‘Never-smokers’ more vulnerable to COPD

City-based Chest Research Foundation (CRF) has, in its latest study, proved that chronic obstructive pulmonary disease (COPD), known as the disease of smokers, affects mostly ‘never-smokers’. This study was released on the occasion of World COPD Day, which will be observed on Wednesday.

The two-year study was conducted in collaboration with KEM Hospital and the Imperial College, London, in 22 villages of Pune district. It was spearheaded by Dr Sundeep Salvi from CRF, Dr Sanjay Juvekar from KEM Hospital and Dr Peter Barnes from the UK.

A total of 3,000 people over 25 years were randomly selected and the prevalence rate of COPD was determined at 7 per cent. This is the first time that the exact rate of COPD in an Indian population sample has been found, claimed Salvi, who is also director of CRF.

Amongst identified COPD sufferers, only 7% were smokers and 93% were ‘never-smokers’. This indicates that smoking is clearly not the most important risk factor for COPD in India, as believed so far, said Salvi.

“It was also noticed that 23% of COPD occurred in those below 40 years of age, which was never reported earlier. It was always believed that COPD occurred after the age of 40 and in people who had smoked for more than 15 to 20 years,” he said.

However, the study shows that exposure to indoor air pollution is the most important cause for COPD at a young age because of exposure to biomass fuel since childhood. Compared to 1.1 billion smokers more than three billion people (50% of the global population) use biomass fuels (wood, crop residue and cowdung cakes) for cooking and heating.

In India alone, 75% of the homes use biomass fuel, exposing over 700 million people to high levels of indoor air pollution. Women and young children are the most vulnerable lot that are
affected due to this exposure.
 
“A woman living in a rural home in India spends an average 60,000 hours in cooking during her lifetime. In this process she inhales a 25 million litres of polluted air that increase the chances of developing COPD,” said Salvi.

He said tobacco smoking is the second biggest cause of COPD in India. Other causes include poorly treated chronic asthma, certain occupations like building and construction, mining, sand blasting, leather industry and farming, and recurrent lung infections and poor nourishment during childhood.

Although COPD is one of the main causes of death in India — more than 5.50 lakh people every year — lack of awareness on this disease in health care providers and policy makers has led to the increase in prevalence rate of lung diseases, Salvi said.