How often have we faced breathlessness while climbing a flight of stairs or felt tired even while carrying out the most routine activities or have seen others go through it? Most pass it off as a symptom of ageing, which is not always the reason. With continuous exposure to air pollution and passive smoke intake, we are most likely to have compromised respiratory health and, in some cases, also be victims of progressive lung diseases like Chronic Obstructive Pulmonary Disease (COPD).
As one of the chronic lung illnesses that is triggered due to prolonged exposure to polluted air, smoke or biomass, COPD is a chronic condition that manifests with symptoms like shortness of breath and cough with or without sputum. There are an estimated 55 million cases of COPD in India, the highest in the world, with China being a close second. It is also the second leading cause of deaths as well as disability-adjusted life years in India.
Among Non-Communicable Diseases (NCD) globally, COPD has been determined to be a major contributor to death and disability. The Sustainable Development Goals of the United Nations and the National Health Policy of India aim to reduce premature mortality from non-communicable diseases (NCD) by one-third in the next decade and by 25 percent in 2025, respectively. However, while the COPD burden is on the rise, there is very little awareness and intervention to tackle it. We, therefore, need a collaborative and focused effort amongst stakeholders to address this silent killer by aggressively pursuing the following agendas.
Making COPD a national health priority
India carries 32 percent of the world’s COPD burden. The recent inclusion of guidelines for the prevention and management of COPD, under the National Programme for Prevention and Control of Cancer Diabetes Cardiovascular diseases and Strokes (NPCDCS), is a step in the right direction. To tackle the COPD burden of the country, we need a structured program aimed at creating awareness, rapid and effective screening, accurate diagnosis, adequate management, and follow up on the disease.
Rallying for clean air
Air pollution levels in India are among the highest in the world, posing a heavy threat to the country's health. The Indian population is exposed to ambient air which is the root cause of chronic respiratory illnesses. The Government of India’s National Clean Air Programme (NCAP) is a powerful step in acknowledging and resolving the problem of deteriorating ambient air quality. However, interventions from the industry and businesses to create products that reduce emission is the need of the hour.
Taking responsibility at an individual level
While there can be policies around reducing air pollution, the onus lies at an individual level to reduce our exposure to biomass smoke and other pollutants. Studies have shown that 70 percent of Indian houses use biomass fuel for cooking and heating purposes in poorly ventilated kitchens. The same study showed that 2,068 women with more than 10 years spent cooking with biomass, were screened and almost one-fifth (18 percent) were diagnosed with COPD. The average age of the women with undiagnosed COPD, who featured in the study, was 47 years. Using improved cookstoves, which aim to burn fuel more efficiently and therefore produce fewer waste combustion products; cleaner or drier fuels, which produce less waste when burnt; improved ventilation to curb air pollution within the household, are some ways to address this issue.
We must also be aware of the risk factors associated with the disease and avoid them as much as possible. Encourage friends and family to give up tobacco smoking. Keep the lungs healthy by regular exercise (walking, pranayama), good food (green leafy vegetables and fruits) and drinking plenty of water.
The COPD diagnosis gap
Lack of timely diagnosis, and in some cases misdiagnosis, of this chronic lung disease results in feeding into the rise in COPD cases. With fewer treatment options and under-diagnosis of the disease in developing countries like ours, it is time to give it the attention it needs. Often patients are misdiagnosed with asthma and prescribed asthma-related therapies. One of the most reliable ways to diagnose COPD is the spirometry test that measures the speed and amount of air a person can blow out of the lungs. Spirometry is considered the gold standard for COPD diagnosis, however, their bulky size, complex functionality, need for regular maintenance are some reasons that impacted the widespread acceptance of conventional spirometers by medical practitioners.
The management of COPD
COPD is a progressive disease and cessation of smoking is a must to not let the disease exacerbate. To live a life that is not compromised, despite living with a prolonged disease like this, it should be effectively managed. Besides using nebulisation therapy which converts the medicine into mist, rehabilitation programs focus on a combination of education, exercise training, nutrition advice and counselling for patients.
For years, we have neglected our lungs, which is the only organ responsible for breathing life into us, and Covid-19 has given us an apt reminder to not ignore it any further. As the country reels under the effects of this pandemic and is faced with the massive threat of air pollution, we have to take a hard look at sustainable solutions from an environmental and health point of view. Let’s pledge to care for our source of life, our lungs, and together rally forces to help India breathe better and breathe freely.
The writer is MD & Global CEO of Cipla.
The thoughts and opinions shared here are of the author.
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