What is Emphysema / COPD?

COPD is a medical term known as Chronic Obstructive Pulmonary Disease and it refers to a group of lung conditions that cause airflow obstruction leading to shortness of breath and difficulty in breathing. COPD includes Asthma, Emphysema and Chronic Bronchitis. A person could have one condition in isolation or a combination of two or all three conditions.

Asthma refers to hyperreactivity of the smaller airways in the lung. Bronchodilators can be used to relax the airways and bring down any swelling that would obstruct air flow.

Bronchitis means the airways are inflamed and narrowed. In chronic bronchitis, the glands that line the breathing tubes produce too much mucus, which blocks the passage of air when you breathe out. People with bronchitis often produce sputum, or phlegm. Physiotherapy is important to help clear secretions and prevent infective exacerbations or recurrent pneumonia.

Emphysema is a chronic disease of the lungs usually caused by long-term exposure to smoke or air pollution. If you have emphysema, the walls of the air sacs in your lungs are damaged. As they break down, normal lung is replaced by holes that enlarge and trap air.

Breathing becomes more difficult. A person feels like he or she is not getting enough air in or out, referred to as “air hunger” or “breathing through a straw”. This may be most noticeable with exercise. Severe emphysema can cause such debilitating breathlessness that simple activities of daily living become problematic. Emphysema is a progressive condition, with symptoms of air trapping more noticeable as individuals age.

Know the Symptoms of Emphysema / COPD

COPD symptoms often do not appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues. COPD diagnosis often surprises people. About half a million people in Ireland are estimated to have COPD, yet half with this condition are unlikely to know this:  in its early stages, COPD may not cause any symptoms, or they may be so mild that the individual does not notice them at first. The symptoms and severity of COPD can also vary from person to person. However, because the disease is progressive, symptoms often get worse over time. So know the state of your lungs by getting an emphysema index, calculated by performing a specialist software analysis of a CT ordering through LungCheck.

Early Symptoms of COPD Include:

At first, occasional shortness of breath may only occur after exercise, but as COPD progresses, the inability to catch your breath becomes more progressive after even mild exercise such as walking up a flight of stairs.

Recurrent chesty cough lasting longer than 3 months that may produce mucus (sputum). A recurrent cough is often one of the first symptoms of COPD.

Needing to clear your throat often, especially first thing in the morning but as the disease progresses leads to the need to clear mucus from your lungs every day.

Progressive Symptoms of COPD Include:

COPD symptoms do get progressively worse over time and becomes harder to ignore. As the lungs become more damaged, you may also experience:

Chest tightness.

Chest pain.

Lack of energy, tiredness. A person with COPD needs to exert extra effort to breathe.

Persistent wheezing.

Frequent chest infections & taking longer to recover.

Shortness of breath, after even mild exercise such as walking up a flight of stairs.

Unintended weight loss (in later stages).

Swelling in ankles, feet or legs from build up of fluid called oedema.

What is a COPD Exacerbation?

A COPD exacerbation, or flare-up, occurs when your COPD symptoms become much more severe than the usual and go beyond your day-to-day COPD symptoms. This may be caused by a viral of bacterial infection. As your lung function declines in the later stages of COPD, exacerbations tend to increase in frequency.

Disease Progression

Who is at Risk of Emphysema / COPD?

According to the WHO (World Health Organization), COPD (chronic obstructive pulmonary disease) is the fourth most common cause of death in the world.  Is estimated that up to 500,000 people have COPD in Ireland.

Specialist Screening Healthcare Ireland’s LungCheck service aims to offer a comprehensive screening service to smokers or ex-smokers to identify and treat symptoms of COPD.

Cigarette Smoking - Tobacco, Pipe & Cigar Smokers

Smoking is the biggest risk factor for the development of COPD (chronic obstructive pulmonary disease. Smoking cessation is crucial to improve quality of life, otherwise significant symptoms will develop between the ages of 40 and 60.

The LungCheck service offered by Specialist Screening Healthcare Ireland includes education on free smoking cessation supports to raise awareness of the health benefits in quitting smoking. Emphysema/COPD is a progressive disease. At any stage of COPD, quitting smoking can prevent further decline in lung function. When you stop smoking you will improve your breathing, reduce coughing and chest tightness, by bringing down inflammation in the airway.

