COPD Update

By Sondra Forsyth

Editor’s Note: November is COPD Awareness Month, and this respiratory condition is something everyone should know more about. It is the third leading cause of death in the United States, killing more than 120,000 people per year, and up to 12 million adults may have it and not know it. Here, experts from the National Heart, Lung and Blood Institute (NHLBI), one of the National Institutes of Health, explain what you need to know about this deadly condition:

COPD (Chronic Obstructive Pulmonary Disease) is a serious lung disease that over time, makes it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways—tubes that carry air in and out of your lungs—are partially blocked, which makes it hard to get air in and out.

When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing.

WHO’S AT RISK

Most people who are at risk for getting COPD have never even heard of it and, in many cases, don’t even realize that the condition has a name. Some of the things that put you at risk for COPD include:

Smoking

COPD most often occurs in people age 40 and over with a history of smoking (either current or former smokers), although as many as one out of six people with COPD never smoked. Smoking is the most common cause of COPD-it accounts for as many as nine out of ten COPD-related deaths.

Environmental Exposure

COPD can also occur in people who have had long-term exposure to lung irritants, like certain chemicals, dust, or fumes in the workplace. Heavy or long-term exposure to secondhand smoke or other air pollutants may also contribute to COPD.

Genetic Factors

In some people, COPD is caused by a genetic condition known as alpha-1 antitrypsin, or AAT, deficiency. While very few people know they have AAT deficiency, it is estimated that close to 100,000 Americans have it. People with AAT deficiency can get COPD even if they have never smoked or had long-term exposure to harmful pollutants.

HOW DOES COPD AFFECT BREATHING?

The “airways” are the tubes that carry air in and out of the lungs through the nose and mouth. Healthy airways and air sacs in the lungs are elastic—they try to bounce back to their original shape after being stretched or filled with air, just the way a new rubber band or balloon does. This elastic quality helps retain the normal structure of the lung and helps to move the air quickly in and out.

In people with COPD, the air sacs no longer bounce back to their original shape. The airways can also become swollen or thicker than normal, and mucus production might increase. The floppy airways are blocked, or obstructed, making it even harder to get air out of the lungs.

Symptoms of COPD include:

Constant coughing, sometimes called “smoker’s cough”

Shortness of breath while doing activities you used to be able to do

Excess sputum production

Feeling like you can’t breathe

Not being able to take a deep breath

Wheezing

When COPD is severe, shortness of breath and other symptoms can get in the way of doing even the most basic tasks, such as doing light housework, taking a walk, even bathing and getting dressed.

COPD develops slowly, and can worsen over time, so be sure to report any symptoms you might have to your doctor or health care provider as soon as possible, no matter how mild they may seem.

Testing for COPD

Everyone at risk for COPD who has cough, sputum production, or shortness of breath, should be tested for the disease. The test for COPD is called spirometry.

Spirometry can detect COPD before symptoms become severe. It is a simple, non-invasive breathing test that measures the amount of air a person can blow out of the lungs (volume) and how fast he or she can blow it out (flow). Based on this test, your doctor or health care provider can tell if you have COPD, and if so, how severe it is. The spirometry reading can help them to determine the best course of treatment.

Spirometry is one of the best and most common lung function tests. The test is done with a spirometer, a machine that measures how well your lungs function, records the results, and displays them on a graph. You will be asked to take a deep breath, then blow out as hard and as fast as you can using a mouthpiece connected to the machine with tubing. The spirometer then measures the total amount exhaled, called the forced vital capacity or FVC, and how much you exhaled in the first second, called the forced expiratory volume in 1 second or FEV1. Your doctor or health care provider will read the results to assess how well your lungs are working and whether or not you have COPD.

Steps to Prevent COPD

Quit Smoking

If you smoke, the best thing you can do to prevent more damage to your lungs is to quit. To help you quit, there are many online resources and several new aids available from your doctor or health care provider. The National Cancer Institute has information on smoking cessation. Visit SmokeFree.gov, the American Lung Association, or call 1-800-QUIT NOW for more information.

Avoid Exposure to Pollutants

Try to stay away from other things that could irritate your lungs, like dust and strong fumes. Stay indoors when the outside air quality is poor. You should also stay away from places where there might be cigarette smoke.

Visit Your Doctor or Health Care Provider on a Regular Basis

See your doctor or health care provider regularly even if you are feeling fine. Make a list of your breathing symptoms and think about any activities that you can no longer do because of shortness of breath. Be sure to bring a list of all the medicines you are taking to each office visit.

Take Precautions Against Seasonal Flu

Do your best to avoid crowds during flu season. In addition to avoiding people with the flu, remembering to wash and sanitize your hands can be one of the best ways to guard against getting sick. It is also a good idea to get a flu shot every year, since the flu can cause serious problems for people with COPD. You should also ask your doctor or health care provider about the pneumonia vaccine.

Take Precautions Against the H1N1 Flu

People with COPD and other chronic conditions may also be at increased risk to become seriously ill with the H1N1 flu (formerly called swine flu). Ask your doctor or health care provider for the H1N1 flu vaccine. This is a flu shot made with inactivated (killed) flu virus. It can be administered at the same visit as any other vaccine, including the pneumonia vaccine. To learn more about the flu, H1N1 and COPD visit the Centers for Disease Control and Prevention.

For more information on respiratory-health issues, click here for the NHLBI website.