Nearly 33% Patients Screened With COPD Found To Be Non-Smokers, Big Reason To Worry

 Chronic Obstructive Lung Disease or COPD is the 2nd leading cause of death in the country with more than 2,400 deaths due to COPD reported every day here. This number is more than the number of people who die because of tuberculosis (1157), diabetes (748), and HIV-AIDS (126) all put together. There are an estimated 50 million people living with COPD in India, according to the latest figures. Air Pollution and tobacco smoking are the major factors responsible for COPD in India. According to 2019 GBD Report, COPD due to tobacco smoking is 29% whereas COPD due to air pollution is 53.3% in India. Yet, the deadly disease does not receive the recognition that it deserves.

Every year, 17th November is observed as the World COPD Day to highlight the burden and impact of Chronic Obstructive Pulmonary Disease and to create awareness about this disease and educate people to keep their lungs healthy. To mark this day, CREST, an institute dedicated for research and education in the field of chronic lung diseases based in Pune, organized a weeklong nationwide screening program for COPD called as "SCREEN" including 44 medical colleges across India.

During the screening program, it was noticed that every 6th patient who visited a Chest OPD had COPD. Total 2440 patients visited OPD for screening, out of those 269 (11%) were found to have COPD, in which 75% were males and 25% were females. Concerningly, nearly 33% patient screened with COPD were non-smokers. This is a big reason to worry, CREST said in a press release. 

Beware of the causes of COPD

Dr. Sundeep Salvi, Director, CREST, highlighted that COPD is a chronic, progressive lung disease with intermittent periods of exacerbations, called lung attacks, that can often be fatal. It is caused by long-term exposure to noxious pollutants that causes damage to the breathing tubes and the gas exchange portion of the lung.

Tobacco smoking in any form, household air pollution from the burning of biomass fuels for cooking purposes, burning of mosquito coils, long-term exposure to ambient air pollution from motor vehicular exhausts, industry smoke, road dust, and working in dusty workplaces for many years are the risk factors associated with COPD. Recurrent respiratory tract infections during childhood, poverty, and chronic poorly treated asthma are the other causes of COPD, he stated.

How to reduce the burden of COPD in India

CREST's nationwide screening program highlighted the huge burden of COPD in India. Use of a simple COPD screening tool followed by Spirometry among those who are screen positive both in the clinic as well as in the community is required to make an early and accurate diagnosis of COPD. But many doctors or hospitals across India do not have this test, and as a result, a lot of COPD remains undiagnosed and wrongly diagnosed. This leads to undertreatment and wrong treatment and therefore more suffering and death, Dr. Salvi noted.

To reduce the burden of COPD in India, the use of spirometry needs to be increased as well as availability of simple, easy-to-use, cheap, and accurate spirometers in the country. In addition, COPD needs to be recognized as an important disease in India. Because awareness, prevention, early diagnosis, and appropriate management, including pulmonary rehabilitation, are the key to reducing the burden of COPD in India, the institute pointed out in its release.  

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Lung disease associated with dementia in later life

According to a recent study, lung disease in middle age could be a risk factor for dementia or cognitive impairment later in life. 
 
A group of researchers report that both restrictive and obstructive lung diseases were associated with dementia, including Alzheimer's disease and with mild cognitive impairment. The link was stronger for restrictive lung diseases, such as idiopathic pulmonary fibrosis and sarcoidosis, than it was for chronic obstructive pulmonary disease (COPD).

"Preventing dementia is a public health priority, and previous studies have suggested that poor lung health, which is often preventable, may be linked to a greater risk of developing dementia," said the Dr.

"In this study, we looked at the long-term association between poor lung function and the risk of developing dementia, using high-quality measures," added the author.

The study found that compared to those without lung disease, the odds of dementia or mild cognitive impairment were:
- 58 percent higher among those with restrictive lung disease.
- 33 percent higher among those with obstructive lung disease.
The study also found that low results on two spirometry tests--forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) - were associated with dementia. FEV1 is the amount of air a person can forcefully exhale in one second. FVC is a measurement of lung size.

According to the authors, possible explanations for these findings are that lung disease produced low blood oxygen levels, which in turn may have led to inflammation, stress and damage to the brain's blood vessels.

