Introduction
Chronic obstructive pulmonary disease (COPD) is a lung disease that is the third leading cause of death all around the globe, causing 3.23 million deaths in 2019. It accounts for nearly 90 percent of deaths in patients who belong to low and middle-income countries. It is the seventh contributing factor to compromised health states throughout the world.
What Is Chronic Obstructive Pulmonary Disease?
Chronic obstructive pulmonary disease is caused by restricted airflow and breathing conditions. It is also called by terms such as emphysema or chronic bronchitis.
The lungs of individuals with chronic obstructive pulmonary disease are damaged or clogged, which happens due to the collection of phlegm. The traditional causes of the disease include chain smoking and air pollution.
What Are the Symptoms of Chronic Obstructive Pulmonary Disease?
The commonest symptoms of COPD are persistent long-term cough, feeling weak and lazy, and difficulty in breathing. The common symptoms develop from middle age onwards. As the disease advances, life becomes more challenging, like a normal routine. This often happens due to breathlessness. COPD symptoms worsen quickly and are called flare-ups. These are similar to panic attacks in occurrence lasting for a few days and require additional extraordinary medical care during these flare-ups. Chronic obstructive pulmonary disease is sometimes called emphysema or chronic bronchitis. This is because there is destruction and damage to the minute airways in the lungs. Chronic bronchitis refers to a long-standing cough along with the production of phlegm that is caused by inflammation of the airways.
What Are Non-traditional Risk Factors of Chronic Obstructive Pulmonary Disease?
The traditional factor contributing to the development of COPD is smoking. There are various non-smoking risk factors for COPD. They are -
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Genetic Factors For COPD - Cigarette smoking is a major risk factor for COPD, but there is strong evidence that genetic factors are responsible for COPD development. The aspects included here are -
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Familial Studies of Lung Function in Non-smokers - The lung function is influenced in individuals who have a family history of COPD and are likely to get COPD, but the chances are low, and the risk of developing COPD is not much in such cases.
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Severe Alpha-1 Antitrypsin Deficiency - This is a well-established reason for non-smoking-induced COPD. It is responsible for the development of airflow obstruction in non-smokers. Moreover, the specific risk factors increase the risk of lower lung function, leading to wheezing and shortness of breath. Occupational exposures, irritants, and dust trigger the development of this kind of COPD in such cases.
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Other Rare Genetic Syndromes - The other rare genetic factor that can cause COPD in non-smokers is Cutis laxa, a disorder caused by elastin gene mutations that cause emphysema in the lungs in childhood. Marfan's syndrome (it is an inherited syndrome that affects the connective tissue, which holds all organs together) and Ehlers-Danlos syndrome (a genetic disorder that affects skin, bones, and joints caused by gene mutation) show pneumothorax and lung blebs.
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- Long-Standing Asthma and the Risk of COPD - The cases of long-standing asthma can eventually lead to COPD. They can be further categorized into-
Chronic Airway Obstruction In Adults - It is a persistent airway obstruction despite reversal attempts by medication. This obstruction is usually seen in older patients with asthma. Adults with asthma can be seen to have radiological features in imaging studies that are similar to COPD. Computed tomography (CT) scan has shown the presence of emphysema in these non-smoking patients with long-standing asthma, especially those who have irreversible airway obstruction, longer duration and severity of asthma. In children with asthma, moving to a cleaner environment stops the recurrent airway obstruction, preventing COPD.
3. Outdoor Air Pollution - Air pollution is caused by a mixture of numerous air pollutants from industries, heating, farming, and daily traffic. People encounter this kind of irritant or stimulant throughout their lifespan. There has been strong evidence that daily pollutants can lead to COPD if persistence is present on a larger scale and intensity.
4. Secondhand Exposure to Smoke and Risk of COPD - Exposure to second-hand smoke contains potential respiratory allergens and may lead to chronic airway obstruction. Second-hand smoke arises from passive smoking, which is caused by the cigarette smoking of a family member or college with whom one works daily. The persistence of these irritants containing tobacco smoke that enter the airway causes COPD.
5. Biomass Smoke and Risk of COPD- In developing countries, a large population is seen to have COOD that occurs in never-smokers, especially the women who cook with open fire stoves. The fuel used in these stoves is called biomass, which includes wood, animal excreta, and crop leftovers. These stoves emit a high content of smoke, which contains irritants similar to cigarette pollutants. This is significant in developing countries where exposure to biomass starts right from birth. In cases where COPD develops, the life span is short.
6. Occupational Exposure And Risk Of COPD - The evidence that shows the direct relations between the two shows the person has respiratory symptoms and fixed airway obstruction. In such cases, occupational exposure, such as exposure in the metal industries, cotton industries, or textile mills, leads to chronic bronchitis and emphysema, causing COPD.
What Is the Diagnosis of Non-traditional COPD?
The diagnosis of smokers associated with COPD is linked to a history of smoking. However, in the case of non-traditional COPD, it is subjective to the thorough medical and personal history.
The imaging techniques are the same as that seen in smokers with COPD.
How Can Non-Traditional COPD be Managed?
The management of non-traditional COPD is similar to the smoker's COPD. With lifestyle modification, one can easily avoid the triggers or allergens that lead to COPD. Air purifiers can be used to keep the environment clean. Work ergonomics in the metal or textile industries can help decrease the inhalation of aerosol or dust particles.
Conclusion
Exposure to less traditional risk factors likely contributes to the increase in global cases of COPD. This is significant in developing countries, where smoking is low, but the fuel consumption as biomass is abundant. Moreover, the relationship between occupational exposure and a polluted environment greatly increases the cases of COPD. Eventually, the efforts to prevent COPD should be aimed at the cessation of traditional and non-traditional factors of COPD. Addressing one without the other will not reduce the load on COPD.
