Smokers fuel prediction of steep rise in lung disease
DUBAI // The prevalence of a progressive and irreversible lung disease is increasing rapidly.
Chronic obstructive pulmonary disease (COPD) affects 4 per cent of the Abu Dhabi population, according to a study by UAE University, Zayed Military Hospital and the Emirates Allergy and Respiratory Society (Ears).
Worldwide, the disease, caused mainly by smoking and characterised by severely restricted breathing as a result of lung damage and inflammation, affects between 2 and 9 per cent of the population, placing Abu Dhabi slightly below the average.
However, with smokers making up nearly a quarter of the adult population in the emirate, experts project that the prevalence of COPD could increase to 7 per cent in the next five years.
"There's a good chance that people who are smoking now will develop the disease as they grow older," said Dr Bassam Mahboub, head of the allergy and respiratory department at Dubai Hospital and vice chair of Ears. "This not only increases the risk of other diseases, but also increases mortality and is a burden and challenge for the health system, draining it to a maximum."
According to the World Health Organization (Who), COPD contributes to 5 per cent of all deaths globally. Who predicts that the mortality rate from the disease could increase by more than 30 per cent in the next 10 years unless urgent action is taken to reduce the underlying risk factors, especially smoking.
In 80 per cent of cases, cigarette smoking is the primary cause. Patients usually begin showing symptoms at 40, and the disease can lead to death if not treated properly.
"There are, of course, exceptions," Dr Mahboub said. "But this is because as you reach the age of 35, your lung function will start declining physiologically, and so both this and the impact of smoking meet at the age of 40."
The disease is characterised by severe episodes of lung attacks, called exacerbations, especially during the winter months. COPD exacerbations are associated with increased airway and systemic inflammation, as well as physiological changes in the lungs, Dr Mahboub said. They include increased breathlessness, a chronic cough, mucus production, and extreme fatigue.
Leonardo M Fabbri, a professor of respiratory medicine and director of respiratory diseases at the University of Modena and Reggio Emilia in Italy, said the risk was lower in western countries, where stringent anti-smoking campaigns had brought the rate of adult smoking below 20 per cent.
However, he said, there was an urgent need to address the issue because the disease was unfamiliar and under-diagnosed.
"The elderly tend to attribute shortness of breath, cough and sputum to their age," Prof Fabbri said. "And doctors treat them accordingly. But once you make the diagnosis and treat the patient properly, by modifying their lifestyle, providing them with medication and hospitalisation, there is a possibility of [positively] influencing mortality."
Doctors must not confuse COPD with asthma or other lung diseases, such as bronchitis and emphysema, experts said.
"Asthma is an allergic disease. It starts with you since childhood and comes and goes," Dr Mahboub said. "Both exhibit similar symptoms, cough, wheezing and shortness of breath, except asthma is usually related to allergies whereas COPD is something that develops over age because of an accumulation of smoke in the lungs, and the condition continues to get worse."
Another factor that can lead to COPD is air pollution.
"One risk that has been heavily underestimated is indoor pollution, particularly due to cooking and heating using biofuels that can create a highly polluted environment," Prof Fabbri said.
The effects of COPD on a countrywide level and their financial implications will be announced by the end of this year. Dr Mahboub said the reports were being sent to the health authorities so that they could begin working on preventive measures.
"I think the best approach is to go to schools and educate students about the dangers of smoking," he said. "We also need to inform the public and general practitioners so they can start picking up these disease at an earlier stage."