One of the most important aspects of COPD is early recognition of symptoms. This, in turn, leads to earlier diagnosis and treatment. Nevertheless, identifying symptoms before the disease has a chance to progress is rather difficult because COPD symptoms can go unrecognized for years. Being aware of the following risk factors for COPD may increase your awareness and lead you to question your own possible symptoms:
Smoking is by far, the most common risk factor for COPD. Although not everyone who gets COPD smokes, 80% to 90% of all people who are diagnosed are either current of former smokers.
The number of cigarettes you smoke and the length of time that you have smoked also plays an important role in a COPD diagnosis. And, smoking cigarettes is not the only thing that places you at risk for COPD; pipe smoking, cigar smoking, long-term exposure to secondhand smoke and smoking marijuana and cigarettes together, also increases your risk.
The single most effective action that you can take if you are a current smoker is to quit. In fact, in many cases, smoking cessation can normalize lung function decline that is associated with COPD.
If you are a smoker who has not yet been diagnosed with the disease, quitting can prevent or delay the development of airflow limitation, one of the primary characteristics of COPD. It can also improve survival.
If you've made a decision to quit, you are going to need some support. Here are some handy tips:
- Complete Guide to Smoking Cessation
- List of Stop Smoking Aids
- Quit Smoking Support in the COPD Forum
Another important risk factor for COPD is the environment in which you work and live. In the United States alone, occupational exposure to dust and fumes is attributed to up to 19% of COPD in smokers, and up to 31% of COPD in nonsmokers. This rate is even higher in undeveloped countries.
The cumulative exposure to indoor and outdoor air pollution is also relevant, to some degree, to a COPD diagnosis. Exposure to biomass fuels during cooking, especially among women, is of particular importance. What can you do to reduce your risks?
In the workplace:
- Make sure your employer recognizes that occupational exposure to airway irritants can cause and/or worsen COPD, and that strategies are implemented, monitored and enforced, to control it.
- Reduce workplace exposure by wearing personal, respiratory protective equipment.
- Make sure your work station is adequately ventilated.
And, at home:
- Clean up your indoor air. In addition, use natural cleaning products that don't irritate the airways.
- Monitor and adhere to public health announcements of poor air quality. Stay indoors when air quality is poor.
- Avoid cooking with biomass fuels. If you can't, invest in a non-polluting cooking stove.
- Take precautions when heating your home with a wood-burning stove.
More and more, genes are being recognized as having an important role in the development of COPD. This relationship is most commonly seen in a severe, genetic deficiency of alpha-1-antitrypsin (AAT,) a protective protein made by the liver. People with AAT deficiency are at greater risk for developing emphysema. Smoking greatly increases this risk. AAT deficiency is most common among people of Northern European decent. If you have AAT deficiency, it is extremely important that you either never start smoking, or quit as soon as possible.
There is also a significant risk, thought to be genetic in nature, of airflow obstruction in smoking siblings of people with severe COPD. This suggests that genetics may influence a person's susceptibility to COPD, but this relationship is inconclusive.
Asthma may be a significant risk factor for COPD, however, further investigation is needed to confirm this relationship. Several studies have looked at the relationship between asthma and COPD, namely a longitudinal, epidemiological study in Tuscon, Arizona. The Tuscon study found that adults with asthma had a twelve-fold higher risk of developing COPD over time than those who didn't have asthma (after adjusting for smoking.) Another study found that 20% of patients with asthma developed functional signs of COPD.
Childhood Lung Infections
Severe viral and bacterial lung infections in early childhood have been associated with reduced lung function and increased respiratory symptoms in adulthood, which may also contribute to the development of COPD. Low-birth weight is thought to increase susceptibility to lung infections, which may also be related to COPD.
When the balance between oxidants and antioxidants shifts in the direction of oxidants, an excess of oxidants or a decrease in antioxidants occurs, resulting in oxidative stress. Oxidative stress in COPD is related to smoking, and causes inflammation of the airways and destruction of the alveoli. An imbalance between oxidants and antioxidants is considered to play a part in the pathophysiology of COPD.
Uncommon Risk Factors For COPD
There are several other possible risk factors for COPD, that are far less understood, but, worth mentioning:
- Reduced maximal attained lung function - caused by processes during gestation, birth, or early childhood.
- Gender - while in the past, COPD occurred more in men, since 2000, the disease affects more women than men, suggesting that women are more susceptible to the negative effects of tobacco smoke than men.
- Socioeconomic status - there is evidence that the development of COPD has an inverse relationship with socioeconomic status. Meaning, the lower the socioeconomic status, the higher the risk for developing COPD.
- Nutrition - malnutrition and weight loss can reduce respiratory muscle strength and endurance. An association between starvation and the development of emphysema has been suggested in experimental studies on animals.
If you identify with any of the risk factors mentioned above and think you may have symptoms related to COPD, talk to your doctor about getting a simple breathing test known as spirometry. For more information about symptoms of COPD, visit Symptom Checker, an interactive guide to COPD and other symptoms.
COPD Self-Assessment Tool: Assessing Your Risk for COPD
A COPD diagnosis can only be determined by your health care provider, however, you can assess your risk for the disease by using the following, self-assessment tool:
Once you have answered the questions in the self-assessment tool, print out the form and take it to your health care provider for further evaluation of your symptoms.
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.
Global Initiative for Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of COPD. Updated 2010.