Study limitations included the fact that participants' lung function was assessed only at the beginning of the study and that many patients died before being assessed for dementia or cognitive impairment.

Because it was not a randomised, controlled trial, the study cannot prove a cause and effect relationship between lung disease and dementia or mild cognitive impairment.

If these associations are causal, the researchers wrote, this would give added weight to efforts to improve air quality and to help people quit smoking. These public health measures might also lower rates of dementia as well as decrease lung disease.

"Preventing lung disease is inherently important," the Dr. said, adding that if other studies confirm their study's findings, "both individuals and policymakers will have an added incentive to make changes that protect lung health, as doing so may also prevent dementia."

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The Fruits that Help Lung Damage Due To Smoking

HEALING properties found in fresh apples and tomatoes can slow down natural ageing of the lungs and even repair damage caused by smoking, research claims.

 

Scientists say the fruits, particularly apples, are crammed with wonder chemicals that provide a protective effect.

 Having at least two tomatoes or three pieces of fruit as part of the recommended five-a-day provides the biggest benefit.

Experts found the natural decline in lung function over a 10-year period was slower among former smokers with a diet packed with nature’s goodness.
 

The protective effect was only observed in fresh fruit and vegetables and not processed foods like sauces.

 There was also a slower decline in lung function among all adults, including those who had never or had stopped smoking, with the highest tomato consumption.

A Professor said: “This study shows that diet might help repair lung damage in people who have stopped smoking.

"It also suggests that a diet rich in fruits can slow down the lung’s natural ageing process even if you have never smoked.”

Researchers, assessed the diet and lung function of more than 650 adults in 2002. A decade later tests were repeated on the same group from different countries.
 

Diet and overall nutritional intake was assessed from questionnaires while participants also underwent spirometry, a procedure that measures the capacity of lungs to take in oxygen.

The study controlled factors such as age, height, sex, body mass, physical activity and total energy intake. Results among former smokers suggested nutrients in tomatoes and fruits help repair damage to their lungs.

A Prof said: “Lung function starts to decline at around age 30 at variable speed depending on the general and specific health of individuals.
 

“Our study suggests that eating more fruits on a regular basis can help attenuate the decline as people age and might even help repair damage caused by smoking.

“Diet could become one way of combating rising diagnosis of chronic obstructive pulmonary disease [COPD], all of which are made worse by smoking, around the world.”

An estimated more than a million people live with COPD making it the second most common lung disease in the world after asthma.

COPD is a group of lung conditions that cause breathing difficulties including emphysema, damage to the air sacs in the lungs and chronic bronchitis, the long-term inflammation of the airways.
 

Previous research has suggested apples, which are a rich source of vitamin C and K, magnesium, potassium and fibre, can slash the risk of an early death by more than a third.

They contain health-boosting flavanoids, which are believed to reduce the risk of killer conditions like cancer.

The fruit is thought to be good for heart health with its potent mix of fibre and polyphenols linked to reductions in the level of so-called “bad” cholesterol.
 

Apples and green tomatoes also possess natural chemicals that help halt the march of time.

Ursolic acid is found in the fruit’s waxy outer layer while tomatidine comes from the skins and leaves of green tomatoes. Both are thought to stop muscle wastage.
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Graphene-based sensor could help ward off asthma attacks

Scientists at Rutgers University-New Brunswick have created a graphene-based sensor that could lead to a wearable device that when blow into predicts the likelihood of an asthma attack.

Asthma affects more than 24 million Americans, nearly 8% of the total population, according to the Centers for Disease Control and Prevention. In 2010, more than 439,000 adults and children were hospitalized due to asthma.

Asthma management typically involves taking medication and avoiding irritants. Current noninvasive ways to diagnose and track asthma require expensive and bulky equipment, Rutgers said in a statement. A portable device that predicts an attack could help sufferers ward off attacks rather than react to them by inhaling a drug.

Spirometry, a current diagnostic method, screens for exhaled nitric oxide to identify inflammation of the airway. The Rutgers team created an electrochemical sensor that uses reduced graphene oxide to measure nitrite in exhaled breath, according to the statement.

