If you’ve ever felt short of breath, wheezy or tight-chested, chances are you’ve blamed it on your age, lack of fitness, weight, hay fever or even asthma.
What you may not know is that 14.5 per cent of the population aged over 40 live with Chronic Obstructive Pulmonary Disease (COPD), and that about half of them don’t know they have it.
Commonly known as COPD, it’s a condition that affects more people than you might think – 29 per cent of over-75s have it – even if you don’t hear about it in the news every day.
COPD is an umbrella term for conditions that affect the airways and/or air sacs of the lungs, and includes illnesses such as emphysema, chronic bronchitis and chronic asthma. In addition to being the second-leading cause of avoidable hospital admissions, it’s the fifth-leading cause of death in Australia, killing more than 6,000 people every year. Only heart disease, stroke and cancer are bigger killers.
COPD is caused when the lungs and airways are exposed to long-term damage from irritants, causing the airways to become narrower over time. This makes it harder to breathe, increases the levels of mucus and the urge to cough.
Most people already know smoking is bad for lung health, and while smoking is the main cause of COPD, it isn’t the only one.
“There’s at least 20 per cent of people who have COPD who have not been exposed to noxious agents such as cigarette smoke,” explains Dr Kerry Hancock, chair of Lung Foundation Australia’s GP advisory group.
“It’s possible that they’ve had long-term asthma and sustained damage to their airways, during their childhood or their adolescent and young adult years, before we had the great treatments that have been available since the 1970s and ‘80s.”
Passive smoking is a huge risk factor, while exposure to environmental agents including fumes, dusts and chemicals can also cause COPD to develop.
COPD isn’t contagious, but it can be inherited as a genetic disorder in some people. Smokers and past smokers are at most at risk of developing COPD, while anyone who has worked or lived in dusty or smoky conditions is also at heightened risk of developing it.
Because COPD develops gradually, it’s not uncommon for people to dismiss symptoms as something else. Many older people live with more than one health condition and can dismiss difficulties with breathing or persistent coughing or coughing up sticky phlegm as being caused by another health problem, such as just “my winter cough”.
Others simply dismiss it as a part of the normal ageing process, even though there’s nothing normal about not being able to breathe properly or coughing up phlegm every day. Others still may start to notice difficulty completing simple physical tasks because they feel unusually tired.
“Breathlessness is not actually normal,” Dr Hancock says. “If we’re a bit unfit and we try to run around the block and get breathless, it’s okay, that’s acceptable. [But] simple things like walking down the street or up one flight of stairs or a little bit of an incline, if we get breathlessness with that, that should be looked at.”
While COPD can’t be cured, it can be managed.
“We do have some good treatments for COPD, so there are some things we can do to slow down that progression over time such as enrolling in a specialised exercise program, which has been shown as one of the best ways to exercise your lungs and stay fit and healthy. It can also go a long way in looking after your emotional wellbeing by offering proactive ways to cope with the challenges of COPD,” Dr Hancock adds.
The doctor says, though, that it’s important that people never ignore symptoms and instead raise any concerns as soon as they notice them with a GP, which makes knowing the risk factors and symptoms of COPD essential to helping people with it have a better quality of life.
Anyone who visits the doctor with symptoms that could indicate COPD will usually be asked about their lifestyle and could be asked to do a simple breathing test. More detailed tests may be required to help your doctor distinguish COPD from asthma, however – something that’s not necessarily easy to do because the two can overlap in some people who have features of both conditions. (With asthma, tightening of the muscle around the airway causes the airway to temporarily narrow, while with COPD the narrowing is permanent.)
The next step is usually for a health professional to prescribe medication to manage symptoms, recommend lifestyle changes to improve overall lung health and/or set up plans to follow in the event of an unexpected or sudden flare-up.
Meanwhile, people with a loved one living with COPD can help them by encouraging them to have flu and pneumonia vaccinations and to remain active, and by making sure they take their COPD medication correctly and regularly, Dr Hancock says.
The doctor says that so many Australians could benefit, however, simply from knowing more about COPD, its symptoms and how to address them, because each time the condition flares up and isn’t diagnosed and treated, it causes further irreversible damage to the airways.
“If we’re trying to prevent more damage to the lungs, because we know it’s potentially a progressive disease, we want to be able to diagnose these people earlier rather than later,” she says.
If you have experienced an increase in coughing, shortness of breath, low energy or a change in phlegm, it’s important to Have the CHAT with your doctor.