What is COPD

Chronic obstructive pulmonary disease (COPD) is a progressive lung condition characterised by airflow limitation due to airway and lung abnormalities. The disease comprises chronic bronchitis and emphysema, sometimes together. COPD is characterised by persistent respiratory symptoms, including breathlessness, chronic cough, increased sputum and reduced exercise tolerance. Asthma is not a form of COPD.

An estimated 2.4 million Australians live with COPD. It is the fifth leading cause of death and a major contributor to disability. Prevalence is highest in adults over 40 and is higher in regional and remote areas, where smoking rates are elevated and occupational exposures are more common.

COPD is a progressive condition that typically develops over many years. Subtle symptoms in the early stages may be attributed to ageing or poor fitness. As COPD progresses, breathing difficulties become more pronounced and significantly impact daily activities and quality of life. COPD is not curable or reversible, but its progression can be slowed with appropriate management and treatment.

Risk factors

Smoking is the primary risk factor and is responsible for 70-90% of COPD cases in Australia. This includes active smoking and sustained passive smoking exposure. Risk increases with pack-years of smoking (a unit of measuring tobacco smoking).

However, some long-term smokers never developed COPD while others developed it over the short term, indicating potential genetic susceptibility. Occupational exposure is the second most significant risk factor and accounts for 10-20% of COPD cases.

High-risk occupations include mining, construction, agriculture, manufacturing and any work involving dust, chemical fumes or vapours.

Genetic factors, such as alpha-1 antitrypsin deficiency - a condition that affects 1 in 2000 Australians - and other genetic variants that influence lung development, function, and response to environmental factors increase the risk.

A family history of COPD also increases risk.

Impact on the Workplace

Physical Activity

Physical activity is essential for managing COPD. It improves exercise tolerance, reducing breathlessness during daily activities, and slows the progression of COPD. Regular aerobic exercise strengthens respiratory muscles, reduces fatigue, and helps maintain independent living. COPD may limit exercise capacity, but even light physical activity can assist management of severe COPD.

Muscle-strengthening

Muscle-strengthening exercises are beneficial as strength training improves functional capacity, reduces fatigue and maintains independence in daily activities. Upper body strength training specifically assists with breathing mechanics.

Sedentary Behaviour

Sedentary behaviour accelerates deconditioning, which rapidly occurs in COPD, creating a cycle whereby decreased physical activity leads to further fitness decline and increased breathlessness. In turn, this makes future physical activity more difficult to complete.

Fruit & Vegetable Intake

Fruit and vegetable intake provide vitamins, minerals and antioxidants that support immune function and may reduce lung inflammation. A healthy diet generally supports overall health maintenance for those living with COPD.

Sugar & Saturated Fat

Added sugar and saturated fat intake are essential for managing body weight and COPD: both underweight and overweight and obesity impact breathing mechanics and disease progression.

Managing Alcohol Intake

Excessive alcohol intake suppresses immune function, increases infection risk and can interfere with medications commonly prescribed to manage COPD.

Mindfulness practices

Mindfulness practice can assist with managing anxiety and panic associated with breathing difficulties, which often worsen COPD symptoms. Chronic breathlessness creates anxiety, which further impairs breathing, and creates an escalating cycle that can be helped with mindfulness.

Controlled Breathing

Controlled breathing techniques are essential tools for managing COPD. Pursed-lip breathing and diaphragmatic breathing improve breathing efficiency, reduce breathlessness and provide active strategies for managing symptoms during acute episodes.

Sleep habits

Sleep habits are essential to optimise sleep quality and duration. COPD often disrupts sleep at night, which then exacerbates daytime symptoms alongside reduced ability to cope with breathlessness and fatigue.

Impact of TENSH Habits

COPD is associated with increased absenteeism and presenteeism, particularly as the condition advances. Progressive breathlessness limits physical work capacity and requires job modifications.

Workplaces can support workers living with COPD by implementing proper ventilation and filtration systems to improve air quality, eliminating or controlling respiratory irritants, and offering flexible working arrangements during periods of high pollution or other symptom exacerbations. The identification and control of respiratory hazards is fundamental to comply with duties under workplace health and safety legislation. If workers are exposed to respiratory hazards, controls must be implemented, which may include engineering controls, personal protective equipment and health monitoring.

Chronic Obstructive Pulmonary Disease