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Chronic obstructive pulmonary disease (COPD) is a debilitating lung condition that affects millions of people across the world.

As the disease progresses, symptoms like breathlessness, chest pain, coughing, and wheezing become increasingly prevalent, and with them, an increased likelihood of mortality.

It’s estimated that around 85 to 90 percent of COPD cases are the result of smoking. Other causes of COPD include the inhalation of airborne irritants such as car exhaust, dust and chemicals. Genetics can even play a role in the form of Alpha-1 deficiency, a rare but often serious condition.

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Throughout the early part of the 20th century, COPD was labeled a “man’s disease.” Cigarette advertisements were primarily directed towards men, and the stigma that surrounds smoking today was nonexistent. Smoking gradually became popular among women as well, bringing with it a slew of negative health effects.

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Today, cigarette smoking has declined significantly among both men and women. Many younger generations have adopted vaping as an alternative, or they reject drugs outright. Yet, despite the decline, COPD is still a leading cause of death in the world. If that’s not bad enough, you may be surprised to hear that death from COPD is still more common in women and women are more likely to die from it.

What’s causing high rates of COPD among women and what can be done about it?

Undiagnosed and Misdiagnosed COPD

One of the most frustrating things about COPD is that it’s notoriously difficult to diagnose. In adults, symptoms like coughing, wheezing and chest pain are often written off as a sign of aging, making these people less likely to visit a doctor.

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What’s more, pulmonary function tests, themselves, may be a cause for concern when it comes to the early diagnosis of COPD. According to Stine Hangaard, who works for the Department of Health Science and Technology at Aalborg University in Denmark, “The primary attributable cause of COPD misdiagnosis is spirometry. Spirometry may be seen as a simple test, but it is actually quite challenging to perform and interpret correctly.”

During a spirometry test, patients are asked to blow into a mouthpiece. The spirometer device measures your forced expiratory volume in 1 second (FEV1) and your forced vital capacity (FVC). The results are then compared to create a ratio. This ratio is used by doctors to diagnose conditions such as COPD, asthma, and pulmonary fibrosis.

However, just because someone doesn’t meet the threshold for COPD diagnosis doesn’t mean they aren’t experiencing the onset of the condition. COPD diagnosis requires an FEV1/FVC ratio of <0.70 which is indiscriminate of age and sex. If this threshold were adjusted to account for factors like these, it would be possible to more accurately diagnose the disease in women.

Another factor contributing to both undiagnosed and misdiagnosed COPD is the fact that women are less likely to receive a spirometry test than their male counterparts.

A study done by Chapman and Colleagues found that not only are women less likely to have a spirometry test done, but they’re also more likely to be misdiagnosed as having asthma.

Physiological Effects of Smoking

Most people in this day and age understand the risks of smoking: lung cancer, heart disease, diabetes, and a whole host of other systemic conditions, just to name a few. But one thing they may not be aware of is that cigarettes pose additional threats for women.

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A study published in the European Respiratory Journal indicates that women experience a greater decline in lung density (emphysema) as well as a greater decline in FEV1 even when they smoke the same amount of cigarettes as men. Additionally, women tend to report a poorer quality of life than men in the same stage of COPD.

There are many theories as to why cigarettes are more detrimental to women and why the onset of COPD is so much more drastic in women, but the facts remain: smoking cessation is the number one way to prevent COPD and reduce its severity.

In the United States, smoking rates among adults 18 years and older have decreased from 20.9 percent in 2005 to 15.5 percent in 2016. However, a staggering 38 million Americans still smoke every day.

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What’s more, younger adults are being targeted by vaping companies who claim vaping is a “healthy alternative” to cigarettes. Unfortunately, more research needs to be done before scientists can confirm this, and even then, vaping has already been linked to a number of respiratory illnesses.

Embracing Pulmonary Wellness

Despite the lungs being one of the most important organs in the body, the lack of media attention they receive is startling. Lung health extends far beyond smoking cessation and there are a number of lifestyle changes you can make right now to improve your lung health.

Adequate exercise, eating right, and preventing respiratory infection are all things you can work on right now to improve your lung health. Since air pollution is a significant risk factor for COPD, you may consider moving to a cleaner city or improving air quality within your home.

Getting more sleep and reducing anxiety are two more ways to promote healthy lungs. Studies have shown that anxiety and stress can contribute to the coagulation of blood.

The bottom line on COPD

Unfortunately, society puts short-term satisfaction above long-term pulmonary wellness. Many people live in polluted cities and are pressured into buying products that damage our lungs and compromise our well-being. What’s more, women are often the most vulnerable people when it comes to pulmonary wellness.

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If you’re looking for a way to help, you can start by encouraging friends and loved ones to give up cigarettes and pursue a lung-healthy life. While COPD has been thoroughly researched, doctors still have a long way to go in discovering new and effective treatments for the disease. Next time you visit your doctor, ask him/her about receiving a spirometry test and don’t be afraid to ask questions if you have any concerns about your pulmonary health.

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