Widespread tobacco smoking and the use of fuels such as wood and coal are a major cause of Chronic Obstructive Pulmonary Disease (COPD). The disease poses a major health hazard and unfortunately remains largely under-diagnosed and under-treated in Pakistan. This was the consensus opinion of experts gathered at a collaborative seminar organised by Aga Khan University and the National Alliance for Tobacco Control. The Seminar was held at Aga Khan University to commemorate World COPD Day.
“COPD affects more than 340 million people and is one of the leading causes of death worldwide,” said Professor Nadeem Rizvi, President Pakistan Chest Society and Head Department of Chest Diseases, JPMC, Karachi. Elaborating on the risk factors, Professor Javaid Khan, Head, Section of Pulmonolgy, AKU and Chair National Alliance for Tobacco Control, said that smoking is a major risk factor for the disease.
“Significant societal and quality of life benefits could be achieved if greater steps were taken to prevent the condition, such as greater access to smoking cessation programmes, earlier diagnosis and appropriate management strategies to control the condition and slow down the spread of the disease,” explained Professor Khan.
COPD can occur due to second-hand smoke and the trend of shisha smoking among the youth of Pakistan could result in exponential increase in the number of cases of COPD in the country, warned Professor Khan. He called for the implementation of clean air laws in the country similar to the Sindh Assembly resolution passed earlier this year banning the use of shisha in restaurants.
The use of biomass fuel like wood and coal in cooking is another important cause for this disease especially for women living in rural areas.
Ms Bushra Masood a “smoking cessation” expert from UK said that quitting smoking is the best way to prevent the disease. Unfortunately most patients visit their doctors very late when severe damage to the lungs has already been done. Smokers should seek help from smoking cessation experts, who could not only share with them some practical tips on how to quit smoking but also how best to utilise new medicine designed to help with quitting.
Talking about diagnosing COPD, Dr Hashir Majid, Assistant Professor, Section of Pulmonology and Critical Care Medicine, AKU said that the most important early symptom of this disease is a persistent cough, accompanied by sputum. As the disease advances the person starts to experience shortness of breath even after the slightest exertion. If COPD is detected early, treatments are available to prevent further deterioration of this condition, he added.
Ms Sunbul Sultana, Staff Technologist, Cardiopulmonary Diagnostic Services, AKUH spoke about the value of pulmonary function tests such as spirometry, a simple test which measures how fast air can move in and out of the lungs as well as how deeply a person can breathe, which is extremely helpful in diagnosing COPD at a very early stage.
Speaking of the devastating impact on the quality of life for patients, Dr Murtaza Kazmi, Critical Care Specialist, AKUH said that a comprehensive pulmonary rehabilitation programme which includes patient and family education, exercise as well as psychosocial counselling can help improve the quality of life of COPD patients.