COPD

Chronic Obstructive Lung Disease

Developed by:
Dana Hughes, RN, PhD
Miners Hospital, University of Utah

Libbey M. Chuy, MPH

Asthma Program, Utah Department of Health

Overview
What is COPD? How do I know if I have COPD? How common is it?
General population Mining population

What increases my risk of developing COPD? How can I prevent getting COPD? How is COPD treated?

What is COPD?
A set of lung diseases that limit air flow and is not fully reversible.
COPD patients report they are hungry for air Usually progressive and is associated with inflammation of the lungs as they respond to noxious particles or gases Potentially preventable with proper precautions and avoidance of precipitating factors Symptomatic treatment is available

Two Major Causes of COPD

Chronic Bronchitis is characterized by
Chronic inflammation and excess mucus production Presence of chronic productive cough

Emphysema is characterized by
Damage to the small, sac-like units of the lung that deliver oxygen into the lung and remove the carbon dioxide Chronic cough
*Source: Braman, S. Update on the ATS Guidelines for COPD. Medscape Pulmonary Medicine. 2005;9(1):1.

Primary Symptoms
Chronic Bronchitis
Chronic cough Shortness of breath Increased mucus Frequent clearing of throat

Emphysema
Chronic cough Shortness of breath Limited activity level

Normal versus Diseased Bronchi

Emphysema

How common is COPD?

About 13.9% of the U.S. adult population (25+ years) have been diagnosed with COPD*
An estimated 15-19% of COPD cases are workrelated**

24 million other adults have evidence of troubled breathing, indicating COPD is under diagnosed by up to 60%***
*Braman, S. Update on the ATS Guidelines for COPD. Medscape Pulmonary Medicine. 2005;9(1):1. **CDC programs in Brief Workplace Health and Safety-Work-related Lung Diseases. www.cdc.gov/programs/workpl18.htm ***COPD Fact Sheet. Oct 2003. www/lungusa.org

COPD-A Major Cause of Hospitalization & Death

COPD was the:
Leading cause of hospitalizations in the U.S. in 2000 Fourth leading cause of death

COPD in the Mining Industry

Studies show:
An increased number of cases of chronic bronchitis in coal & gold miners
Long-term exposures to low levels of silica may lead to the development of chronic bronchitis & emphysema Chronic exposure to coal dust, particularly high levels, may lead to severe respiratory impairment (emphysema)

*Hnizdo & Vallyathan Chronic obstructive pulmonary disease due to occupational exposure to silica dust: a review of epidemiological and pathological evidence. Occup Environ Med 2003;60:237-243.

COPD Death Rates in Mining Industry 1999

Coal mining was at the top of a list of industries with a significantly elevated death rate from COPD Non-metal and metal mines were also in the top 5 industries for elevated COPD death rate Top 5 occupations for elevated COPD death rate included:
Helpers, mechanics and repairers
Mining machine operators

What can cause COPD?

Smoking is the primary risk factor
Long-term smoking is responsible for 8090 % of cases
Smoker, compared to non-smoker, is 10 times more likely to die of COPD

Prolonged exposures to harmful particles and gases from:

Second-hand smoke, Industrial smoke, Chemical gases, vapors, mists & fumes Dusts from grains, minerals & other materials

Other Risk Factors for COPD History of childhood respiratory infections Genetic makeup
Increasing age

Ways to prevent or slow the progression of COPD

Stop smoking, if you smoke, to prevent further damage to your body
Smoking cessation is critical for all severities of COPD

Avoid or protect yourself from exposures to Second-hand smoke and Other substances such as chemical vapors, fumes, mists, dusts, and diesel exhaust fumes that irritate your lungs

How is COPD Treated?

COPD can be managed, but not cured Treatment is different for each individual and is based on severity of the symptoms

Early diagnosis and treatment can

Slow progress of the disease Relieve symptoms Improve an individuals ability to stay active Prevent and treat complications Improve quality of life

When should you see your doctor?

If smoker, see doctor for baseline evaluation of your lungs When first experiencing shortness of breath or having other lung symptoms

When your symptoms get worse

Seek emergency medical treatment if:
Breathing suddenly becomes more difficult

If diagnosed with chronic bronchitis, emphysema or COPD, see doctor 1-2 times yearly to review your treatment plan

What medications are used to treat symptoms?

Bronchodilators
Relaxes muscles around airways

Steroids
Reduces inflammation

Oxygen therapy
Helps with shortness of breath

What medications are used to prevent complications?

Annual flu vaccine
Reduces risk of flu and its complications

Pneumonia vaccine
Reduces risk of common cause of pneumonia

Resources & References

American Lung Association. Breathing hazards at work, Workplace exposures can generate breathing hazards, accessed 11/02/06 American Lung Association. Chronic obstructive pulmonary disease (COPD) Fact Sheet, 2003 www.lungusa.org

Centers for Disease Control, DHHS, CDC Programs in BriefWorkplace Health and Safety-Work-Related Lung Disease, 2005 www.cdc.gov/programs/workpl18.htm
National Heart, Lung, and Blood Institute, NIH. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease Executive Summary, Updated 2003 National Heart, Lung, and Blood Institute, NIH. COPD-Key points and How is COPD treated? January, 2006