"Nitrite level in breath condensate is a promising biomarker for inflammation in the respiratory tract," said Clifford Weisel, Ph.D., a professor at Rutgers' Environmental and Occupational Health Sciences Institute, who co-authored the study, which was published in Microsystems & Nanoengineering. "Having a rapid, easy method to measure it can help an asthmatic determine if air pollutants are affecting them so they can better manage use of medication and physical activity."

In addition to personal asthma management, the device could also be used in healthcare settings to track the effectiveness of anti-inflammatory drugs and optimize care, Weisel said.

The Rutgers team isn’t the only one working on ways to prevent asthma attacks. Researchers from North Carolina State University developed a wearable system comprising a wristband, chest patch and spirometer that monitors environmental factors—such as humidity and compounds in the air—that could trigger an asthma attack. Eventually, the NC State team hopes to create software that will track a user’s data and automatically warn of an impending attack.

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Signs of COPD?

Having trouble catching your breath? Getting winded just walking the dog? Your lungs may be sending you a signal. Get a pulmonologist’s perspective on spotting the early warning symptoms of COPD and what to do to keep your lungs healthy at any age...

Once thought of as a man’s, and even a coal miner’s, disease, chronic obstructive pulmonary disease (COPD) is now on the rise in women.

“COPD was considered a man’s disease because more men than women smoked and worked in factories,” says Stephen Mueller, M.D., a pulmonologist at Methodist Charlton Medical Center in Dallas.

“In fact,” he says, “a much larger population of women are developing COPD primarily because they’re smoking as much as men.”

According to the National Heart Lung and Blood Institute (NHLBI), more than 12 million people are living with the disease and 12 million more may not realize they have early stage COPD, which blocks airflow and makes it tough to breathe.

The best way to prevent it is to stop smoking – immediately.

But educating yourself about the warning symptoms of COPD – as well as preventive measures and treatment options – could save your life or that of a loved one, Dr. Mueller says.
The best news: If COPD is diagnosed early enough, you can slow down – even stop – lung damage, he says.
Here, Dr. Mueller explains symptoms of the disease, risk factors and the latest treatments for COPD.
What is COPD?
COPD describes a number of progressive chronic lung diseases, including emphysema and chronic bronchitis, which slowly kill healthy lung tissue.
Emphysema causes the air sacs in the lungs to lose their flexibility, which prevents oxygen from entering the bloodstream, making it hard to breathe.
Chronic bronchitis, or “smoker’s cough,” is a chronic lung disease caused by inflammation that leads to bronchial tube scarring.
This produces excessive mucus that causes frequent coughing and respiratory infections.
When these conditions prevent air from flowing freely throughout the lung, parts become damaged or die. Air trapped in the dead or dying areas keeps the lungs from operating on full power, and the COPD patient has a hard time breathing.
Until we discover a way to grow or build new lung tissue, there’s no cure for the disease. 

 

Who is at risk for COPD?Smokers. The No. 1 contributing factor for developing COPD is smoking. At least 80% of all COPD cases are related to smoking.

What are some other risk factors?Genetics may play a role in early symptoms of COPD development, even if a person never smokes, but it’s rare.

Unfortunately, there are no genetic tests that can identify who is at risk for developing the disease.

Environmental factors, such as volatile chemicals, certain hardeners used in factories and diesel fuel fumes can injure lungs. Coal miners and those who work with asbestos or even cement increase their risk for developing symptoms of COPD.

Long-term exposure to high ozone, the main ingredient in urban smog, is thought to contribute to COPD because it deprives the lungs of fresh air.

Age is also a factor. Most people develop emphysema in their late 70s or 80s. 

 

So, as we age, everyone is at risk for COPD?Yes, eventually just about everyone will develop COPD simply through aging.

After age 35, you begin to lose about an ounce of lung tissue a year. It’s a slow process and isn’t noticeable in most healthy people.

Smoking can quadruple the speed of the tissue loss, reducing lung capacity and increasing the likelihood of becoming oxygen dependent.

But after 40-50 years of this cumulative loss, you may get winded doing simple things, such as carrying groceries from the garage.

