Seven Surprising COPD Risk Factors Managed Care Organizations Should Watch

COPD strikes 15.7 million Americans (6.4%), while at least as many have low lung function still undiagnosed with chronic obstructive pulmonary disease (COPD), reports the CDC. Approximately 90% of those cases may be caused by cigarette smoking, according to the American Lung Association. Each butt has a major but: The release of 7,000 toxins that expose lungs to infections, narrow air passages, and ignite inflammation-all contributors to COPD.

Managed care organizations also should be on high alert for lesser known culprits. Here are seven more factors to blame for this costly progressive disease:

• Outdoor pollution. Long-term exposure to toxic chemicals, dust, car exhaust fumes, and secondhand smoke in the air spark inflammation within the lungs, damaging them, says Mark T. Dransfield, MD, medical director at the University of Alabama at Birmingham Lung Health Center.
   
•  Emotional distress. Even low levels of anxiety and depression spike the risk of COPD by 44%, while moderate levels raise it 125%, and high, 148%, according to a study appearing in the Journal of Psychosomatic Research. “Screening for distress may help to identify those at risk,” says Catharine R. Gale, PhD, lead author of the study, which was based on a review of clinical records of 16,485 United Kingdom residents over a three-year span.
   
• Occupational hazards. Coal miners, firefighters, factory workers, and pest control providers aren’t the only individuals exposed to dust, harmful chemicals such as formaldehyde, aerosol sprays, pesticides, and bleach. So are farmers, hair stylists, nail technicians, housekeepers, construction crews, painters-and healthcare providers. Doctors, nurses, and other hospital and medical office staff are often exposed to lung diseases including flu, tuberculosis, and severe acute respiratory syndrome.
   
• Childhood health issues. Premature birth, low-birth weight, and childhood asthma, respiratory infections, or exposure to secondhand smoke hinder lung development in utero and up to age 25, Dransfield says. That could limit a patient’s lung growth and put them at risk, Dransfield says. “Lung function peaks at age 25 and in those with low function rapidly declines.”
   
• Adult asthma. Four of 10 women with asthma develop COPD, according to a University of Toronto study that followed 4,051 women for 14 years, as reported in the August issue of the Annals of the American Thoracic Society.
   
• Ethnic heritage. American Indians, native Alaskans, and multiracial non-Hispanics also have a higher likelihood of suffering COPD, according to the latest CDC figures.
   
• Genetic flaws. Between 1% and 3% of people lack alpha-1 antitrypsin, a protein that helps protect the lungs, Dransfield says. There may be other genetic risks yet to be identified that increase susceptibility to COPD.