Smoking increase chances of contracting COPD

Smoking increase chances of contracting COPD

Tantri Yuliandini, The Jakarta Post, Jakarta

A man is shown breathing heavily, a long tube protruding out of
his chest into a contraption at the base of his hospital bed is
filled with blackish matter.

"This man is in the advanced stages of COPD. The machine helps
reinflate his lungs because they can no longer reinflate
themselves," Pradjnaparamita of the COPD Center at the Department
of Respiratory Medicine at the University of Indonesia said.

A couple of scenes later, the video showed a sleeping woman
with various tubes and monitoring devices coming from her nose
and body.

"This woman could no longer breathe without help from a
respiratory machine," Pradjnaparamita explained.

COPD, or Chronic Obstructive Pulmonary Disease, is an umbrella
term used to describe the airflow obstruction associated mainly
with emphysema and chronic bronchitis.

Emphysema causes irreversible lung damage by weakening and
breaking the air sacs within the lungs, while chronic bronchitis
is an inflammatory disease in the airways that causes an increase
in mucus and bacterial infections that block the bronchial tubes.

Both conditions decrease the lungs' ability to take in oxygen
and remove carbon dioxide. The combination of too little oxygen
and too much carbon dioxide in the blood may have an impact on
the brain, causing a variety of other health problems, including
headaches, sleeplessness, impaired mental ability and
irritability.

Approximately 80 percent to 90 percent of COPD cases are
caused by smoking, Hadiarto Mangunnegoro, a pulmonologist at the
University of Indonesia, said, adding that a smoker is 10 times
more likely to die of COPD than a nonsmoker.

"The first, second, third and fourth causes of COPD are
smoking, then the other causes come fifth," he said, explaining
that other causes included heredity, second-hand smoke, air
pollution and a history of frequent childhood respiratory
infections.

The World Health Organization (WHO) has estimated some 2.74
million deaths are caused by COPD every year, with more than 600
million people in the world suffering from the disease.

Pulmonologist Faisal Yunus estimated that in Indonesia some
4.8 million people suffer from COPD.

"However, the figures are only a rough estimate because the
disease isn't yet well known in Indonesia," he said, adding that
COPD is often overlooked by both the public and doctors who often
confuse it with asthma or other diseases caused by old age.

Because COPD symptoms are only apparent when the lungs have
lost 60 percent of their functions, for most of their lifetime
sufferers do not realize they have the disease, Hadiarto, who is
also the chairman of the Indonesian COPD Expert Committee (ICEC),
said.

The lungs function at their peak when a person is between the
ages of 20 and 30, after which they slowly begin to decline, he
said, explaining that the lung capacity of an average Indonesian
was approximately three liters.

"Among smokers, the lungs' capacity can shrink by as much as
50 milliliters a year," he said.

According to the American Lung Association, a typical course
of COPD might begin after a person has been smoking for 10 years,
after which the patient begins developing a productive chronic
cough and, after the age of 40, they may begin developing
shortness of breath during exertion.

The quality of life for a person suffering from COPD
diminishes as the disease progresses. At the onset, there is
minimal shortness of breath, but people with COPD may eventually
require supplemental oxygen and rely on respiratory assistance.

In a survey, Confronting COPD in America, of 573 people with
COPD-related diseases interviewed between August and November
2000, some 58 percent of respondents said they had shortness of
breath every day during their worst three months of the previous
year, and 23 percent said symptoms woke them up every night.

In general, 51 percent said their condition limited their
ability to work and many said it also limited them in normal
physical exertion (70 percent), household chores (56 percent),
social activities (53 percent), sleeping (50 percent) and family
activities (46 percent).

None of the existing medications for COPD have been shown to
modify the long-term decline in lung function, Hadiarto said,
therefore, pharmacotherapy for COPD is used mainly to decrease
symptoms and complications.

The best weapon against COPD is to avoid or cease smoking all
together, he said, explaining that ceasing smoking slows the
disease process significantly.

Because the diagnosis of COPD is frequently made when patients
are in their late 50s or 60s, the goal of treating patients with
COPD is to help relieve symptoms, help better manage the effects
of their disease, and to help them live as full and active lives
as possible.

People with COPD can better manage their disease by:

* Avoiding cigarettes, dust, air pollution, cigarette smoke and
work-related fumes.

* Avoiding contact with people who have respiratory infections,
such as colds and flu.

* Avoiding excessive heat, cold or high altitudes.

* Maintaining a healthy diet and an exercise program supervised
by a health care provider.

* Having regular contact and visits with a health care provider
so that he or she can carefully monitor the disease.