Opinion: What Is COPD? Poor AQI Also A Risk Factor For Disease Usually Caused By Smoking

While smoking remains the leading risk factor for COPD, non-smokers should be aware of other environmental and occupational hazards that can also contribute to the disease.

By Dr Shivraj A.L.

Chronic Obstructive Pulmonary Disease (COPD) is a lung condition that is progressive and debilitating in nature as it causes airflow blockage. Individuals with COPD experience difficulty in breathing. Smoking is the primary cause of COPD — accounting for around 90% of cases. However, non-smokers can also develop this disease due to a range of other risk factors. These include environmental and occupational exposures that may lead to long-term lung damage.

Biomass exposure is one of the significant non-smoking-related risk factors for COPD. This is particularly common in regions where people cook with traditional fuels such as wood, charcoal, or cow dung in poorly ventilated indoor spaces. This domestic combustion releases harmful pollutants through the smoke, including particulate matter, carbon monoxide, and volatile organic compounds. Prolonged inhalation of these substances can damage lung tissue over time, similar to the effects of tobacco smoke, increasing the risk of COPD.

Another major risk factor is occupational exposure. Certain professions, such as mining, construction, and agricultural work, expose individuals to harmful dust, fumes, and chemical vapours. These particles can irritate and damage the lungs. Workers in these environments can also face respiratory obstructions due to chronic exposure to substances like asbestos, silica dust, or chemical solvents, which can lead to respiratory diseases over time, including COPD. Protective measures, such as proper ventilation, masks, and workplace safety regulations, are critical in reducing the risk of lung damage for individuals in such high-risk occupations.

Air Quality As A Risk Factor

Beyond biomass and occupational exposure, the poor air quality of late is also becoming an increasingly common factor that contributes to COPD. The Air Quality Index (AQI) is a tool used to measure air pollution levels, with readings above 150 indicating unhealthy air quality. Key pollutants like fine particulate matter (PM2.5) and nitrogen dioxide (NO2) are major contributors to respiratory problems. Prolonged exposure to polluted air with AQI higher than 150 can damage the airways and make individuals more susceptible to COPD, even if they have never smoked. 

The effects of poor air quality are not just restricted to adults. In children, who are classified as vulnerable, poor AQI can lead to developmental problems in the lungs, including impaired growth and function, increasing the likelihood of respiratory diseases like asthma and COPD later in life. These children are often predisposed to several respiratory issues in their adulthood, and are also prone to repeat infections of the lungs and the respiratory tract.

While smoking remains the leading risk factor for COPD, non-smokers should be aware of other environmental and occupational hazards that can also contribute to the disease. Indoor air pollution, occupational exposure to harmful particles, and poor air quality are all significant contributors to lung damage. 

Public health efforts should focus on reducing air pollution, improving workplace safety, and raising awareness about the risks of biomass and environmental exposure. People living in high-pollution areas can take steps to minimise their exposure, such as staying indoors during periods of poor air quality and using air purifiers. Ultimately, regulatory measures aimed at controlling air pollution and promoting cleaner, safer environments will be crucial in preventing COPD and protecting lung health on a broader scale.

The writer is Consultant-Pulmonology, Manipal Hospital Sarjapur Road, Bengaluru.

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