Who Is at Risk for COPD?

Chronic obstructive pulmonary disease is also known as COPD. COPD is a chronic lung disease that results from damaged lungs and airways. COPD develops slowly over time.^1,2

Smoking is the most common cause of COPD in the United States. But there are several other possible causes of COPD. Worldwide, smoking accounts for only about half of COPD diagnoses.^1,2

Risk factors for COPD

Several behaviors and things in your environment can increase your risk of developing COPD. Some of these risk factors are avoidable. Others are not. Avoiding the risk factors you can may lower your risk of developing COPD.^2,3

Smoking and secondhand smoke

In high-income countries like the United States, smoking causes COPD in about 7 out of 10 people. This is because cigarettes and other tobacco products contain chemicals that can:^1,2

• Damage the air sacs in the lungs
• Lead to swelling in the airways
• Weaken the lungs’ defense against infection

Pregnant people who smoke put their babies’ health at risk. Smoking affects the developing fetus’ lungs and immune system. This can increase their risk of health problems later in life.¹

Also, smoking indoors puts the entire household at risk. This is because long-term exposure to secondhand smoke can lead to respiratory problems, including COPD.^1,3

Both people who currently smoke and those who used to smoke can develop COPD. Not all smokers will develop COPD. But smoking is the main cause of COPD, and it is an avoidable risk factor.^1-3

Indoor and outdoor air pollution

Another common cause of COPD is air pollution. Air pollution can occur inside or outside. It poses an especially large risk to people who live in lower-income countries or households. It is also more dangerous for people who live with other COPD risk factors.^1,2

Indoor air pollution can result from burning coal, wood, or other organic matter for heat or cooking. When burned without proper ventilation, these materials produce smoke and other small particles that can damage the lungs. Secondhand smoke is another form of indoor air pollution.^1-4

Outdoor air pollution can result from cars, factories, power plants, and wildfires. If you live or work around these sources of pollution, especially over a long time, your risk of lung problems increases. If you already have COPD, poor air quality can raise your risk of:^1,2

• Disease flares
• Hospitalization
• Death

Work-related toxin exposure

Certain work environments may expose you to chemical fumes, dust, or other toxins that can damage your lungs over time. Up to 1 in 5 cases of COPD stem from workplace exposures.^1-4

For example, agricultural workers who inhale large amounts of pesticides have higher rates of COPD and other lung problems. And construction workers who regularly inhale dust on construction sites also have higher rates of COPD than workers who do not.^1,5

History of asthma

About 1 out of every 5 people with COPD also lives with asthma. One long-term study showed that adults with asthma were 12 times more likely to develop COPD later in life. Childhood asthma also increases a person’s risk of developing COPD as an adult.^1,4,5

Genetic factors

Researchers are still learning about all the ways that genetics might affect COPD risk. People who have a parent or sibling with COPD have higher rates of the disease. But this is also due, at least in part, to environmental factors like secondhand smoke.^1,5

Experts have found links between changes (mutations) in certain genes and increased COPD risk. These changes can be passed down through families. The most clear genetic change related to COPD results in a condition called alpha-1 antitrypsin (AAT) deficiency.^1-4

In AAT deficiency, your body does not produce enough AAT. AAT is a protein that helps protect the lungs from damage. People with AAT deficiency are more prone to lung damage from causes like smoking and air pollution. Some people with AAT develop COPD with no other risk factors. Experts estimate that as many as 100,000 people may live with AAT deficiency.^1-4

Other risk factors

Your risk for COPD may be higher due to other factors as well. Most of these are not avoidable, but it is important to be aware of them:^1-5

• Age – Most people diagnosed with COPD are over age 40. Older age increases your risk, especially if you have other COPD risk factors.
• Sex – While overall COPD rates are higher for men, the disease may be more severe in women. Women also may begin to have symptoms earlier than men. Women are at particular risk for COPD stemming from household air pollution.
• History of respiratory infections – Having multiple respiratory infections during childhood increases your risk of developing COPD as an adult.
• Other infections – Having HIV or tuberculosis (TB) increases your risk of developing COPD.
• Underdeveloped lungs – Fetal or childhood diseases that prevent the lungs from developing properly can increase COPD risk.
• Socioeconomic status – Having a lower income or belonging to a disadvantaged community can put you at higher risk for COPD. The increased risk may stem, in part, from a lack of access to quality healthcare.

What to do if you are at risk

The best way to help prevent COPD is to quit smoking if you smoke. This includes e-cigarettes, pipes, cigars, and marijuana or cannabis. Your doctor or the American Lung Association can give you helpful advice and resources for quitting.^1-3

Even if you have already been diagnosed with COPD, it is important to not smoke. People with COPD who smoke have a higher death rate than people with COPD who do not smoke.¹

Also, take action to prevent respiratory infections like colds and flu. These infections can damage your lungs and often lead to COPD flare-ups, which can be dangerous. Preventive actions you can take include:^3,6

• Getting all available vaccines
• Wearing a mask in large crowds
• Avoiding crowds during cold and flu season

Finally, avoid chemical or smoke exposure at home and at work as much as possible. Try wearing protective gear or limiting your time inside. Make sure any wood or coal-burning stove vents the smoke outdoors. And follow any safety training your employer provides.²