Chronic obstructive pulmonary disease
| Chronic obstructive pulmonary disease | |
|---|---|
| Other names | Chronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD) |
| Section of a lung showing centrilobular emphysema, with enlarged airspaces in the centre of a lobule usually caused by smoking and a major feature of COPD | |
| Specialty | Pulmonology |
| Symptoms | Shortness of breath, chronic cough Sputum production |
| Complications | Anxiety, depression, pulmonary heart disease, pneumothorax |
| Usual onset | Over 35 years old |
| Duration | Long term |
| Causes | Tobacco smoking, air pollution, genetics |
| Diagnostic method | Spirometry |
| Differential diagnosis | Asthma, congestive heart failure, bronchiectasis, tuberculosis, obliterative bronchiolitis, diffuse panbronchiolitis |
| Prevention | Stopping smoking, improving indoor and outdoor air quality, tobacco control measures, occupational safety |
| Treatment | Pulmonary rehabilitation, long-term oxygen therapy, lung volume reduction, |
| Medication | Inhaled bronchodilators and steroids |
| Frequency | 213 million (2021); 2.7% of global population |
| Deaths | 3.65 million (2021); 5% of global deaths |
Chronic obstructive pulmonary disease (COPD) is a long-term lung condition that makes it progressively harder to breathe. It occurs when the airways and lung tissue become damaged, leading to reduced airflow and less efficient oxygen exchange in the lungs. COPD develops gradually over time, and while it cannot currently be cured, treatments and lifestyle changes can help control symptoms and slow disease progression. Early diagnosis and treatment are recommended.
The condition includes two related lung problems: chronic bronchitis and emphysema. Chronic bronchitis involves ongoing inflammation of the airways, causing excess mucus production, coughing, and chest discomfort. Emphysema involves damage to the small air sacs in the lungs, which reduces the lungs' ability to transfer oxygen into the bloodstream. Many people with COPD experience shortness of breath, persistent cough, wheezing, and reduced exercise tolerance. Symptoms can become more severe during acute flare-ups, which can be triggered by bacterial and viral infections and exposure to irritants. People with COPD generally display a combination of these symptoms, and are likely to have additional health issues.
COPD can develop due to multiple factors, most often involving long-term exposure to lung irritants. The strongest risk factors are tobacco smoke, air pollution, and workplace dust and chemical fumes. Smoke from fuels used for cooking and heating is a major risk factor in some places, particularly for women and young children. Factors affecting lung development in early life such as respiratory infections, poor nutrition, and physical inactivity, can increase risk of COPD in later life. Genetics can also play a role.
Diagnosis of COPD is usually confirmed using lung function tests that measure how well air moves in and out of the lungs. While COPD cannot currently be cured, treatment can significantly improve quality of life. Common treatments include inhaled medications that help open the airways, pulmonary rehabilitation programmes that improve fitness and breathing control, and oxygen therapy for people with advanced disease. Quitting smoking is strongly recommended, as is reducing exposure to other lung irritants.
As of 2021, COPD affected about 213 million people worldwide. COPD typically occurs in people over the age of 35–40, and risk increases with age. In 2021, COPD was the fourth-biggest cause of death, responsible for approximately 5% of total deaths. Almost 90% of COPD deaths in those under 70 years of age occur in low and middle income countries. The number of deaths is projected to increase further because of continued exposure to risk factors and an ageing population.