COPD Chronic Obstructive Lung Disease Developed by: Dana Hughes, RN, PhD

Chronic Obstructive Lung Disease
Developed by:
Dana Hughes, RN, PhD
Miners Hospital, University of Utah
Libbey M. Chuy, MPH
Asthma Program, Utah Department of Health
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
How can I prevent getting COPD?
How is COPD treated?
What is COPD?
A set of lung diseases that limit air flow and
is not fully reversible.
– COPD patients report they are “hungry” for
– 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
– Symptomatic treatment is available
Two Major Causes of COPD
Chronic Bronchitis is characterized by
– Chronic inflammation and excess mucus
– 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. 2005;9(1):1.
Primary Symptoms
Chronic Bronchitis
Chronic cough
Shortness of breath
Increased mucus
Frequent clearing of throat
– Chronic cough
– Shortness of breath
– Limited activity level
Normal versus Diseased Bronchi
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 workrelated**
 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. 2005;9(1):1.
**CDC programs in Brief– Workplace Health and Safety-Work-related Lung Diseases.
***COPD Fact Sheet. Oct 2003. www/
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
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 2003;60:237-243.
COPD Death Rates in Mining Industry
 Coal mining was at the top of a list of industries
with a significantly elevated death rate from
 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
– Helpers, mechanics and repairers
– Mining machine operators
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
Other Risk Factors for COPD
History of childhood respiratory
Genetic makeup
Increasing age
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
– Other substances such as chemical vapors,
fumes, mists, dusts, and diesel exhaust fumes
that irritate your lungs
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 individual’s ability to stay active
Prevent and treat complications
Improve quality of life
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
What medications are used to
treat symptoms?
Bronchodilators –
• Relaxes muscles around airways
• Reduces inflammation
Oxygen therapy
• Helps with shortness of breath
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
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
Centers for Disease Control, DHHS, CDC Programs in Brief-Workplace
Health and Safety-Work-Related Lung Disease, 2005
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