Patients generally don’t die of age-related COPD.

Does having asthma predispose you to COPD?Yes and no. Untreated and uncontrolled asthma can stiffen airways and cause similar symptoms of COPD, such as difficulty in breathing.

Do men and women have similar symptoms of COPD?Unlike heart disease, the symptoms are similar.

However, the progression of the disease in women seems to be faster, especially if they continue smoking once diagnosed or are diagnosed in the later stages of the disease, or don’t take their prescribed medicines.

Unfortunately, no one knows why.

What are the symptoms or warning signs of COPD?Chronic bronchitis and coughing up clear mucous are certainly early warning signs of COPD.

But its hallmark is shortness of breath. Regardless of frequency, it’s a sign of COPD you should address with your doctor.

Most patients in the early stages of COPD feel great sitting or resting. But they’re out of breath if they walk 10 feet.

If you suddenly feel winded or short of breath after normal activities, such as walking the dog, grocery shopping or riding a bike, see your physician.

Is early diagnosis important in treating or managing symptoms of COPD?Early diagnosis may halt – or slow – its progression.

Proper medication can open the airways and improve lung function, which makes it easier to breathe. 

 

How is COPD diagnosed?There are several non-invasive ways to test for lung disorders, such as emphysema, but only one will diagnose COPD: a lung function test.

What is that?Called a spirometry, this two-step, non-invasive test measures the amount of air your lungs can hold and how fast you can blow the air out of your lungs.

The test can detect COPD before you have any symptoms, track the disease’s progression and monitor treatment. The optimum air-flow range depends on [several factors], such as age, weight, smoking history, etc.

If a person is diagnosed with COPD, is it too late to quit smoking?It’s never too late to quit. Smoking destroys lung tissue continuously. Quitting now halts the accelerated destruction process, giving the lungs the opportunity to age normally.

Is COPD diagnosis an automatic death sentence?No, COPD is an irreversible condition, but some patients have successfully managed the symptoms of this chronic lung disease for more than 20 years.

 

What medications are typically prescribed in the treatments of COPD?Most COPD medications are inhaled, just like asthma drugs. They’re used to widen the airways and make it easier to breathe.

Two common drugs are budesonide/formoterol fumarate dihydrate and fluticasone propionate and salmeterol. Both were initially designed for asthma treatment, but have been approved by the Food and Drug Administration (FDA) to treat COPD.

What are the side effects of those medications?
They have side effects that vary with every patient. The most common is dry mouth, which is temporary and may be managed with designated mouth rinses or by changing medicines.

Cost is a much bigger factor and deterrent for people. Many COPD medications are expensive and aren’t covered under prescription plans, insurance or Medicare.

Are there alternative remedies for COPD? There’s insufficient scientific information to support any benefits of alternative remedies. Acupuncture may help symptoms a little, but not much.

Herbs and other treatments have not been effective in treating COPD.

Does exercise help manage symptoms of COPD?
Most definitely. Aerobic activity, such as walking or riding a stationary bike, improves lung power and capacity, and allows you to be active without getting winded.
Can surgical treatments of COPD minimize symptoms?
The most common surgical procedure is lung volume reduction surgery, which removes about 30% of each lung to allow air to circulate more easily.
There are currently two surgical options used with this in-patient procedure. A sternotomy is a surgical incision made through the breastbone that allows the surgeon to remove the affected tissue through the chest.
The second, a thoracoscopy, is less invasive. It uses graspers and staplers inserted through small incisions on either side of the chest to remove damaged tissue and reseal the remaining lung. Both procedures require hospital stays between 5-10 days and multiple weeks of pulmonary rehabilitation.
Unfortunately, it’s a short-term solution. The disease typically recurs two to three years after surgery, which is one reason the procedure is rarely covered by insurance.
Gradually, the lung cells begin to die again, symptoms reoccur and patients again become easily winded and need oxygen. 

 

What new treatments are on the horizon?
A new minimally invasive procedure is being tested in the U.S. It uses umbrella-shaped valves inserted into the lungs through a bronchoscope (a flexible tube passed into the bronchial tubes through the mouth or nose) to redirect airflow from diseased portions to healthier areas.

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