Beware of COPD
DR. R. NARASIMHAN
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The problem is much larger than was anticipated.
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NOVEMBER 15 is World COPD day. COPD means Chronic Obstructive Pulmonary Disease. This is to be differentiated from asthma, as asthma is a completely reversible and controllable. COPD is a progressive disease. Once diagnosed, it only worsens unless the patient stops smoking.
Awareness on COPD has increased appreciably. The early hope that increasing awareness about its ill effects would decrease the incidence of smoking has been proved wrong. This is because the number of people who live longer has increased coupled with an increase in pollution and increased tobacco consumption in developing countries.
In India, though acute asthma admissions have decreased COPD admissions are on the increase.
Cause for concern
In the recent past, COPD has become a major point of discussion in medical circles with asthma being pushed to second place. This is because the problem of COPD is much larger than anticipated — the reason: COPD is the only chronic disease showing an upward trend in both mortality and morbidity. It is expected to be the third leading cause of death by 2020.
Approximately 14 million Indians are suffering from COPD. Currently there are about 98 million smokers in India and about 10,00,000 Indians die due to smoking-related disorders in India.
Given the magnitude of the problem, it is only right that organisations disseminate the message that smoking is harmful to both the smoker and the onlooker.
Despite all this, it receives little attention from the patient and the physician. It is important to be aware of the symptoms of COPD because these patients will be either diagnosed as asthmatics or as TB patients.
Many solutions
Though the problem is much larger than anticipated there are many solutions. Intensive smoking cessation programmes can produce long-term benefits although it may take many years before these are evident. There should also be a concerted effort from the public and authorities to reduce pollution.
One solution is a better public transport system, which will reduce the use of private vehicles that contribute to pollution in a big way. If this method has helped reduce automobile pollution in the U.K., there is no reason why it should not in India.
Similarly industries that emit pollutants should not be allowed in the heart of the city or in residential localities. These small measures will help establish a pollution-free India.
The writer is a Senior Respiratory Physician, Apollo Hospitals, Chennai.
E-mail: drrnarasimhan@gmail.com
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Symptoms
Chronic cough
Chronic sputum production
Breathlessness that is persistent, progressive, increases on exertion and during respiratory infections.
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Risk factors
Smoking and cooking fuel
Occupational dust and chemicals
Increasing age
Nutrition
Enzyme deficiency alpha 1 anti trypsin deficiency
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