Unexpected Triggers & Hidden Causes Of COPD: It's Not Just A Smoker's Disease

Majority of the Chronic Obstructive Pulmonary Disease (COPD) cases, a lung condition marked by obstruction of airflow are due to smoking. However, there are certain other causes and triggers of COPD which are often not widely discussed. Knowledge of these uncommon causes, particularly among individuals who do not smoke, may aid in managing or preventing the progression of COPD. 

• COPD and Air Pollution: A significant environmental component that contributes to the onset and exacerbation of COPD is elevated air pollutants, or an AQI more than 150. Tiny airborne particles known as particulate matter (PM2.5) are known to trigger inflammatory reactions, cause oxidative stress, and increase airway resistance, severely affecting the lung function, thereby leading to COPD.

• Other environmental triggers include nitrogen dioxide (NO2), a common finding in automobile emissions and industrial processes, exacerbating hyper-responsiveness and inflammation in the bronchi. Ozone (O3) yet another potent environmental trigger irritates the airways, which over time reduces lung function. Volatile Organic Compounds (VOCs), which are present in paints, solvents, and cleaning products, can cause oxidative damage and inflammation of the airways.

• Occupational Exposures: People in the mining, construction, manufacturing, agricultural, and transportation industries are particularly susceptible to occupational dangers as they are exposed to dust, fumes, and chemicals that can greatly raise the chance of developing COPD. The following are the most prevalent workplace dangers: 

• Dust exposure from construction (coal dust), mining (silica dust), textiles (cotton dust), and agriculture (grain dust) respectively.

• Chemical exposure to substances such as chromium (electroplating), cadmium (welding), diisocyanates (polyurethane), and isocyanates (from painting or foam manufacture).

• Fumes and gases include welding fumes, diesel exhaust, and gases like ammonia, sulphur dioxide, and nitrogen dioxide. 

• Secondhand Smoke (SHS): Even for people who have never smoked, SHS might be a silent trigger. Long-term exposure to SHS can elevate the chance of hospitalisation for COPD by 10–20 per cent and the risk of developing COPD by 20–30 per cent. Because this risk is dose-dependent, an individual's chance of developing COPD increases with their level of secondhand smoking exposure. 

• Asthma: Asthma another respiratory condition shares many characteristics with COPD. There is a significant airway remodelling and inflammation in asthma similar to that of COPD that may cause irreparable lung damage. People who have poorly managed or untreated asthma are more likely to develop COPD or have a co-occurrence of asthma and COPD, medically called Asthma-COPD Overlap Syndrome (ACOS). 

• Respiratory Infections: The development of COPD may also be accelerated by recurrent respiratory infections, including TB, influenza, bronchitis, and pneumonia. Exacerbations and a faster reduction in lung function result from these infections, which further harm the already compromised lungs. People who have underlying medical disorders such as immunodeficiency, bronchiectasis, or asthma are more prone to COPD because they are more likely to get respiratory infections frequently.

• Deficiency in Alpha-1 Antitrypsin: Alpha-1 antitrypsin or AAT is a rare genetic condition. It is marked by deficiency or absence of AAT, a protective enzyme that helps protect the lungs. In the absence of this enzyme, the lungs may gradually deteriorate leading to severe lung damage and emphysema, a common form of COPD

Dr. Praveen Kumar B.S

Guest Author Consultant – Pulmonology, Manipal Hospital Yeshwanthpur