COPD Chronic Obstructive Lung Disease

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COPDChronic Obstructive Lung Disease

• Developed by
• Dana Hughes, RN, PhD
• Miners Hospital, University of Utah
• Libbey M. Chuy, MPH
• Asthma Program, Utah Department of Health

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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?

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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

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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.
  20059(1)1.

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Primary Symptoms

• Chronic Bronchitis
• Chronic cough
• Shortness of breath
• Increased mucus
• Frequent clearing of throat
• Emphysema
• Chronic cough
• Shortness of breath
• Limited activity level

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Normal versus Diseased Bronchi
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Emphysema
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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. 20059(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

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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

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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
  200360237-243.

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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

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What can cause COPD?

• Smoking is the primary risk factor
• Long-term smoking is responsible for 80-90 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

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Other Risk Factors for COPD

• History of childhood respiratory infections
• Genetic makeup
• Increasing age

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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

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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

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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

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What medications are used to treat symptoms?

• Bronchodilators
• Relaxes muscles around airways
• Steroids
• Reduces inflammation
• Oxygen therapy
• Helps with shortness of breath

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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

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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