Breathe Clean Air Air and Breathing

Lung Diseases

Air Quality

Some Topics

 

YINYANG

Chronic Obstructive Lung Disease

Chronic Obstructive Pulmonary Disease (COPD) is a general category that points to an increasing population of aging patients who have chronic cough and trouble breathing. I recall as an intern at the Toronto General hospital my month’s assignment to the respiratory ward which housed about 20 patients, all men older than 60, all smokers who had chronic lung disease. The coughed all day and night and their sputum was collected every morning. They all received oxygen by nasal catheter which they removed to leave the ward for a cigarette break out in the hall. The futility of the hospital experience was obvious.

Chronic obstructive pulmonary disease (COPD) is estimated to affect 32 million persons in the United States and is the third leading cause of death. COPD is obstruction to air flow in the lungs that is not reversible. The air flow obstruction is usually progressive and associated with an inflammatory response of the lungs to inhaled particles or gases. The term COPD includes other diagnoses such as chronic bronchitis, asthma and emphysema. Heavy smokers develop COPD even after they quit smoking. Symptoms develop after age 40 in people who have smoked a pack a day for 10 years or more. The single most important preventive measure for COPD is not to smoke at any age in any amount. COPD also develops in family members of smokers and in people exposed to heavy doses of air pollution.

Chronic bronchitis is low grade inflammation of the tubes in the lung associated with increased mucous production and cough that is productive of sputum. The term “chronic” refer to duration of more than two years. Chronic bronchitis occurs in 85% of COPD patients, but many patients have chronic bronchitis commonly without airway obstruction.

Emphysema refers to damaged alveoli that lose their elasticity and fail to empty during expiration. Air remains in these air sacks and gradually the lungs become rigid and hyperinflated. Early in the process, reduced air exchange is felt as shortness of breath with exertion. Smokers are the most obvious group who accumulate lung damage over many years and eventually are disabled. Smoking cessation is essential to reduce the progression of COPD.

Increased mucous production is a defensive mechanism in the branching tubes of the airway. The mucous also provides food and shelter for invading pathogens and may contribute to airway obstruction. Sputum is mucous that is coughed up and collected for analysis. Sputum samples may contain numerous microorganisms, fungal spores, pollens, other particles and chemicals there were inhaled. Air pollution is obviously not recommended.


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