According to the latest Global Burden of Disease Report, Chronic Obstructive Pulmonary Disease or COPD is the second leading cause of death in India after cardiovascular diseases. In Maharashtra, one of the few states in India that has identified the top leading causes of death, COPD is the leading cause of death. More than 600,000 people die due to COPD every year in India. Yet, COPD remains an unknown disease.
COPD is a chronic, rapidly progressive disease of the airways and lung parenchyma caused by long-term inhalation of noxious substances into the lungs. Tobacco smoking was the first major risk factor identified for COPD. Apart from nicotine, tobacco smoke contains very high amounts of noxious substances that go directly into the lung. Each puff of tobacco smoke contains 4000 different chemicals, at least 200 of which are known to cause lung damage and even lung cancer. Bidis are worse than cigarettes and 70% of people in India smoke bidis. Hookah and chillum are worse than bidis. A single session of hookah smoking in a bar is equal to smoking more than 100 cigarettes. Unfortunately, many people are falsely led to believe that hookah smoking is safe because the smoke passes through water, which cleanses it. Not true.
More recently, non-smoking risk factors have been identified. Exposure to biomass smoke (burning of wood, animal dung, crop residues) causes more COPD in India than tobacco smoking. 70% of homes in India still continue to use biomass fuel for cooking and heating purposes, especially in rural areas. Women and children are particularly exposed to very high levels of biomass smoke inside the homes. Moreover, burning of mosquito coils, which is currently practiced by 60% of people in India to get rid of mosquito bites, exposes people to the same amount of particulate pollution as that equal to smoking 100-cigarettes. Use of agarbattis, in particular, dhoop agarbatti produces 10-times more pollution than mosquito coils. Therefore, in country like India you don’t need to be a smoker to develop COPD. It seems that more than 60% of COPD in India is due to non-smoking causes.
Early diagnosis is important to prevent the rapid decline in lung function that is characteristic of this disease. Because the lung has a huge back-up, symptoms start manifesting only after a sufficiently large amount of lung is damaged. Cough and breathlessness are the two main symptoms found in COPD patients. Spirometry is the gold standard diagnostic test for COPD. Yet, it remains very poorly used in clinical practice. A large number of COPD patients therefore remain undiagnosed. Treatment of COPD is with regular inhaled medications, but only few patients are prescribed inhaled drugs by their doctors. Even among those who are prescribed these drugs, very few take them on a regular basis. This has been shown to contribute to worsening of the disease, more suffering and more deaths due to COPD.
Even doctors are not much aware about this disease. It is time to wake up to this silent epidemic of COPD that is occurring in India. More people need to be made aware about this disease. Doctors as well as health care policy makers also need to be made aware about this disease. Chest Research Foundation (CRF), a Pune-based research institute has been conducting research and educational activities in this field for more than 10 years. CRF along with the Johns Hopkins University, USA, are together hosting the ICONIC-2016 international conference on COPD, which will be held on 6th and 7th of February 2016 in Pune. It is aimed at updating doctors about the latest advancements in this field, so that they can diagnose and treat their patients better. More than 10 international speakers and 20 national speakers have confirmed their presence and this event is supported by several national as well as international lung societies.
Dr Rajesh Swarnakar MBBS, DTCD,DNB,FCCP(USA)
Director & Consulitant Lungs Specialist
Mobile; +91 9822225130