Chronic obstructive pulmonary disease, or COPD, is the third-leading cause of death in the United States, according to statistics reported in 2011 by the Centers for Disease Control and Prevention (CDC). The U.S. Department of Health and Human Services (HHS) states that besides causing long-term disability, this disease kills over 120,000 Americans annually—the equivalent of one death every four minutes. And the numbers are increasing.
Over 12 million people are currently diagnosed with COPD (which includes chronic bronchitis and emphysema, the lung diseases that cause constant coughing and progressive breathing difficulties). However, in 2011, the HHS reported that another 12 million people may have the disease without knowing it. This is partly because those in the early-stages of the condition, which occurs primarily among smokers, often dismiss symptoms.
Although COPD develops slowly, it usually worsens over time. Early prevention and treatment can be key to avoiding serious lung damage, respiratory problems, and even heart failure. A first step is to recognize your personal risk factors for developing this disease.
The primary risk factor for COPD is smoking, which causes up to 90 percent of COPD deaths, according to the American Lung Association (ALA). ALA’s statistics show that smokers are approximately 13 times more likely to die from the disease than those who have never smoked and, according to HHS, smoking accounts for up to nine out of 10 COPD-related deaths. Long-term exposure to tobacco smoke is particularly dangerous— the Mayo Clinic reports that the more years and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers, and marijuana smokers are all at risk, as are those exposed to second-hand smoke. Second-hand smoke includes both the smoke from burning tobacco and smoke exhaled by a smoker.
While smoking is by far the principle 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, according to the National Institutes of Health (NIH). Indoor air pollution includes particulate matter from the smoke of solid fuel used for cooking and heating—for example, 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 the World Health Organization (WHO) states that urban air pollution—such as traffic and combustion-related pollution—poses a greater health risk worldwide.
Occupational Dusts and Chemicals
Long-term occupational exposure to industrial dust, chemicals, and gases can irritate and inflame the airways to your lungs, increasing your chance of COPD. People in professions that deal with frequent exposure to dust and chemical vapors in the workplace, 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 exposure to develop COPD. The genetic disorder results in a lack of the protein alpha-1 antitrypsin (AAT). HHS estimates that as many as 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, according to European Respiratory Journal, it’s likely that several genes are additional risk factors, though researchers haven’t yet proven this.
Most risk factors for COPD can be prevented, but like genetics, age is a non-modifiable. Because the condition develops slowly over time, COPD is most common in people at least 40 years old who have a history of smoking. The CDC reports that of the estimated 3.7 million Americans ever diagnosed with emphysema, 94 percent were 45 or older. People age 65 and older have the highest rate of chronic bronchitis, at 56.3 per 1,000 people.
If you have risk factors for COPD, it’s important to discuss them with your doctor. 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.