Chronic Obstructive Pulmonary Disease (COPD)

 What is COPD?

COPD includes diseases such as emphysema, chronic bronchitis and asthma. These cause air movement through the lungs to be slowed by obstructions.

Chronic bronchitis causes obstruction through inflammation and scarring of the lining of the bronchial tubes.

Emphysema results when the air sacs in the lungs lose their ability to stretch and recoil, so that air becomes trapped in the lung's air sacs. Airway support is also lost resulting in obstruction of airflow.

In asthma, inflammation and narrowing of the airways cause obstruction of airflow. Although narrowing of airways from asthma is reversible, repeated and prolonged attacks can lead to chronic disease.  

How common is COPD?

COPD is the fourth-leading cause of death in the United States. Its incidence and rates are rising faster among women than among men.

What causes COPD?

Smoking is the most common cause of COPD.

Other causes include:

• Frequent lung infections
• Expose to indoor and outdoor air pollution
• Enzyme deficiency (this affects about 5 percent of people, and puts them at risk for COPD even in they do not smoke. People with this condition are sensitive to indoor and outdoor air pollution and often develop COPD at young ages).
• Asthma caused by inflammation of the lining of the airways. This condition can be triggered by allergens, respiratory infections, smog or cold air. Other aggravating factors include aspirin, physical exertion, and food additives.

What are the symptoms of COPD?

Symptoms of COPD include: chronic cough, increased mucous, shortness of breath.

COPD diseases are progressive diseases. Except for asthma, the symptoms appear gradually, and then increase in severity over time. Most people with COPD begin to experience symptoms in their 40s and 50s. In the early stages, people experience a shortness of breath and decreased exercise tolerance. Later, people may require supplemental oxygen or mechanical respiratory assistance.   

Who should be screened for COPD?

You should be screened for COPD if:

• You are over age 45 and you smoke

• You have symptoms of any of the following pulmonary disease:

o        Chronic bronchitis: Chronic cough, increased mucous, shortness of breath

o        Emphysema: cough and shortness of breath. This is minimal in the early stages

o        Asthma: Cough, shortness of breath and wheezing 

What can I do about COPD?

Be aware. Keep track of air pollution levels and be aware of the quality of air that you breathe. Pollution levels, in the form of the Air Quality Index, are often given with local weather reports printed in newspapers.

In Greater Cincinnati, check with the following organizations for up-to-date information:

• Hamilton County Department of Environmental Services or 513.946.7753
• Kentucky Division of Air Quality or 1.800.AIRINKY
• Ohio Kentucky Indiana Regional Council of Governments 1.800.621.SMOG

When the air quality index is high, avoid strenuous or outdoor activities.  Avoid congested streets and rush hour traffic, since motor vehicles are the primary source of air pollution. 

If I’ve been diagnosed with COPD, what can I do to cope?

•  Monitor air quality before going out

•  If you are prescribed inhalers, learn how to use them properly.

• Notify your doctor at the first signs of respiratory infection

• Eat a balanced diet high in vitamins and minerals

• Maintain a healthy weight to avoid putting extra burden on your respiratory system.

•  If you are a smoker, stop. Smoking cessation may improve lung function in the early stages of COPD and preserves lung function in the later stages of the disease.

•  If a family member smokes, encourage them to smoke outside.

How is smog formed?

Smog is formed as the result of chemicals reacting in the presence of sunlight, especially in warm weather.

Smog tends to be worst from May through October. 

What can I do to reduce smog and promote better air quality?

• Find alternatives to driving—public transit, carpooling, etc.
• Keep motor vehicles and all other gas-powered engines maintained. Properly maintained engines run cleaner and more efficiently.
• Use gasoline-powered vehicles and refuel after 6 p.m.
• Practice energy efficiency to reduce power plan emissions. Adjust the thermostat properly, turn off lights, computers, TVs and radios

Where can I look for more information on COPD?

View a PDF of the Health Department's brochure on smog (Adobe Acrobat required).

 Some other helpful Web sites:

American Academy of Asthma and Immunology

American Lung Association’s COPD page 

How prevalent is COPD in Kentucky? 

Kentucky has one of the highest rates of deaths from COPD. In 1997, Kentucky was one of 11 states with COPD rates between 46 and 61 COPD deaths per 1000.