Risk Factors for Chronic Obstructive Pulmonary Disease

“Breathing is the greatest pleasure in life.” – Giovanni Papini

Chronic Obstructive Pulmonary Disease (COPD) is a serious lung condition that gradually makes it harder to breathe. It’s a major health issue and one of the top causes of death globally. In this blog, we will explore the key risk factors for COPD.

COPD is not a singular disease, but rather a group of lung diseases. The two main types are emphysema and chronic bronchitis. Emphysema damages tiny air sacs in the lungs, making it difficult for oxygen and carbon dioxide to get exchanged. Chronic bronchitis causes swelling in the airways that carry air to the lungs. Both lead to issues like shortness of breath, coughing, wheezing, and fatigue. For more information, check out our previous blog on the fundamentals of COPD.

What are the risk factors for COPD?

• Smoking: The primary risk factor for COPD is smoking. In fact, both current and former smokers are at risk of developing this condition. According to the Center for Disease Control and Prevention (CDC), smoking is responsible for about 80% of deaths related to COPD, and nearly 38% of the 16 million adults in the US diagnosed with COPD are current smokers. However, the story does not stop there. You may be wondering… I never smoked, so I have nothing to worry about… right? Wrong! Even being around secondhand smoke can put you at risk for COPD. Interestingly, about 1 in 4 people with COPD have never smoked. Exposure to smoking and secondhand smoke during childhood and teenage years can hurt lung growth, which may increase the chances of getting COPD later in life. Check out our previous blog on how one can get ‘hooked’ to smoking and ways to combat this habit: https://community.wholistics.health/smoking-and-how-you-get-hooked/
• Environmental Factors: Exposure to air pollution, dust, and chemical fumes, especially in occupational settings, can also contribute to the development of COPD. Smoke exposure, particularly from coal or wood-burning stoves can also put you at increased risk of developing COPD. Diez et al (2019) wanted to see if air pollution and weather conditions were linked to hospital visits for worsening COPD. The study found over 160,000 hospital visits for COPD with more visits and deaths tied to colder weather and high air pollution. So, what can you do? You can move to a warmer climate if the cold weather is bothersome. And you can also protect yourself from air pollution. Check out our previous blog on four ways to armor yourself against it.
• Genetic Factors: Unfortunately, some people are naturally more wired to develop COPD over others! This is because our genetic makeup influences how well our lungs function. Within our bodies, there is a specific protein called ɑ-1 antitrypsin. This protein helps control the activity of another protein called neutrophil elastase. You can think of neutrophil elastase as an overprotective guard dog. Not only does it help fight foreign infections, but sometimes it also attacks normal tissue (especially the lungs). To keep the protein ‘on its leash’, ɑ-1 antitrypsin comes in. It blunts the overactivity of neutrophil elastase. Now, certain people do not produce enough ɑ-1 antitrypsin. Without adequate levels of this protein, our lungs, therefore, become vulnerable to attack by neutrophil elastase. People with this deficiency usually develop the first signs and symptoms of COPD between the ages of 25 and 50. As this deficiency is an inherited condition, it runs in families and cannot be prevented. It can affect anyone, regardless of race or ethnicity, but it is more common in white people of Northern European descent.
• Age: As we get older, the chances of developing COPD also go up for a few reasons. First, over the years, many of us get exposed to cigarette smoke, air pollution, and dust from jobs, which can take a toll on our lungs. Plus, our lung function naturally declines with age, so they become less elastic and cannot hold as much air. On top of that, our immune systems change, making it harder for our bodies to fight off inflammation in the lungs. Older folks often have other health issues too, like asthma or heart problems, which can further complicate lung health.  All these factors, collectively, make COPD more common with age.
• Gender: COPD is often more common in men, and there are a few reasons for that. For starters, historically, more guys have smoked than women, and since smoking is the biggest culprit behind COPD, that plays a huge role. Plus, many men work in jobs that expose them to harmful substances, like construction or mining, which can damage their lungs over time. However, what is interesting to note here is that this statistic is changing as we speak. More and more studies are pointing to the increased prevalence of COPD in women. Why? Well, because more and more women are smoking these days. It also doesn’t help that women’s lung structures are more vulnerable to the harmful effects of cigarette smoke than men’s! Milne et al (2024) found that women generally have smaller airways compared to their lung size than men. Smaller passageways mean harmful particles from smoke can more easily settle in the lungs. Because of this, women often develop lung problems more quickly than men, even if they smoke the same amount. Female smokers also tend to lose lung function faster than male smokers. They also start showing lung issues, such as breathing difficulties, and wheezing, at a younger age and may have smoked less overall compared to men with similar lung damage. However, COPD should not be treated lightly by either gender.

Conclusion

Understanding the risk factors for COPD is crucial for taking steps to prevent its development or manage it effectively if one already has the condition. Factors like smoking, environmental influences, genetics, and age can all increase our susceptibility to COPD. But we don’t have to succumb to its harmful effects! In our next blog, we will share practical ways to prevent and treat COPD.