Thread by @vimalrajslm

#WorldCOPDDay
#GOLDguidelines
@GOLD_COPD

Creating awareness for the public on the key factors which influence the lung development till adulthood and sharing the ways to keep the lungs healthy is important.

Because we all have only one set of lungs. (1/n)

#GETomics

This is a new term introduced recently which highlights the 'complex and dynamic' interactions between #Genetics and #Environment over #time which plays the crucial role in the development of #COPD (2/n)

When i was a resident, I was taught that #Cigarettesmoking contributes to ~90% of COPD burden in the world.

But now the data suggets that more than half of COPD burden, worldwide is due to causes other than tobacco. Why? What has changed? (3/n)

#LMIC

This is the cause. We in Lower & Middle Income Countries #LMIC are the cause.

Research data from predominantly, developed nations showed the impact of cigarette smoking on COPD while non-smoking COPD was a cause in less than 10% of patients (4/n)

As new data emerge from #LMIC, cigarette smoking is attributed to <50% of patients with COPD. #Indoorpollution
due to #biomassfuel exposure is emerging as an important cause for COPD in #LMIC nations.
What is the magnitude we are talking about? .. (5/n)

#LMIC contribute to 85% of global COPD burden.

Thats the magnitude!!

While #smokingcessation still remains the 'most important intervention' one can make to improve the lung functions and Quality of life of COPD patients .. .. .. (6/n)

The sheer volume of patient load from LMIC shows the need to focus our attention on 'non-smoking COPD'

Wood
Animal dung
Crop residues
Coal, typically burnt in open fires/poorly functioning stoves

All the above are the main contributors of "Indoor air pollution".
(7/n)

So then, how many are at risk because of this #biomassfuel exposure?

Yesterday we reached a milestone in world population. 8 billionth baby was born somewhere in the world people!!

'3 biilion' of them use biomass fuel as a source for cooking, heating & other needs (8/n)

So, more than 1/3rd of the global population is at risk of developing COPD due to this pollution.

That will be a huge toll to take care given the fact that world elderly population is bound to increase as days goes by.

(9/n)

So, where does it leave us with smoking cessation?

That will be a simple intervention which can not only save the person who smokes, but also
- the person who smokes second-hand/third-hand
-the child who is exposed to the smoke from a pregnant mother who is smoking (10/n)

Thus tobacco cessation has both direct and indirect benefits.

And the possibility of a person quitting tobacco and staying quit for a long time, increases to 25% if it is guided by a professional trained in smoking cessation program. (11/n)

Back to non-smoking COPD:

Who are at risk?
People exposed to organic and inorganic dusts,
Chemical agents and fumes
(High doses of Pesticides)
Heavy metal exposure

That is
Farmers, sculptors, gardeners, warehouse workers,etc

(12/n)

And the general ones, few of which are related to our place of living-->

Air pollution - exposure to particulate matter (PM) exposure, ozone, greenhouse gases, oxides of sulphur and nitrogen..

Genetic: rare but a defined population- alpha 1 antitrypsin deficiency (13/n)

And few other genetic mutations causing COPD (need to suspect them in the usual age groups- less than 40 years) must also be kept in mind.

(14/n)

In a nutshell, whenever there is breathlessness on exertion (walking/climbing stairs/running) with or without cough (+/- sputum production), +/- smoking history +/- biomass fuel exposure, in a person >40 years, possibility of COPD should cross your mind. (15/n)

If that happens, meet a pulmonologist. If we are far and few in your area, meet a physician. The rest will be taken care of.

(16/16)

*unusual age group for COPD

* 3 billion, typo error

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