1. COPD 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

2. Overview 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 COPD?
How can I prevent getting COPD?
How is COPD treated?

3. What is COPD?
A set of lung diseases that limit air flow and is not fully reversible.
COPD patients report they are “hungry” for air
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 factors
Symptomatic treatment is available

4. Two Major Causes of COPD
Chronic Bronchitis is characterized by
Chronic inflammation and excess mucus production
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.

5. Primary Symptoms Chronic Bronchitis Emphysema Chronic cough
Shortness of breath
Increased mucus
Frequent clearing of throat
Emphysema
Limited activity level

6. Normal versus Diseased Bronchi

7. Emphysema

8. 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 work-related**
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 www/lungusa.org

9. 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

10. 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:

11. COPD Death Rates in Mining Industry 1999
Coal mining was at the top of a list of industries with a significantly elevated death rate from COPD
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 included:
Helpers, mechanics and repairers
Mining machine operators

12. What can cause COPD? Smoking is the primary risk factor
Long-term smoking is responsible for % 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

13. Other Risk Factors for COPD
History of childhood respiratory infections
Genetic makeup
Increasing age

14. 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
and
Other substances such as chemical vapors, fumes, mists, dusts, and diesel exhaust fumes that irritate your lungs

15. 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

16. 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

17. What medications are used to treat symptoms?
Bronchodilators –
Relaxes muscles around airways
Steroids
Reduces inflammation
Oxygen therapy
Helps with shortness of breath

18. 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

19. 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,