This story is from June 18, 2019

Chronic obstructive pulmonary disease caused by air pollution: Study

Chronic obstructive pulmonary disease (COPD) is predicted to become the third leading cause of death by 2030. Low and middle-income countries shoulder much burden of COPD and it is a major public health problem in India.
Chronic obstructive pulmonary disease caused by air pollution: Study
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CHANDIGARH: Chronic obstructive pulmonary disease (COPD) is predicted to become the third leading cause of death by 2030. Low and middle-income countries shoulder much burden of COPD and it is a major public health problem in India.
However, current prevalence pattern of COPD in India is not well understood. The study on COPD in the industrial town of Ludhiana in Punjab, where one of the leading risk factors was found to be air pollution, was conducted by Arun Sharma, Narinder Kumar Saini, Harshita Kelkar of department of community medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi and Om Prakash Kalra, vice-chancellor of Pandit Bhagwat Dayal Sharma, University of Health Sciences, Rohtak.
The outcome of the study which was started in 2011 has been made public recently.
Studies carried out in small geographical areas can help to determine the local prevalence and locally existing risk factors of a disease. In this study, all households were screened in each of the identified colonies using a structured questionnaire for identifying probable cases of COPD based on the Global initiative for chronic obstructive lung disease criteria and then confirmed by spirometry. The study was approved by the Institutional Ethics Committee for Human Research of the University College of Medical Sciences.
“Residential colonies were identified in an industrial and non-industrial area and all households were screened for COPD using the Global initiative for chronic obstructive lung disease criteria and confirmed by spirometry. Information about exposure to possible risk factors was also collected from suspected cases of COPD. Cases were mapped on a digital map of the city and hotspots were identified.
As a result, 56 cases of COPD were detected. More than half (71%) were in the industrial area. The overall prevalence rate of COPD in the city was 3.17 per 1000. The highest prevalence (5.6-9.4 per thousand) was observed in the colonies of the industrial area. All surveyed colonies in the non-industrial area showed a low prevalence (0.0 to 0.9 per thousand),” Dr Sharma told TOI. He further added that spots of COPD were located in the industrial area and there was no such aggregation in the non-industrial area.

The study mentioned that smoking and ambient air pollution are major risk factors for COPD. For the purpose of establishing associations, longitudinal studies are required to examine levels of PM2.5, sulfur dioxide and nitrogen oxide with real-time data along with incidence data of COPD. A strength of the present study is that it provides important baseline data as there are no previously published community-based studies showing the prevalence of COPD in Ludhiana.
Besides the geographical factors, they also found socio-economic determinants. “Poor people or workers who lived in an industrial area were living in a polluted environment. Owing to their financial constraints, they most of the time live in poorly ventilated rooms, especially women suffering the most by inhaling the smoke arising from cooking with wood and coal as fuel in these dingy houses. They also lack a good nutritional diet to keep the diseases at bay. These factors further augment the risk of diseases in the population in industrial pockets than those in non-industrial, “ Dr Sharma added.
As the poor people find it difficult to bear the treatment expenditure, he recommended that the governments to come forward in extending subsidy benefit for the payment of insurance premium which is likely to go high for the pre-existing diseases, making it difficult for poor people to pay.
No insurance scheme to cover healthcare of people suffering from various diseases due to air pollution, barring cancer, ” said Ved Pal, LIC development officer, Chandigarh.
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