The Air We Breathe: Is Pollution Turning COPD Into A National Crisis?

Increasing air pollution in the recent times is becoming an insidious environmental hazard stemming from various sources including industrial emissions, vehicle exhaust, domestic combustion, and even natural events like forest fires releasing harmful chemicals, particulates, and gases into the atmosphere. These pollutants can have severe consequences for human health, particularly on respiratory systems including Chronic Obstructive Pulmonary Disease (COPD), a debilitating lung condition that is emerging as a national and global health crisis.

Air pollution is typically measured using the Air Quality Index (AQI), which categorises air quality into different levels: 

• 0 – 50: Good air quality with minimal health risk

• 51-100: Satisfactory air quality where individuals might experience mild breathing discomfort

• 101- 200: Bad air quality. People with lung conditions such as asthma or COPD can experience discomfort, while those with heart disease, children, and the elderly may also be at risk. 

• QI above 200: hazardous air quality that can cause severe, prolonged health impacts, including the development or exacerbation of COPD.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease. It is characterized by chronic inflammation in the airways, leading to breathing difficulties, persistent coughing, and excessive mucus production. According to the World Health Organization (WHO), COPD is currently the third leading cause of death globally, after ischemic heart disease and stroke. 

While tobacco smoking remains the primary cause of COPD, responsible for nearly 46 per cent of all cases, recent years have seen air pollution as the growing contributor to the disease. Exposure to airborne pollutants, especially ambient particulate matter, is linked to the development and worsening of COPD. In fact, outdoor air pollution accounts for approximately 20.7 per cent of COPD cases, while occupational exposure to harmful fumes contributes another 15.6 per cent. WHO data indicates that nearly 99 per cent of the global population breathes air that exceeds the recommended safety limits for pollutants. Notably, low- and middle-income countries bear a disproportionate burden, where air pollution levels are often higher, and access to healthcare is more limited. In fact, it is estimated that outdoor air pollution causes approximately 4.2 million premature deaths every year. Of these, a significant percentage are attributed to COPD. 

Moreover, several studies also document this relationship between air pollution and COPD. Studies state that long-term exposure to both gaseous pollutants like nitrogen dioxide (NO2) and particulate matter (PM2.5) can significantly damage lung function. For example, the Framingham Heart Study, published in the American Journal of Respiratory and Critical Care Medicine in 2014, found that even relatively low levels of particulate matter exposure were associated with reduced lung capacity and accelerated lung function decline. Similarly, a study conducted in Taiwan showed a clear link between constant exposure to polluted air and the development of COPD. In addition to worsening existing COPD, air pollution is also implicated in developmental COPD, which is impaired lung growth seen in children who are exposed to polluted air from a young age. 

Air pollution doesn’t only affect the lungs. It is also linked to a variety of other health issues, including cardiovascular diseases, stroke, and lung cancer. In 2019, WHO reported that 68 per cent of outdoor air pollution-related deaths were due to ischemic heart disease and stroke, while 14 per cent were linked to COPD and another 14 per cent to respiratory infections. This underscores the widespread impact of air pollution on human health, especially in vulnerable populations such as the elderly, children, and individuals with pre-existing health conditions.

Adopting cleaner technologies to reduce emissions from industrial facilities and modes of transport, improving the management of waste, and shifting toward renewable energy sources such as solar, wind, and hydro power. Enhancing the energy efficiency of buildings, developing greener and more compact cities, and creating green spaces that can absorb pollutants. Raising awareness about the dangers of air pollution through public health initiatives can help us mitigate the public health burden of air pollution and curb the rising incidence of COPD. 

Dr. Suhas H S

Guest Author Consultant – Pulmonologist, Manipal Hospital Sarjapur Road