The COPD Stigma
For the vast majority of people, when they hear the words "COPD" they automatically think "they must be a smoker." While smoking is the leading cause of COPD, it isn't always the case.
What is stigma?
Stigma is defined as a mark of disgrace associated with a particular circumstance, quality, or person. Stigma occurs when society labels someone as tainted, less desirable, or handicapped. When I tell people I have asthma/COPD overlap, I am always then asked if I am a smoker. When I reply with a simple "no, I have never smoked" I get a puzzled look or a "huh? How is that possible?"
As I stated above, while smoking is the leading cause of COPD, 25% of COPD sufferers have never smoked. The other 25% of people have COPD as a result of occupational, environmental, and genetic factors. Due to the smoking stigma, many people with COPD suffer in silence, whether or not they have smoked.
For a very long time I kept my diagnosis in the closet. It was so much easier to just tell people that I have asthma, rather than explaining that I also do in fact have COPD. I received my COPD diagnosis at the age of 25. It was a major blow to hear that news, especially being a Respiratory Therapist and knowing what I do about the lungs. I had recently given birth to my first child and now getting the news that my lungs were essentially in a fixed state and those of an 80 year old was terrible.
I wanted to spend some more time focusing on the other 25% of the causes of COPD. With over 11 million people in the United States diagnosed with COPD, 25% is 2,750,000 people. That is almost 3 million people with COPD who have never smoked a day in their life.
Workplace exposure
There are many careers that have a significant amount of exposure to lung irritants. Some of these being careers in the coal industry, grains, chemicals, and jobs that have excessive exposure to dust etc. Miners and textile workers being in the the higher risk of developing COPD category.
Genetic factors
A small number of COPD patients suffer from a genetic imbalance called alpha-1 antitrypsin deficiency which is a protein that normally protects the lungs against various enzymes that naturally occur in the body.
History of asthma
There are more recent studies that suggest that some childhood asthma sufferers develop COPD later in life. The repetitive lung inflammation over the years which leads to weakened lungs can lead to a higher risk of getting a severe obstruction of the airways.
Air Pollution
Living in places with higher than average air pollution can lead to COPD. Not only outdoor pollution in highly populated areas with a lot of motor vehicle exhaust, but also in homes who use wood to heat (in a non sealed fireplace or stove) or open cooking fire smoke more commonly found in developing countries.
Regardless of the cause of a person's COPD, there shouldn't be a sense of shame surrounding it. There is a definite lack of education surrounding COPD as a whole due to the COPD stigma. It's up to us to start the dialogue to transform those who are misinformed.
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