COPD is the third leading cause of death in this country behind only heart disease and stroke, yet many people don’t realize that in many cases, the disease is preventable. Although smoking is the most common cause of COPD, there are a number of other important risk factors that increase your chances of being diagnosed.1
Risk Factors: What Are They?
It is becoming increasingly evident that risk for COPD is related to an interaction between genetics and long-term, cumulative exposure to environmental irritants. Take a look at the following risk factors for COPD, some of which may surprise you:
- Genetics: Whether you’re tall or short, have blue eyes or brown, are thin or full-figured has little to do with what your parents wished for, but everything to do with genetics. And your looks aren’t the only thing affected by your genes; genetics also play an important role in the development of many chronic diseases. The most easily recognized genetic risk factor for COPD is alpha-1 antitrypsin (AAT) deficiency.
AAT deficiency is passed on to a child at birth by one, or both, parents. It is caused by lack of AAT, a protective protein made by the liver. People who have AAT deficiency are at greater risk for developing liver and/or lung disease. If you have AAT deficiency, smoking dramatically increases your chances of developing COPD.1
- Tobacco Smoke: Tobacco smoke remains the single most important risk factor for COPD, worldwide. In fact, as many as 73% of all deaths from COPD are related to cigarette smoking. The fact that not all smokers develop COPD tells us that the relationship between smoking and COPD death rates has a lot to do with genetics. However, the number of smokers who go on to develop COPD is steadily rising; recent reports suggest that as many as 50% of all smokers are diagnosed. Moreover, smoking during pregnancy is known to affect fetal growth and development and is thought to lead to the development of lung disease later in life.1
- Occupational Exposure: It is estimated that in the United States alone, workplace exposure to dust, chemicals, vapors and fumes is attributed to 19.2% of COPD cases in smokers and 31.1% in never-smokers. These risks are assumed to be even greater in countries with less stringent work laws.1
- Indoor and Outdoor Air Pollution: In certain parts of the world, biomass fuels such as coal, straw, wood and animal dung are commonly used for cooking and heating. The World Health Organization (WHO) estimates that, in countries where incomes fall between the low and middle range, 35% of people diagnosed with COPD developed it after being exposed to indoor smoke from biomass fuels. What’s more, 36% of all deaths from lower respiratory disease are associated with biomass exposure. A report in China found that the prevalence of COPD in never-smoking women who were exposed to biomass fuels in rural areas was up to three times higher compared to women in urban areas where biomass exposure was not a factor. Outdoor air pollution poses a much smaller risk than indoor air pollution in the development of COPD. In high income countries, only 1% all of COPD cases are associated with urban air pollution compared to 2% of lower income nations.1
- Increased Age:The prevalence of COPD, as well as the risk of death and disability associated with COPD, increases with age. This is especially true in recent years because many people are living longer. Although many people remain healthy and vibrant throughout their lives, others are at risk for developing chronic illnesses such as COPD.1
- Early Childhood Lung Infections: Severe lung infections in early childhood have been associated with decreased lung function and the development of COPD in later life. Furthermore, low birth weight may predispose a child to lung infections, which may also increase the risk of COPD.1
- Asthma: Although more research is needed to confirm a relationship between asthma and COPD, one study found that, after adjusting for smoking, adults with asthma were 12 times more likely to develop COPD than adults who didn’t have asthma.2 Another study found as many as 20% of people with asthma developed signs of COPD.2
- Gender: Historically, COPD was found to be more prevalent in men. Since 2000, however, more women than men have died from COPD annually.3 This is largely attributed to the rise in women smokers over the years due, in part, to the increase in advertising that specifically targeted women. Additionally, there is some evidence to support that women are more susceptible to the damaging effects of tobacco smoke thereby increasing their risk of COPD, but this theory continues to be a matter of controversy.1
- Socioeconomic Factors: Sadly, people who live in poverty have a higher risk of developing COPD, and complications associated with COPD, compared to people who are wealthier. This is often attributed to high smoking rates, poor nutritional status, overcrowding, exposure to pollutants (especially in the workplace), poor access to health care and early childhood respiratory infections.1
COPD Screening Tool
If you have symptoms of COPD, such as shortness of breath, cough and sputum production, and a history of exposure to risk factors, please take a moment to participate in this 5 Question COPD Risk-Screener brought to you by the COPD foundation. Be sure to print out your results and take them to your doctor.
Author: Deborah Leader RN, BSN, PHN
David M. Mannino, A. Sonia Buist. Global burden of COPD: risk factors, prevalence, and future trends
. The Lancet. 2007; 370:765-73.
Silva GE, Sherrill DL, Guerra S, Barbee RA. Asthma as a risk factor for COPD in a longitudinal study.
Chest. 2004 Jul;126(1):59-65.
Cote, C.G., Chapman, K.R. Diagnosis and treatment considerations for women with COPD.
March, 2009.Image Credit: Flickr, Senior Couple in Swimming Pool