November has arrived, the month when winter sets in, in some parts of the country, and the monsoon in others. With changes in weather, smoggier air and colder conditions, it a good time to be aware of lung conditions. November is also marked as Chronic Obstructive Pulmonary Disease or COPD awareness month. So here is all you need to know about it.
What is COPD?
Chronic obstructive pulmonary disease is a condition caused by damage to the lungs that results in breathing difficulties. The damage, which is inflammation and scarring, can be in the airways to the lungs, in the air sacs of the lungs, or both. While the damage is generally permanent, COPD can be treated and managed.
According to the World Health Organization (WHO), COPD is the fourth-leading cause of death worldwide, causing 3.5 million deaths in 2021, approximately 5% of all global deaths.
Types of COPD
There are two main types of COPD: chronic bronchitis and emphysema.
Chronic bronchitis is caused by inflammation of the lining of the airways, or the tubes that bring air into your lungs. When these tubes, known as bronchi, are inflamed, they become narrower, leading to restricted airflow, and causing the formation of extra, thick mucus, making it hard to breathe, and causing coughing.
Emphysema develops when the air sacs of the lungs, known as alveoli, are damaged. This makes it difficult for the lungs to pass adequate oxygen into the bloodstream, causing shortness of breath.
What causes COPD?
One of the main causes of COPD is damage caused to the lungs by smoking. Another significant cause is indoor air pollution. The WHO states that tobacco smoking accounts for over 70% of COPD cases in high-income countries. In low and middle-income countries, tobacco smoking accounts for 30–40% of COPD cases, and household air pollution is a major risk factor. Indoor air pollution is caused by the use of biomass fuel (wood, animal dung, crop residue) or coal used for cooking and heating, with high levels of smoke exposure.
Other causes include long-term exposure to chemical fumes or dust at workplaces, or toxins in the air, exposure to second-hand smoke, and, in rare cases, a genetic disorder known as Alpha-1 antitrypsin deficiency (“alpha-1”) that causes lung damage.
Risk factors include: asthma, a history of childhood respiratory infections, underdeveloped lungs, and age.
Signs and symptoms
Many people with COPD have both chronic bronchitis and emphysema, though some could have one or the other. Symptoms for COPD generally appear late, after a significant amount of lung damage has occurred.
Symptoms include: a cough with mucus that lasts for three months or more at a time; experiencing tightness in the chest; shortness of breath especially during physical activities; wheezing or whistling sounds in the breath; frequent chest infections and fatigue or extreme tiredness.
People with COPD sometimes experience a worsening or exacerbation of their symptoms, ‘flare-ups’, that may last for several days or weeks. This worsening can be caused by triggers such as cold air, pollution, having a cold or infection or smells. Not everyone with COPD will have these symptoms: it is important to seek medical care to arrive at a correct diagnosis.
People with COPD are also at a higher risk of other health conditions including flu, pneumonia and heart conditions.
Diagnosis and treatment
COPD is diagnosed based on a medical history, symptoms and through tests including imaging, pulmonary function tests and lab tests. A spirometry is one of the main tests to check for COPD: this lung function test measures how much air the lungs can hold and how fast air can move in and out of the lungs. COPD is staged based on its severity.
A diagnosis of COPD may sometimes be missed as symptoms may be similar to other lung conditions, or may be made late, and so it is important to seek medical help as early as possible.
Treatment for COPD
There is no cure for COPD. Treatment is based on the severity and is focused on managing symptoms and reducing flare ups. The most important treatment is to quit smoking, and tobacco cessation programmes may be recommended to help with this. Medicines, oxygen therapy and pulmonary rehabilitation are some other forms of treatment.
Medicines include inhaled medications such as bronchodilators and steroids. While bronchodilators relax the muscles around the airways, the steroids reduce inflammation in the airways. Medicines may also be given through a nebulizer. Oral steroids, antibiotics and other medicines may also be prescribed. Some patients may need supplemental oxygen, provided through an oxygen tank. Pulmonary rehabilitation consists of exercise and educational programmes, teaching patients breathing techniques, how to strengthen their lungs and how to manage symptoms.
For some people wit COPD, surgery may be recommended. Surgery could be to: remove damaged tissue from the lungs (lung reduction surgery); remove large air spaces, known as bullae from the lungs (bullectomy) or place a one-way endobronchial valve in the lung allowing air to leave the damaged part of the lung, but not re-enter. In certain cases, a lung transplant may be recommended.
Not smoking, avoiding exposure to secondhand smoke and other pollutants, getting recommended vaccine such as the flu and pneumonia vaccine, staying physically active and practicing good hygiene are some ways to help prevent COPD and live with the condition.
In India and the world
According to the WHO, COPD is the eighth leading cause of poor health worldwide (measured by disability-adjusted life years). Nearly 90% of COPD deaths in those under 70 years of age occur in LMICs. An editorial published in Lung India in 2021, citing a systemic review and meta-analysis, noted that the reported prevalence of COPD in India was 7.4%, with a prevalence of 11% in urban areas and 5.6% in rural areas. “Using these prevalence rates, and the fact that 34.9% of the India’s population live in the urban areas and 65.1% live in the rural areas, and that COPD occurs at a younger age in India (>35 years) like in other low- and middle-income countries, the estimated burden of spirometry-defined COPD in India is 37.6 million,” it said. It also highlighted the fact that COPD is caused not only by tobacco smoking but also by a wide variety of different nonsmoking causes, which account for a significant number of deaths. “India now needs to start taking COPD very seriously,” it stressed.
Published – November 04, 2025 05:52 pm IST
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