What Causes COPD?

What Causes COPD?

COPD makes it hard to breathe. Learn about the symptoms and risks of this condition, causes of COPD, diagnosis and treatment options.

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COPD, or Chronic Obstructive Pulmonary Disease, affects over 800,000 people in the UK each year. For asthma sufferers, it is essential to know what COPD is, what causes and and what you can do to prevent developing the condition.

COPD. Chronic Obstructive Pulmonary Disease. Are you wondering what it is and how it might affect you or a loved one?

For asthma sufferers, one of the main concerns is developing more severe respiratory problems down the line due to repeated damage to the airways that occurs with exposure to triggers such as allergens and other substances. 

One of the most common diseases that is associated with asthma is COPD – but what exactly is it, what are its causes, and how can it interact with asthma?

Don’t worry, we’re here to help. Let’s answer some common questions about COPD to try and clear things up. Read on to find out more…

What is COPD?

COPD is short for Chronic Obstructive Pulmonary Disease, and is a condition where an individual’s airways become inflamed, and the air sacs in the lungs are damaged. As a result, the airways narrow, making it more difficult to breathe, as well as causing a range of other unpleasant symptoms.

These symptoms include wheezing, breathlessness, a tight chest, coughing, and producing more mucus (phlegm) than normal.

Most people develop COPD after the age 40 years old, although in rare cases, it can set in at an earlier age, often due to cofactors such as a genetic condition known as Alpha-1 Antitrypsin Deficiency.

According to the Pharmaceutical Journal, around 835,000 people are registered with the NHS as having COPD, with many more going undiagnosed. However, in the large majority of cases, the onset of COPD can be avoided by lifestyle choices.

What causes COPD?

So, what causes COPD to develop? Well, as The National Heart, Lung and Blood Institute explain, most COPD cases are caused by “long-term exposure to lung irritants that damage the lungs and the airways”. These vary from case to case, and can interact with other predispositions and conditions. However, the main causes of COPD involve the inhalation of noxious materials.

Smoking

It is a well-established fact that the main cause of COPD, like many other respiratory diseases, is smoking. Up to 75 percent of COPD patients either smoke or used to smoke, and it is thought to be responsible for a staggering 90 percent of cases. 

As NHS UK explains, ingesting hot smoke and tar can severely damage the airways and lungs, causing the inflammation that is a leading symptom of COPD. People diagnosed with COPD must therefore consider quitting smoking as a first port of call to improve their symptoms. Secondhand smoke can also cause COPD, meaning that people who live with smokers, and smokers’ children, can also develop COPD. 

Harmful fumes and dust

However, it is not only smoking cigarettes that can cause COPD. Inhaling many other harmful fumes and dust particles can also lead to the condition. This may occur at work or home, most commonly during construction work.

Substances that have been linked to the development of COPD include:

  • Cadmium dust and fumes
  • Grain and flour dust
  • Silica dust
  • Welding fumes
  • Isocyanates
  • Coal dust

This risk is compounded in those who breathe in fumes and dust and also smoke.

Air pollution

In some cases, people who live in areas of high air pollution can also develop COPD. Exposure to airbound pollution for long periods of time can damage the lungs, and although the link between this and COPD is still being researched, scientists believe air pollution can cause COPD to develop.

According to the World Health Organisation, this is particularly common in low-income countries, where exposure to indoor air pollution such as biomass fuels used for cooking and heating, is rife.

Genetics

Although the majority of causes of COPD are environmental, genetics can also play a part in increasing the likelihood of developing the disease. As the British Lung Foundation suggests, some people are more likely to be affected than others by inhaling noxious materials, which is down to genetics.

 However, this also interacts with lifestyle factors, as those with a family history of COPD are more likely to develop the illness if they smoke.

There is also a condition that denotes a genetic tendency to develop COPD, called Alpha-1-antitrypsin Deficiency. Around 1 in 100 people with COPD have this condition. Alpha-1-antitrypsin is a substance that protects your lungs from damage, and a deficiency in this substance can cause people to develop COPD at a younger age – often under 35 – especially if they smoke. 

Respiratory illnesses during childhood

In some rare cases, respiratory illnesses encountered during childhood can increase the chances of developing COPD. 

For example, frequent lower respiratory infections experienced as a child can heighten the risk of COPD, whereas children who suffer from severe, persistent asthma are almost 32 times more likely to develop COPD as adults, according to the American Lung Association. This makes the effective management of asthma in children essential to prevent problems in later life.

The link between COPD and asthma

As COPD is caused by persistent damage to the airways and lungs, severe long-term asthma can, in some cases, lead to COPD, as asthma narrows the airways. This is more likely to occur if asthma is improperly managed and treated. The American Lung Association suggests:

“Many people who develop COPD will need to continue to treat the inflammation caused by their asthma as well as add treatments to manage the symptoms of COPD and retain as much lung function as possible.”

However, asthma and COPD are initially caused by slightly different medical processes. In asthma, inflammation is caused primarily by eosinophils, whereas COPD is also caused by neutrophils – an important distinction in diagnosis and treatment. 

For example, corticosteroids are effective against eosinophilic inflammation but largely ineffective against neutrophilic inflammation. Despite this, in exacerbations of both diseases, the patterns of inflammation can become similar, for example, COPD exacerbations can see an increase in eosinophil numbers. This a factor can lead to patients being prescribed corticosteroids such as asthma inhalers to manage acute flare-ups of their conditions.

Because of these clinical associations, it is essential that asthma patients properly manage their condition in order to prevent the development of conditions such as COPD. Asthma management is essential for patients to avoid further issues, and can be supported by the use of smart inhalers, which send reminders to patients to take their dose and track the effectiveness of each application.

 

*References

American Lung Association

Asthma.org

British Lung Foundation

NHS UK

Pharmaceutical Journal

The National Heart, Lung and Blood Institute

World Health Organisation