Chronic obstructive pulmonary disease, known by the acronym COPD, is a chronic disease of the airways that become disabling and greatly impacts the life quality of the people who suffer from it.
This disease, which currently has no cure, consists of chronic inflammation of the bronchial mucosa that causes abnormal mucus to be produced, leading to airway obstruction. The consequence is that adequate oxygenation of the body and blood is prevented.
“This bronchi disease is mainly caused by exposure to tobacco smoke and causes an accelerated loss of lung function.
According to the latest data from the EPI-SCAN II study, carried out by the Spanish Society of Pneumology and Thoracic Surgery (Separ), the prevalence of COPD in the Spanish population over 40 years of age is 12.4 per cent, a figure that confirms that it is the most frequent chronic pathologies in adults.
COPD can appear as two different disorders: emphysema and chronic bronchitis.
- Emphysema widens the alveoli (small air sacs in the lungs) and destroys their walls.
- Chronic bronchitis manifests as a persistent, sputum-producing, chronic cough, not due to a discernible clinical cause, such as lung cancer. Still, instead, the bronchial glands are dilated, causing excessive secretion of mucus.
Both diseases are closely linked and usually occur simultaneously, or one ends up causing the other. This is why emphysema and chronic bronchitis are grouped under the name chronic obstructive pulmonary disease, which could be considered two different forms of presentation. Generally, the clusters of alveoli connected to the small airways (bronchioles) have a relatively rigid structure and keep those airways open.
In the case of emphysema, the alveolar walls are destroyed, and the bronchioles lose their structural support and collapse when breathing. In emphysema, the reduction in airflow is permanent. In chronic bronchitis, inflammation of the small airways, scarring of their walls, swelling of their lining, mucus, and smooth muscle spasm contribute to airflow obstruction.
COPD is a common chronic lung disease worldwide. Millions of people suffer from COPD, the second leading cause of incapacitation from work after heart disease.
Those most affected by the disease are people exposed to the two external factors that contribute to the greatest extent to its development: smoking and working in polluted environments. That is why the disease affects especially coal miners, those who work with cereals in metallurgy and other workers exposed to dust.
The disease is more frequent among men than women and has higher mortality among men. Mortality among people with the disease is also higher in white and blue-collar patients than among white-collar workers.
COPD also appears very frequently in some families, a fact that suggests that there could be a hereditary tendency.
The most important cause of COPD is, without a doubt, tobacco. Over the years, lung function has been lost more quickly among smokers. A relevant fact is that between 10 per cent and 15 per cent of people who smoke develop the disease. And it is that chronic smoking causes the inflammatory process to develop, and after many years, the disease occurs.
An important piece of information is that the influence of tobacco on this disease is not so much related to the number of cigarettes the person smokes as it is to the time the person has been in contact with tobacco, as pointed out by Carlos A. Jiménez, pulmonologist and Separ’s President “The more years you smoke, the more likely you are to develop the disease,” he points out. He indicates that “the prevalence of COPD in smokers aged 40 or 50 is lower than among those aged 50-60. Therefore, the more years, the more possible.”
Atmospheric pollution, the increase of abnormal particles and gases in the atmosphere, also entails risks. For example, carbon monoxide and sulfur oxide from the combustion of gasoline, automobile hydrocarbons or ozone, to name a few examples, irritate the respiratory tract and make it difficult for oxygen to transport through the body.
Chronic bronchitis is twice as common in industrial areas and big cities than in the countryside. This factor, combined with the previous one, tobacco, is the main cause of most chronic obstructive pulmonary disease cases.
Although it is beyond doubt that an infection is rarely the initial cause of COPD, it can be affirmed that an infection may be responsible for the aggravation of a previous irritation triggered by the two previous factors.
An infection can also trigger subsequent outbreaks of the disease. For example, if repeated lung infections have been suffered during childhood, the adult will be more predisposed to COPD.