COPDChronic Obstructive Lung Disease

Developed by: Dana Hughes, RN, PhDMiners Hospital, University of Utah Libbey M. Chuy, MPHAsthma Program, Utah Department of Health

OverviewWhat is COPD?How do I know if I have COPD?How common is it?General populationMining populationWhat 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 airUsually progressive and is associated with inflammation of the lungs as they respond to noxious particles or gasesPotentially preventable with proper precautions and avoidance of precipitating factorsSymptomatic treatment is available

Two Major Causes of COPDChronic Bronchitis is characterized byChronic inflammation and excess mucus productionPresence of chronic productive cough Emphysema is characterized byDamage to the small, sac-like units of the lung that deliver oxygen into the lung and remove the carbon dioxideChronic cough *Source: Braman, S. Update on the ATS Guidelines for COPD. Medscape Pulmonary Medicine. 2005;9(1):1.

Primary SymptomsChronic BronchitisChronic coughShortness of breathIncreased mucusFrequent clearing of throat

EmphysemaChronic coughShortness of breathLimited 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 work-related**

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 IndustryStudies 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 1999Coal 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 factorLong-term smoking is responsible for 80-90 % of casesSmoker, 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 & fumesDusts from grains, minerals & other materials

Other Risk Factors for COPDHistory 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 bodySmoking cessation is critical for all severities of COPD Avoid or protect yourself from exposures toSecond-hand smoke andOther 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 canSlow progress of the diseaseRelieve symptomsImprove an individuals ability to stay activePrevent and treat complicationsImprove 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 vaccineReduces 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 Brief-Workplace 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 http://www.nhlbi.nih.gov/health