Underdiagnosed: COPD due to occupation

Chronic Obstructive Pulmonary Disease (COPD) is a prevalent global health issue characterized by chronic respiratory symptoms and irreversible airflow limitation. It comes with two primary clinical phenotypes: emphysema, marked by exertional breathlessness, and chronic bronchitis, with chronic cough and mucus. The prevalence of COPD is significant, affecting nearly 4% of the population and escalating to 10% among individuals aged over 40.
Beyond the substantial loss of lives, COPD exacts a considerable economic and societal toll. The socioeconomic burden accounts for over 3% of healthcare expenditure. The total economic cost of COPD is close to $50 billion each year. COPD and COPD symptoms can significantly lead to disability, thus high rates of years of life lost and years lived with disability.
As per definition made by the Global Initiative for Obstructive Lung Disease (GOLD), COPD is a preventable disease primarily caused by significant exposure to harmful particles and noxious gases, influenced by host factors, including genetics, lung development, and pre-existing asthma. One should note that tobacco fstands out as the most significant risk factor, as the population-based studies suggest: According to their studies, up to 97.6% of COPD cases are attributed to smoking.
Other than smoking, essential risk factors include occupational and environmental exposures, respiratory infections and early-life events that affect lung development. Among the mentioned risk factors, exposures to e.g., inorganic dust due to one’s area of occupation, play a critical role in defining an "occupational" variant of COPD. Epidemiological evidence supports the association between workplace exposures and COPD as well.
Although there has been significant progress in understanding COPD, several areas continue to require further investigation. Identifying other risk factors, such as irritant substances, specific types of organic dust, and certain metals are some examples of those areas. Moreover, further epidemiological studies are needed. Extensive data from various parts of the world is necessary to create a more comprehensive picture of COPD's global prevalence.
What about the diagnosis of such a disease that has a huge impact on global health and economy? Early diagnosis is crucial in preventing further decline of the lung function due to ongoing exposures. However, from a clinical perspective, diagnosing occupational COPD can be challenging as it lacks specific hallmarks compared to general COPD. This complexity often leads to underdiagnosis due to lack of education in occupational medicine during the training of healthcare professionals.
In order to overcome this, clinicians can incorporate effective occupational histories and targeted questions about workplace exposures into their diagnostic process. This approach would enable the identification of occupational factors contributing to COPD in individual patients, making it possible to initiate appropriate interventions like smoking cessation and optimal treatment.
Overall, COPD is a global health challenge with devastating consequences for many sides. Research efforts must be continued to explore new risk factors and mechanisms contributing to this complex disease. The importance of early diagnosis and collaborative care can’t be stressed enough, as these are key in managing COPD effectively. In this context, clinicians play a pivotal role in identifying occupational factors and initiating timely interventions. The multifaceted nature of COPD must be well understood and addressed to work towards both reducing the global burden and improving the quality of life of occupational COPD patients.
Here at Breathment, we do our part to lessen the global economic burden COPD creates. Our aim is to reduce hospitalizations and readmissions through continuous and personalized therapy. We offer an interactive and integrated option for the preventive treatment of COPD, where patients can perform their prescribed exercises from their home. Our contribution is not limited to that: We are also conducting our own clinical research on COPD and supporting centers that are dedicated to this cause. Book your first online appointment to find out more about our approach to respiratory care and about the Breathment Therapy App.