Monday, Sep 20, 2004
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Chennai
By Our Staff Reporter
CHENNAI, SEPT. 19. Pulmonologists have called for a combination of public education, legislation and higher taxes on cigarettes to discourage smoking — the single most important cause of Chronic Obstructive Pulmonary Disease (COPD) — a silent killer that accounts for more deaths worldwide every year than AIDS. Adressing the media, Bartolome Celli, Chief of Pulmonary and Critical Care at St. Elizabeth's Medical Center, Boston, accompanied by Raj B. Singh and Narasimhan, respiratory physicians at Apollo Hospital, said smoking-induced lung obstruction followed by air pollution were responsible for over 80 per cent of COPD cases. The disease was the fastest rising cause of death in the world. It was the fourth biggest cause of death after heart disease, stroke and cancer in the U.S. where 1,30,000 deaths due to COPD occurred in the year 2000. According to estimates, COPD would become the third biggest cause of death in the world by the year 2020. Statistics available for India show a prevalence of 0.5 per cent in men and 0.25 per cent in women. Going by the available data for 1996, there were 12.36 million COPD cases in the country. The condition comprises a group of diseases in which the predominant manifestation is obstruction to airflow through the lungs by narrowing of the airway. Though the symptoms of persistent cough and breathlessness were asthma-like, COPD differs in that it was not a reversible condition. The key to preventing COPD is in avoiding smoking and exposure to air pollution. Treatment with bronchodilators, sometimes in combination with anti-inflammatory drugs or antibiotics, is effective to a limited extent but gross damage to the lung cannot be reversed and the management strategy then would be to treat the symptoms and improve the patient's quality of life. Early detection is important to limit the damage to the lungs. Spirometry is the recommended diagnosis because routine pulmonary function tests may fail to pick up damage to the lung. Recent guidelines suggest that doctors should consider COPD if a patient above the age of 40 has persistent cough with phlegm, recurring respiratory tract infections and breathlessness.
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