though few people are aware of it. While AAT deficiency is the only established genetic risk factor for COPD, it’s likely that several genes are additional risk factors. Researchers haven’t yet proven this.
COPD is most common in people at least 40 years old who have a history of smoking. Incidence increases with age. Though there is nothing you can do about your age, you can take steps to stay healthy. If you have risk factors for COPD, it’s important to discuss them with your doctor. The ALA recommends talking to your doctor proactively about COPD if you are over the age of 45, have family members with the disease, or are a current or former smoker. Early detection of COPD is the key to successful treatment.