The longer you smoke and the more packs you smoke, the greater your risk is of developing COPD. When a cigarette burns, it creates more than 7,000 chemicals, many of which are harmful. The toxins in cigarette smoke weaken your lungs’ defence against infections, narrow air passages, cause swelling in air tubes and destroy air sacs which are all contributing factors for the development of COPD.

Passive Smoking / Environmental Tobacco Smoke (ETS)

This is smoke that you unintentionally inhale from someone else’s cigarette, pipe or cigar. Being around secondhand smoke increases your risk of emphysema.

Long-term exposure to secondhand smoke (SHS) during childhood increases the risk of  COPD death in adulthood. New studies also suggests secondhand smoke exposure in adulthood increases the risk of death not only from COPD but also from ischemic heart disease and stroke.

Family History & Genetics

If you have a family history of COPD, your risk is further increased if you smoke or are exposed to secondhand smoke for a prolonged period of time.

Some people may develop some forms of COPD and emphysema despite never smoking or being exposed to environmental irritants. A small number of people have a rare form of COPD called alpha-1 antitrypsin deficiency (AATD). This is a genetic (inherited) type of emphysema that affects the body’s ability to produce a protein called Alpha-1 antitrypsin. This protein helps to protect the lungs.

Occupational Chemical Exposure to Dust & Fumes

Occupational exposures are important, preventable causes of COPD. Identification
of COPD high-risk jobs is key to focus preventive strategies, but a definitive job-list is unavailable.

Occupational asthma is now the most common form of occupational lung disease in industrialised countries. Wood dusts are a common cause of occupational asthma.

The European Respiratory Journal published a list of COPD risk occupations to help focus preventive strategies:

  • Sculptor, painter, engraver, art restorer.
  • Gardener, groundskeeper, park-keeper.
  • Food, drink and tobacco processor.
  • Plastics processor, moulder.
  • Agriculture and fishing occupations.
  • Warehouse stock handler, stacker.

Occupational exposure can be a key factor in never-smokers who have developed COPD. After smoking, being exposed to chemicals and substances such as coal mine dust, cotton dust, silica, and grain dust in the workplace, particularly long term, is among the leading causes of COPD.

LungCheck supports business owners and their employees by offering specialist diagnostics to exclude lung disease linked to occupational exposures. 

Long Term Exposure to Indoor & Outdoor Air Pollution

What you breathe every day at home and outside can play a role in developing COPD. The quality of the air we breathe is important to our health and well-being.

Indoor Air Pollution
Indoor air pollution includes particles from the smoke of solid fuel used for cooking and heating. Examples include poorly ventilated wood stoves, burning biomass or coal, or cooking with fire. The pollutants cause inflammation in the airways, leading to lung tissue destruction.

Because people with COPD spend much of their time indoors, it is extremely important to take steps to improve your indoor air quality. Get rid of dust mites by washing linens frequently and keeping pets off furniture. Be conscious of harmful household chemicals and choose natural products.

Outdoor Air Pollution
Outdoor pollutants such as fumes from power plants, fuel burning from vehicles and heavy machinery, burning diesel such as a car exhaust cloud can increase your risk of emphysema and developing COPD.

Older Age

Older age is a risk factor for emphysema. Lung function normally declines with age. Therefore, it stands to reason that the older the person, the more likely they will have enough lung tissue destruction to cause emphysema.

Frequent Lung Infections as a Child

Childhood illnesses (such as asthma, bronchitis, pneumonia, allergic rhinitis, eczema) and exposures to parental smoking are also linked as risk factors in developing COPD.

What Does LungCheck Screening for Emphysema / COPD Involve?

Specialist Screening Healthcare Ireland’s LungCheck service offers a comprehensive screening service providing specialist diagnostics with consultant specialist reporting to identify COPD lung disease in individuals of the community that fall into the high risk category.  LungCheck’s goal is to identify and slow down the progression of Emphysema/COPD lung disease.

  • Respiratory Rate (RR)
  • Oxygen Saturation (O2 Sats)
  • Pulmonary Function Tests (PFTs)
  • CT Chest Screening
  • StratX Lung Analysis (if clinically indicated from CT report)
  • Smoking Cessation Supports +/- Referral to Tobacco Cessation Specialist
  • Exercise for Wellness +/- Referral to Pulmonary Rehabilitation

Are you at increased risk of developing Emphysema/COPD?

Consider LungCheck with Specialist Screening Healthcare Ireland.