Assignment: Chronic Obstructive Pulmonary Disease Due to Smoking Presentation
Assignment: Chronic Obstructive Pulmonary Disease Due to Smoking Presentation
Assignment: Chronic Obstructive Pulmonary Disease Due to Smoking Presentation
Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death worldwide, causing 3.23 million deaths in 2019 [1].
Over 80% of these deaths occurred in low- and middle-income countries (LMIC).
COPD causes persistent and progressive respiratory symptoms, including difficulty in breathing, cough and/or phlegm production.
COPD results from long-term exposure to harmful gases and particles combined with individual factors, including events which influence lung growth in childhood and genetics.
Environmental exposure to tobacco smoke, indoor air pollution, and occupational dusts, fumes, and chemicals are important risk factors for COPD.
Early diagnosis and treatment, including smoking cessation support, is needed to slow the progression of symptoms and reduce flare-ups.
What is COPD?
COPD is a common, preventable, and treatable chronic lung disease which affects men and women worldwide.
Abnormalities in the small airways of the lungs lead to limitation of airflow in and out of the lungs. A number of processes cause the airways to become narrow. There may be destruction of parts of the lung, mucus blocking the airways, and inflammation and swelling of the airway lining.
COPD is sometimes called “emphysema” or “chronic bronchitis”. Emphysema usually refers to destruction of the tiny air sacs at the end of the airways in the lungs. Chronic bronchitis refers to a chronic cough with the production of phlegm resulting from inflammation in the airways.
COPD and asthma share common symptoms (cough, wheeze, and difficulty breathing) and people may have both conditions.
The impact of COPD on daily life
Common symptoms of COPD develop from mid-life onwards, including:
breathlessness or difficulty breathing,
chronic cough, often with phlegm,
tiredness.
As COPD progresses, people find it more difficult to carry out their normal daily activities, often due to breathlessness. There may be a considerable financial burden due to limitation of workplace and home productivity, and costs of medical treatment.
During flare-ups, people with COPD find their symptoms become much worse – they may need to receive extra treatment at home or be admitted to hospital for emergency care. Severe flare-ups can be life-threatening.
People with COPD often have other medical conditions such as heart disease, osteoporosis, musculoskeletal disorders, lung cancer, depression and anxiety.
Causes of COPD
COPD develops gradually over time, often resulting from a combination of risk factors:
tobacco exposure from active smoking or passive exposure to second-hand smoke;
occupational exposure to dusts, fumes or chemicals;
indoor air pollution: biomass fuel (wood, animal dung, crop residue) or coal is frequently used for cooking and heating in low- and middle-income countries with high levels of smoke exposure;
early life events such as poor growth in utero, prematurity, and frequent or severe respiratory infections in childhood that prevent maximum lung growth;
asthma in childhood; and
a rare genetic condition called alpha-1 antitrypsin deficiency, which can cause COPD at a young age.
Reducing the burden of COPD
There is no cure for COPD but early diagnosis and treatment are important to slow the progression of symptoms and reduce the risk of flare-ups.
COPD should be suspected if a person has typical symptoms, and the diagnosis confirmed by a breathing test called spirometry, which measures how the lungs are working. In low- and middle-income countries, spirometry is often not available and so the diagnosis may be missed.
There are several actions that people with COPD can take to improve their overall health and help control their COPD:
stop smoking: people with COPD should be offered support to quit smoking;
take regular exercise; and
get vaccinated against pneumonia, influenza and coronavirus.
Inhaled medication can be used to improve symptoms and reduce flare-ups. There are different types of inhaled medication which work in different ways and can be given in combination inhalers, if available.
Some inhalers open the airways – they may be given regularly to prevent or reduce symptoms, and to relieve symptoms during acute flare-ups. Inhaled corticosteroids are sometimes given in combination with these to reduce inflammation in the lungs.
Inhalers must be taken using the correct technique, and in some cases with a spacer device to help deliver the medication into the airways more effectively. Access to inhalers is limited in many low- and middle-income countries – in 2019 salbutamol inhalers were generally available in primary care public health facilities in approximately half of low-income countries [2].
Flare-ups are often caused by a respiratory infection – people may be given an antibiotic or steroid tablets in addition to inhaled or nebulised treatment as needed.
People living with COPD must be given information about their condition, treatment and self-care to help them to stay as active and healthy as possible.
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