COPD: What we know about the disease that killed a million Indians in 2017

Levels of air pollution have risen dramatically over the last two to three decades. That has had a major impact on COPD.

Chronic Obstructive Pulmonary Disease (COPD) was the second highest cause of death in India after heart disease in 2017, killing 1 million (958,000) Indians that year, according to University of Washington’s Global Burden of Disease study, 2018.

COPD led to 13% of all deaths in India, and 7.5 million were at risk of the disease in 2016, IndiaSpend reported in January 2018.

COPD is an incurable and progressive condition, which inflames airways in the lungs and destroys air sacs, which extract oxygen from the air and expel waste, including carbon dioxide. Patients often cough, wheeze and are short of breath.

(Business Standard)

COPD can be caused by long-term exposure to lung irritants and toxins in the air. In the West, a majority of COPD cases are caused by smoking tobacco, but in the developing world, including India, most COPD cases spring from exposure to indoor and outdoor air pollution, particularly burning biomass, from wood to cow dung.

Knowledge about non-smoking risk factors for COPD is only about a decade old, and one of the researchers instrumental in proving India’s burden is primarily because of burning biomass for fuel is Sundeep Salvi, 53, Director of Chest Research Foundation (CRF) in Pune, which he helped establish.

CRF is a leading research institute dedicated to research on chronic respiratory diseases, especially COPD and asthma. The 30-member team of researchers at CRF collaborates with international institutes, including Imperial College in the UK, Johns Hopkins University and Massachusetts Institute of Technology in the USA, and McMaster University, Canada.

Salvi is also a member of Global Initiative for Obstructive Lung Disease, founded by the World Health Organization and national health institutes in the USA, to improve diagnosis and treatment of COPD, and is a fellow and visiting faculty of Imperial College, London and John Hopkins University in Baltimore.

Salvi talked to IndiaSpend about the under-diagnosis of COPD in India, the implications of rising air pollution in India’s cities for COPD risk, and the need for a multi-pronged policy approach. Excerpts.