World COPD Day: Understanding The Link Between COPD And Air Pollution

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. According to the World Health Organisation, COPD caused 3.23 million deaths worldwide, and around 90% of those deaths were of people under 70 years of age and occurred in low and middle-income countries. Air pollution has a direct effect on COPD, with people experiencing symptoms of shortness of breath, cough, sputum, headaches and dryness on the face and throat almost instantly after being exposed to air pollution.

COPD is a group of progressive lung diseases that are common, preventable, and treatable. This is usually seen among patients above 35 to 40 years of age with or without smoking history and mostly among men though prevalence is increasing in women gradually. Most people with COPD have emphysema, a condition in which the alveoli (air sacs in the lungs) are destroyed by smoking. The air sacs weaken and eventually break, which reduces the surface area of the lungs and the amount of oxygen that can reach the bloodstream. Another condition that comes under the umbrella of COPD is Chronic bronchitis, in which the lining of the bronchial tube experiences inflammation. People who have bronchitis often have a persistent cough that brings up thick, discoloured or purulent sputum.. They may also experience wheezing, chest pain and shortness of breath.

COPD makes it harder to breathe. The symptoms may be mild at first, beginning with occasional coughing and shortness of breath. As it develops, symptoms become more constant, and it can become increasingly difficult to breathe. The person also experiences chest tightness, a lack of energy, swelling in the feet or ankles, and weight loss.

The causes of COPD can be linked to a number of factors, such as smoking, infections, family history, and other diseases like asthma. The main cause, however, remains long-term exposure to air pollution, toxic fumes, and other lung irritants. Indoor air pollution can also be a source of exposure to air contaminants, which are made up of multiple pollutants, including environmental or second-hand smoke and the combustion of solid fuels for home heating and cooking.

The disease can affect people in late 30s to old age with already existing chronic lung diseases like persistent Asthma. If these high risk people are exposed to air pollution for a long period of time, it can affect local immunity of their lung leading to repated infection and exacerbation of COPD. There's also evidence that children who grow up in highly polluted areas are more likely to develop asthma. Sometimes damage to the lungs is irreversible and can cause suffering for many years or even a lifetime which culminate in COPD in their middle age. It is not ideal to live in conditions of severe air pollution, and immediate efforts must be made to improve the situation.

(Dr. Davinder Kundra, Consultant Pulmonology, HCMCT Manipal Hospitals, Dwarka)

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