Chronic Obstructive Pulmonary Disease (COPD) is a condition that affects approximately 15 per cent of the adult population over the age of 45 years in New Zealand according to the Ministry of Health, but unfortunately there are many other people who ignore the symptoms of this condition putting it down to the fact they are getting older and are therefore less fit.
As a result, they do not seek medical attention and are often not diagnosed with either Chronic Bronchitis or Emphysema.
Both these conditions are mainly caused by people who smoke, although this in not the only cause. Some people, who work in industries that have fumes, dust or air borne pollutants are also at risk of developing the condition. Others may have a family history of COPD and may therefore have a hereditary component to it, while others again may have had long term uncontrolled asthma that has also led to permanent lung impairment.
No matter what the cause, people will complain of increasing breathlessness, at first with exercise more than their peers but as the condition progresses breathlessness can occur even at rest. They may have a cough that produces sputum, on a daily basis, for three months, or for two years in a row.
The cough though does not have to be moist, it can also be a dry cough. Other signs are wheezing (a whistling sound when breathing out) and chest tightness. Other symptoms such as weight loss, recurring chest infections and other symptoms can occur as the condition progresses. Māori have the highest rates of hospital admissions, followed by Pacific Island Populations.
The main ways that COPD is diagnosed are by considering, family history, work history, and smoking history, plus by diagnostic testing. If there is a family history of COPD especially in people who have never smoked and develop symptoms at a young age (signs can show from as young as 25 years of age), then this will need review.
Alpha 1 Antitrypsin Deficiency is a genetic disorder that runs in families mainly of white European decent although it can be found is most ethnic groups. Alpha 1 Antitrypsin Deficiency causes emphysema and liver damage. If there is a known family history, then children will be needed to be tested for it when they are young. This will enable them to have counselling to encourage them never to smoke and to go into jobs that will not exacerbate their condition.
Work history also needs to be investigated, as many occupations can cause COPD. These include farming, mining, construction workers, dock workers, pottery, and ceramic workers, to name just a few. Some of these not only lead to COPD but can also worsen asthma symptoms.
Smoking is the main cause of COPD. It is therefore essential to identify what people are smoking and how many they are smoking. It is also important to understand that it is not only cigarette smoking itself, but passive smoking can have an impact. Vaping can also damage the lungs so should not be encouraged long term, as we do not yet fully understand the implications vaping may have on the lungs.
Along with all the above, it is essential that a person has a spirometry test to check on the health of the lungs. Spirometry is the definitive tool when diagnosing COPD. Spirometry will also help with the different treatment options that are available to treat this condition.
What can people do if they suspect that there may be a problem with their lungs? The most important thing is to seek medical attention early and to find out what the problem is. Once the condition has been diagnosed, then treatment can be commenced that will help to alleviate some of the symptoms of COPD. Unfortunately COPD cannot be cured but with early diagnosis people can be given assistance and education to help them to live as normal a life as possible.
The second most important point that people can do is to stop smoking – it is never too late. Stopping smoking can slow down the progression of COPD and can therefore extend life expectancy. This is supported by the British Lung Foundation that says that every cigarette people do not smoke, can add 11 minutes to their life expectancy. If people find it difficult to stop smoking, then it is important to seek help from their general practitioner or groups such as Quit Line. There are several products on the market that are available to help people stop smoking.
Finally, learn as much as you can about the condition and how to keep yourself well. Use medications correctly and as directed by your health provider, and ensure that you eat healthy meals and exercise regularly. These are all important measures for helping to keep yourself well.
For further information and assistance please contact Asthma New Zealand and speak with a nurse educator on 09 623 0236.