Understanding COPD Risk Factors
We know definitively that smoking causes COPD, as well as exposure to certain environmental factors and having an alpha-1 antitrypsin deficiency.
There are also other factors that appear to increase the odds of developing COPD:
- The risk for COPD increases with age, and it is most common over the age of 40.
- Family history. People with a family history of COPD appear to have a greater risk of developing this condition, regardless of their smoking status.
- Former smokers. Even if you have quit smoking, your risk of COPD is increased. This risk is intensified if you began smoking in your teenage years.
- People who began smoking during their teenage years.
- People who had mothers who smoked while they were in utero.
- People who had frequent illnesses as a child.
- People who experienced a history of childhood respiratory infections.
How Is a Diagnosis of COPD Made?
According to Mayo Clinic, COPD is often misdiagnosed. For example, "former smokers may sometimes be told they have COPD, when in reality they may have simple deconditioning or another less common lung condition.”
Unfortunately, many people are also not diagnosed until later stages of their disease process, when it becomes more difficult to treat and the medications become less effective.
When your physician suspects a diagnosis of COPD, your physician will initially review your symptoms, discuss your medical history (as well as your family history), and discuss exposure to chemicals and irritants – especially cigarette smoke. Then, she will likely order diagnostic tests.
Pulmonary Function Test
A pulmonary function test is the gold standard when it comes to diagnosing COPD; it measures the amount of air that you inhale and exhale, and can detect COPD even before you have symptoms of the disease.
During a pulmonary function test, or PFT, you’ll be asked to blow into a tube, which is connected to a small machine – the spirometer. The spirometer measures your lung capacity and how fast you can blow air out of your lungs.
PFTs not only help with diagnosis but they can also track the progression of a lung disease and monitor how well a therapy is working.
Other Diagnostic Tests for COPD
A chest x-ray can detect emphysema, as well as rule out other lung problems, such as heart failure.
A CT scan can also detect emphysema, and may determine if surgery would be beneficial. A CT scan is also used for lung cancer screenings.
Arterial blood gas analysis is a blood draw that measures how well the lungs are bringing oxygen into the blood, as well as removing carbon dioxide. This blood draw is typically drawn from an artery in your wrist.
Other lab tests can’t diagnose COPD, but they may be used to rule out other conditions. A lab test can also detect alpha-1 antitrypsin deficiency. This test is often performed on someone who has a family history of COPD and develops COPD under the age of 45.
What are the Stages of COPD?
Like many other chronic conditions, COPD is staged to describe the severity of your condition. The classification system used to stage COPD is the GOLD staging or grading system.
The GOLD is an acronym for the Global Initiative for Chronic Obstructive Lung Disease; the National Heart, Lung, and Blood Institute, National Institutes of Health, and the World Health Organization created this initiative in 1997.
GOLD’s goal was to raise awareness for COPD, to improve treatment, and to improve prevention. Ultimately, the GOLD staging system was born, which allows physicians to classify COPD in a consistent manner.
The GOLD staging system used to use the term “stage” but now uses the term “grades” and is based on the following criteria:
- The severity of your current symptoms
- Spirometry results
- The chances that your COPD will worsen
- The presence of other comorbid conditions
Based on the above criteria, plus a questionnaire that your physician will have you fill out, you will be placed into one of the following “groups”:
- Group A: low risk, fewer symptoms
- Group B: low risk, more symptoms
- Group C: high risk, fewer symptoms
- Group D: high risk, more symptoms
A Breakdown of Each COPD Stage
The GOLD criteria is one way to stage COPD. We can also label COPD by stages, which is what most people are used to hearing when discussing a chronic condition:
- Stage I; this stage is considered the most mild form of COPD. Often, in this stage, there are little to no symptoms present. If symptoms are present, a mild cough may begin that is thought of as a “smoker’s cough” that is merely annoying. At this point, COPD is very treatable, but most people do not realize that they have it.
- Stage II; this stage is considered moderate COPD. This is the stage that most people are diagnosed with COPD. Why? Because symptoms have become bad enough for them to realize that there is an issue – symptoms have begun to interfere with daily life. It is estimated that by the time stage II occurs, lung function is approximately 50 percent to 80 percent.
- Stage III; this stage is considered severe COPD. Serious breathing issues are occurring now that greatly affect a person’s quality of life. A person may require a large number of medications, as well as oxygen therapy. It is estimated that by the time stage III occurs, lung function has diminished to 30 percent to 50 percent.
- Stage IV; this stage is considered very severe COPD, or “end-stage” COPD. Exacerbations may become frequent, and symptoms are severe. Hospitalizations can become regular. Maintaining regular activity can become difficult, because activity can worsen breathing. Lung function is estimated to be less than 30 percent.
