This presentation provides a comprehensive overview of Chronic Obstructive Pulmonary Disease (COPD), covering its causes, symptoms, diagnosis, and management strategies. It is designed for healthcare professionals, students, and patients interested in understanding COPD. The slides discuss risk factors such as smoking and air pollution, common signs like chronic cough and breathlessness, diagnostic methods including spirometry, and current approaches to treatment and care. Whether you are studying respiratory medicine or seeking practical guidance, this presentation aims to deliver clear and concise insights into COPD and how it can be managed effectively.

2. • INTRODUCTION
• EPIDEMIOLOGY
• RISK FACTORS
Abisha Gautam
Ashmita Dhital
Ayush Labh
Jagriti Khanal
Raju Raj Shakya
Sajina Nepal
Suhana Sigdel

3. Introduction
• COPD is a disease characterized by persistent airflow limitation
• It is usually progressive, and associated with an enhanced chronic
inflammatory response in the airways and the lung to noxious particles
or gases
• COPD is defined as a preventable and treatable disease characterised
by persistent airflow obstruction that is usually progressive and
associated with an enhanced chronic inflammatory response in the
airways and the lung to the noxious particles or gases.
- Davidson’s Principles and Practice of Medicine (22nd
edition)
• It includes Chronic bronchitis and emphysema

5. Introduction
• COPD is preventable and treatable disease.

6. Epidemiology
• In 2005, COPD contributed to more than 3 Million deaths (5% of
deaths globally)
• In 2020, it is the third most important cause of death worldwide
• The World Health Organization (WHO) reports that 90% of COPD-
accounted deaths occur in low- and middle-income countries

7. Epidemiology
• Low and middle Income countries

8. Epidemiology
• Prevalence of COPD is directly directed to the prevalence of tobacco
smoking

9. Epidemiology
FIG: Prevalence of chronic bronchitis in relation to active smoking, stratified by age. : nonsmokers;
□
: 1–10 cigarettes per day; : 11–20 cigarettes per day; : >20 cigarettes per day
▒ ░ ▪
https://err.ersjournals.com/content/18/114/213.figures-only

10. • Use of Biomass fuels

11. Epidemiology In Nepal
• In Nepal, COPD bears the patient load of 43% of all non-
communicable diseases and also accounts for 2.56% of total
hospitalization.
• This situation is aggravated in the case of Nepal, since almost 85% of
households still rely upon biofuels such as wood and others to cook
for their meal, thus making Nepalese women more prone to the
development of COPD due to indoor air pollution.
• The situation is made worse by the fact that health literacy among our
people is not so high as compared to the developed western
countries.
https://www.clinicone.com.np/copd-cases-in-nepal/

12. Epidemiology in Nepal
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810531/

13. Epidemiology in Nepal
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810531/

14. Risk Factors
• Environmental Factors
‐ Tobacco Smoking: accounts for 95% cases.
‐ Ambient air pollution: eg: cooking with biomass fuels.
‐ Occupational exposure: coal dust , silica, cadmium etc.
‐ Premature birth: low birth weight increases risk of COPD.
‐ Infections: exacerbates the inflammation.
‐ Passive smoking: exposure of children to maternal smoking
reduces lung growth.

15. Risk Factors
• Host Factors
‐ Genetic susceptibility: α1-antitrypsin deficiency and
alterations in other genes like : HHIP, FAM13A, and IREB2.
‐ Airway Hyper-reactivity: many asthma patients are seen to
develop COPD.