Chronic obstructive pulmonary disease (COPD)

POST TIME: 23 November, 2015 00:00 00 AM / LAST MODIFIED: 22 November, 2015 11:21:01 PM

In high income countries, COPD is growing as a cause due to increased tobacco use. WHO

Chronic obstructive pulmonary disease (COPD) is a lung ailment that is characterized by a persistent blockage of airflow from the lungs. It is an under-diagnosed, life-threatening lung disease that interferes with normal breathing and is not fully reversible. The more familiar terms of chronic bronchitis and emphysema are no longer used; they are now included within the COPD diagnosis.
Causes of COPD
Smoking
The primary cause of chronic obstructive pulmonary disease (COPD) is tobacco smoke (including second-hand or passive exposure).
WHO estimates that in 2005 5.4 million people died due to tobacco use. Tobacco-related deaths are projected to increase to 8.3 million deaths per year by 2030.
Other risk factors
The causes for COPD have opposite patterns according to the geographic areas. In high- and middle-income countries tobacco smoke is the biggest risk factor, meanwhile in low-income countries exposure to indoor air pollution, such as the use of biomass fuels for cooking and heating, causes the COPD burden.
Almost 3 billion people worldwide use biomass and coal as their main source of energy for cooking, heating, and other household needs. In these communities, indoor air pollution is responsible for a greater fraction of COPD risk than smoking or outdoor air pollution. Biomass fuels used by women for cooking account for the high prevalence of COPD among nonsmoking women in parts of the Middle East, Africa and Asia. Indoor air pollution resulting from the burning of wood and other biomass fuels is estimated to kill two million women and children each year.
Other risk factors for COPD include occupational dusts and chemicals (such as vapours, irritants, and fumes) and frequent lower respiratory infections during childhood.
Symptoms

Key facts
•   Chronic obstructive pulmonary disease (COPD) is a life-threatening lung disease that interferes with normal breathing – it is more than a “smoker’s cough”.
•   More than 3 million people died of COPD in 2012, which is equal to 6% of all deaths globally that year.
•   More than 90% of COPD deaths occur in low- and middle-income
countries.
•   The primary cause of COPD is tobacco smoke (through tobacco use or second-hand smoke).
•   The disease now affects men and women almost equally, due in part to increased tobacco use among women in high-income countries.
•   COPD is not curable, but treatment can slow the progress of the
disease.

The most common symptoms of COPD are breathlessness (or a "need for air"), abnormal sputum (a mix of saliva and mucus in the airway), and a chronic cough. Daily activities, such as walking up a short flight of stairs or carrying a suitcase, can become very difficult as the condition gradually worsens.
Diagnosis and treatment
COPD is confirmed by a diagnostic test called "spirometry" that measures how much air a person can inhale and exhale, and how fast air can move into and out of the lungs. Because COPD develops slowly, it is frequently diagnosed in people aged 40 or older.
COPD is not curable. It is essential to stop smoking to prevent the progression of COPD. Various forms of treatment can help control its symptoms and increase quality of life for people with the illness. For example, medicines that help dilate major air passages of the lungs can improve shortness of breath.
The availability of treatment options for COPD differ across varying resource settings. WHO has released a guideline (1) with specific recommendations for COPD management in primary health care in resource-constrained settings.
Who is at risk?
At one time, COPD was more common in men, but because of increased tobacco use among women in high-income countries, and the higher risk of exposure to indoor air pollution (such as solid fuel used for cooking and heating) in low-income countries, the disease now affects men and women almost equally.
More than 90% of COPD deaths occur in low- and middle-income countries, where effective strategies for prevention and control are not always implemented or accessible.
Risk factors
COPD is preventable. The primary cause of COPD is tobacco smoke (including second-hand or passive exposure). Other risk factors include:
indoor air pollution (such as solid fuel used for cooking and heating);
outdoor air pollution;
occupational dusts and chemicals (vapours, irritants and fumes);
frequent lower respiratory infections during childhood.
WHO response
WHO’s work on COPD is part of the Organization's overall efforts to prevent and control noncommunicable diseases. WHO aims to: raise awareness about the global epidemic of noncommunicable diseases;
create more healthy environments, especially for poor and disadvantaged populations;
decrease risk factors of noncommunicable disease, such as tobacco use, unhealthy diet and physical inactivity; and prevent premature deaths and avoidable disabilities from major noncommunicable diseases. The WHO Framework Convention on Tobacco Control (WHO FCTC) was developed in response to the globalization of the tobacco epidemic to protect billions of people from harmful exposure to tobacco. It is the first global health treaty negotiated by WHO, and has been ratified by 180 countries.
WHO also leads the Global Alliance against Chronic Respiratory Diseases (GARD), a voluntary alliance of national and international organizations, institutions and agencies working towards the common goal of reducing the global burden of chronic respiratory diseases. Its vision is a world where all people breathe freely. GARD focuses specifically on the needs of low- and middle-income countries and vulnerable populations.
Source: WHO