Do you have trouble catching your breath? Do you struggle to breathe when doing the simplest activities?
In certain parts of the United States, the chances are greater you will suffer from these symptoms.
In fact, if you live in a poor or rural community, your chance of having chronic obstructive pulmonary disease (COPD) is almost 12 percent. Nationwide, the rate of prevalence is slightly more than 7 percent.
That’s according to a new study released by the Johns Hopkins University School of Medicine in Baltimore, Maryland, and presented at the American Thoracic Society 2015 International Conference.
COPD is one of the leading causes of death in the United States, said Dr. Sarath Raju, MPH, at Johns Hopkins and the study’s lead author. Even Vulcans are vulnerable. COPD claimed Star Trek actor Leonard Nimoy earlier this year.
In the study, living in the South or a rural area as well as community poverty were all associated with a greater prevalence of COPD. However, when individual income was factored in, community poverty was no longer significant.
Tens of thousands of patients studied
Raju and his colleagues used data from the National Health Interview Survey, the U.S. Census, and the National Center for Health Statistics Urban-Rural Classification Scheme. They ended up with 87,701 participants, all over age 40. COPD was defined as self-reported emphysema or chronic bronchitis.
Some of the patients did not have a formal diagnosis of COPD, Raju said. They may instead have been diagnosed with emphysema, bronchitis, or asthma.
COPD is an umbrella term for emphysema, which causes enlargement of the air sacs, and chronic bronchitis, in which the air tubes narrow, explained Dr. Linda Nici. She is chief of the pulmonary/critical care section at the Providence Veterans Administration Medical Center in Rhode Island and a professor of medicine at Brown University.
With these illnesses, the air sacs lose their elasticity and are unable to stretch. In addition, the lining of the air tubes thickens and becomes inflamed or excessive mucous is secreted, which clogs the tubes.
Raju acknowledged that one of the limitations of COPD research is that the disease is self-reported. The true number of people who have COPD may, in fact, be higher.
“We wanted to identify the prevalence of COPD in urban and rural areas in the U.S. and determine how residence, region, poverty, race and ethnicity, and other factors influence COPD rates,” Raju said.
Smoking, biomass fuels listed as causes
There is a good way of not getting COPD in the first place: Don’t smoke.
“Quitting smoking is the number one thing I tell my patients to do,” Raju said. But despite the motivation to stop when they find it hard to breathe, “People don’t quit easily.”
Nici sang the same song.
“The first, second, and third thing I tell my patients is to quit smoking,” she said, noting that the problem is compounded by the fact that many smokers start in their teens “when their lungs are still growing.”
She acknowledged the difficulty of quitting.
“Nicotine is more addictive than cocaine,” she said. She recalled patients who “try everything, from the patch to cold turkey.”
Still, smoking is not the only culprit. Researchers found an association between biomass fuels and COPD in the South. (Biomass is biological material derived from living, or recently living, organisms.) They suggest further research to understand the potential contribution of occupational exposure, fuel sources, and indoor air pollutants to COPD prevalence in poor, rural areas.
The data from other parts of the world reflects this.
“In Third World countries, the high prevalence may be due to biomass fuels,” Nici said.
In countries were biomass fuel is burned indoors for cooking, women have high rates of the disease from standing over the stove, she said.
Both Raju and Nici noted that community action can also be effective in lowering rates of COPD.
“Rates [of smoking] have gone down after communities take action to discourage it,” he said.
While the scientific evidence isn’t in yet, it’s likely that burning biomass contributes to disease.
“It’s probably better to use environmentally friendly fuels,” Raju said.
Nici reinforced that thought, saying that public advocacy works.
“The higher you tax cigarettes, the higher the quit rate,” she said.