Chronic obstructive pulmonary disease (COPD) claims nearly a million lives per year in India alone yet still remains a relatively unknown condition in the country.
COPD is India’s second most common cause of death, accounting for thirteen percent of all deaths in the country according to studies from 2018. Despite such a high burden, it is given little public attention and its public profile pales in comparison to diseases such as diabetes and cancer.
Tobacco is thought to be one of the main causes of the disease, though is only thought to account for around a quarter of all disease instances in India. The most common cause of the disease is pollution, presenting a dire situation for India.
Recent studies indicated that even a short stay of only a week in an Indian city blighted by high levels of pollution was enough to cause damage to the lungs. This damage was found to be reversible, though, with a stay of extended duration, the damage accumulates. This carries dire implications for the health of the city’s residents.
Such is the case for COPD, which is a broad classification encompassing a number of lung conditions each caused by chronic exposure to lung irritants and toxins. The condition is chronic and worsens over time. For many in Indian cities, there is no escaping the air pollution, with the economic incentives of living in a city necessitating they remain in an environment that is detrimental to their health.
This is not to suggest that rural residents are immune from the disease. The opposite, in fact, is true. Household biomass fuel burning, such as the use of wood stoves, accounts for a significant portion of the COPD burden. Rural environments make common use of wood burners in enclosed spaces in order to cook, creating a source of concentrated pollution within the household. Indeed, 75 percent of pollution-related deaths occur in rural areas.
What makes COPD concerning is the rate at which cases are increasing. The number of cases of COPD in India increased from 28.1 million in 1990 to 55.3 million in 2016, according to a study published in The Lancet. Of the disability-adjusted life-years (DALYs) due to COPD in India in 2016, 53.7 percent were attributable to air pollution. 25.4 percent could be ascribed to tobacco use and 16.5 percent to occupational risks.
Efforts can be made to reduce disease incidence, with some paths of action more simplistic than others. Curbing smoking rates is a start, and would reduce disease instance considerable for both COPD and numerous cancers. Other factors such as pollution are a far more difficult and long-term issue to address. This should not be a cause for complacency, however: finding a sustainable solution to air pollution would provide benefits that far exceed the single aspect of reducing instances of COPD.