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Mar 15, 2008

Smokers face higher risks

WHILE smoking has always been associated with lung cancer, many may not be aware that the habit is also the most common cause of another lung disease known as chronic obstructive pulmonary disease or COPD.

COPD is not one single disease but an umbrella term which includes chronic bronchitis and emphysema. While patients can have either of these diseases, both often occur simultaneously.

Those suffering from COPD experience chronic airflow limitation, shortness of breath, cough and increased mucus production.

Institute of Respiratory Medicine director Datin Dr Aziah Ahmad Mahayiddin says the lack of awareness of COPD stems from misconceptions about the symptoms as many do not feel they are serious enough to see a doctor.
“Most patients do not complain or seek help. Sometimes they have come to expect coughing and shortness of breath as something that come naturally with smoking or ageing.

“We also need more proactive physicians to actively screen patients, especially smokers or ex-smokers above 40 years of age.”

Smoking is responsible for 90 per cent of COPD cases. Those at risk are men and women aged above 40, who have been smoking a pack of cigarettes for the past 20 years. However, Dr Aziah says with the increase in teen smokers, the onset of the disease might develop earlier.

Smoking causes inflammation of the airways and increased mucus production which result in chronic airflow obstruction.

“As 49 per cent of males in this country smoke, naturally they are at higher risks. But as the number of female smokers is on the rise, women too have at least the same risk of developing COPD.”

It was reported that smokers with COPD have higher death rates than non-smokers with the disease. They also have more frequent respiratory symptoms such as coughing and shortness of breath as well as more deterioration in lung function than non-smokers. Passive smokers are also at risk of the disease.

Other contributing factors include occupational exposure to dust, indoor pollution from wood-burning and coal-burning stoves and air pollution, especially exposure to sulphur dioxide and black smoke. Diets and genetics may also play a part in COPD.

Due to a lack of awareness of the disease, by the time a patient is diagnosed, an irreversible damage has already occurred.

“It is vital that we are aware of the disease symptoms and treatment options as early diagnosis can reduce the amount of damage to the lungs. Proper advice from medical professionals can also lead to better management of the disease.”

COPD is often misdiagnosed as asthma or goes undiagnosed in its mild and moderate stages. Making it more difficult is that as the disease generally strikes after the age of 40, symptoms are often first attributed to ageing.

A simple breathing test known as spirometry would be able to detect if a person suffers from COPD. The test enables the doctor to tell the difference between COPD and other respiratory diseases such as asthma.

COPD is easily diagnosed and early diagnosis can improve the chances of stopping the progression of the disease and the deterioration of lung function.

“Don’t ignore symptoms as shortness of breath, morning cough and increased mucus production as these could be an indication of mild COPD.

“Those with the disease should be more proactive in taking control of it.”

According to the latest World Health Organisation figures, currently there are 210 million people with COPD. The disease will become the fourth leading cause of death worldwide by 2030.

The number is expected to be higher in the Asia Pacific, where there are high rates of tobacco smoking and widespread use of biomass fuels — the two key reasons for COPD.

In Malaysia, it is estimated that 16,000 people were admitted for COPD each year for the last six years and, in the same period, there were 1,000 deaths reported annually. There are about 448,000 moderate to severe COPD sufferers in the country. COPD is ranked fifth in Malaysia in terms of disease burden.

Dr Aziah says lifestyle modifications that can help prevent or improve function in COPD patients include stopping smoking, avoiding being exposed to second-hand smoking, respiratory irritants, infections and allergens, maintaining good nutrition and drinking a lot of fluid.

COPD cannot be cured but treatments are able to relieve the symptoms and help patients breathe easier.

“Treatments generally aim to slow the progress of the disease, improve exercise tolerance, prevent and treat complications and sudden onset of problems and improve overall health.

“Quitting smoking is the single most important thing you can do to reduce your risk of developing COPD and slow the progress of the disease.”

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