Avoid Obstructive-Lung-Disease

Obstructive-lung-disease (COLD or COPD) is a chronic, progressive respiratory disease. It is a pulmonary airflow obstruction that is not fully reversible. Like most chronic diseases it is easier to prevent than it is to reverse. COPD is a common diagnosis in skilled nursing homes. The only therapeutic intervention shown to alter the course of COPD is removal of the noxious trigger.

This disease is the result of abnormal inflammation caused by irritants in the air that we breathe. It is the fourth leading cause of death in the United States and is projected to be the third leading cause of death by 2020. Each year about 119,000 people in the United States die from COPD and another 30,000 people in the United Kingdom.

Obstructive-lung-disease is a common disease. The cumulative effect of years of “smoking” is the leading cause of COPD. Sources of irritants that can cause COPD include tobacco smoke, air pollution, and the burning of certain fuels in poorly ventilated areas. Like cancer and other chronic diseases there is no early warning that the victim may be at risk.

COPD and Lung Function

As we breathe air enters through our nose (and mouth) and enters the lungs through the windpipe (trachea) and bronchial tubes. Oxygen is made available to our blood by the air sacs (alveoli) and carbon dioxide is removed. Any obstruction in the windpipe and/or the bronchial tubes will restrict the availability of life-sustaining oxygen and removal of carbon dioxide.

Our bodies were designed with a system to protect our airways and lungs from irritants. First several ounces of mucus are produced per day to keep the air passages moist and protected from irritants. This mucus that lines the breathing tubes is in constant motion with the help of cilia. Cilia are tiny hairs that move back and forth to move mucus up the throat to an elastic cartilage flap (epiglottis). Secondly, irritation of the bronchial tubes causes us to cough an action that can quickly remove mucus.

If airways are regularly attacked by environmental irritants such as cigarette smoke, more mucus is produced to trap particles. Eventually, mucus glands are two or three times their normal size and cilia in air passages are also damaged. To make matters worse, any undamaged cilia are paralyzed for at least 20 minutes after the smoker has had a cigarette. In COPD, the lungs lose elasticity and bronchioles (small secondary air tubes) can collapse.

The presence of obstructive-lung-disease is associated with bronchitis and emphysema. Bronchitis is an inflammation of the bronchioles with dilation of the mucus glands and their ducts. In emphysema, air ducts enlarge and lose the ability to perform the gas exchange function of the lungs. The result is fewer air sacs with a sharp decline in their ability to perform the oxygen and carbon dioxide exchange.

A large number of COPD patients also have asthma. Asthma is defined as an inflammatory disease of the airways, in which obstruction is often completely reversible. When a patient has asthma, the muscle bands that surround the airways in the lungs tighten. This allows less air to pass through. Mucus production increases, narrowing the airways even further.

Risk Factors, Prevention and Reversal

  • Smoking. While only 15% to 20% of smokers get obstructive-lung-disease, smoking is by far the single biggest risk factor. Do not smoke. Quitting the smoking habit can dramatically slow down the progression of the disease.
  • Air pollution such as ozone, which is a dangerous pollutant is formed when nitrogen oxides and volatile organic compounds are combined in the presence of heat and sunlight. Ozone damages lung tissues when inhaled. Exposure to particle pollution means increased risk. The risk of damage depends on the type of particles, the length of exposure, and the concentration. Be aware of air quality conditions in your location and avoid outdoor activities during peak pollution periods. On high ozone days, COPD patients should avoid mowing the lawn or filling the car with gas during daylight hours.
  • Chemical fumes such as chlorine. Avoid breathing chlorine fumes from swimming pools or hot tubs.
  • Auto exhaust. When driving follow the vehicle ahead at a safe distance to avoid inhalation of exhaust fumes. Have car cabin air filtration checked regularly.
  • Dry air should be avoided. Winter time heated air can be very dry, which thickens the mucus in your airways and is damaging to your lungs. A humidifier is an excellent idea. During winter, try a warm mist vaporizer in small spaces such as in your bedroom to humidify and warm the room.
  • House plants are a good idea to produce oxygen and to help filter irritants from the air in your home.
  • Stay lean. Excess abdominal fat can limit our ability to take a deep breath.
  • Age is a risk factor for obstructive-lung-disease simply because the effects of irritants accumulate over time. However, loss of lung capacity does not have to be an inevitable result of aging.

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References and Suggested Reading:

  • I suggest reading chapter 8 of Dr. Sears’ book, Prime Time Health.
  • "chronic obstructive pulmonary disease (COPD) ." Encyclopedia Britannica. Encyclopedia Britannica Ultimate Reference Suite. Chicago: Encyclopedia Britannica, 2011.

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