Chronic Obstructive Pulmonary Disease (COPD) is a long-term lung disease characterised by persistent airflow obstruction. It affects millions of people worldwide and is mainly associated with tobacco use. COPD is more prevalent in people who smoke or who have a history of long-term smoking.
Early symptoms may be mild, such as the so-called “smoker’s cough” or feeling tired after minor physical activity.
COPD primarily includes chronic bronchitis and emphysema, and the condition can gradually worsen if not properly diagnosed and treated. Early identification of symptoms and reducing risk factors are essential to slow the disease’s progression and improve quality of life.
Tobacco as the primary (and preventable) cause
Approximately 90% of COPD cases are directly linked to active smoking. Each puff damages the bronchi and alveoli, causes chronic inflammation, destroys lung tissue, and increases mucus production.
Exposure to second-hand smoke and air pollution may also contribute, although to a lesser extent.
Stopping smoking is the most effective way to slow disease progression and improve response to treatment, regardless of the stage of the condition.
Who is at greater risk of developing COPD?
COPD affects both men and women. Although it was once more common in men, increasing smoking rates among women have now narrowed the gap. Groups at higher risk of developing COPD include:
- People over 40 years old with a history of smoking.
- Current or former smokers with a smoking history exceeding 10 years.
- People prone to frequent respiratory infections or bronchitis.
- Workers exposed to dust, gases, or chemicals without adequate protection.
Early diagnosis allows timely treatment and can improve disease progression.
In Spain, it is estimated that up to 70% of people with COPD are undiagnosed, delaying the start of treatment.
COPD management includes adopting personalised healthy habits, such as supervised physical activity, avoiding polluted environments, and maintaining a balanced diet. Adhering to treatment and receiving psychological support—especially to quit smoking—are key to achieving better outcomes.
Can people who have never smoked develop COPD?
Yes, it is possible to develop COPD even if you have never smoked. Although tobacco smoke is the main risk factor, other factors can cause the disease in non-smokers.
The main factors include:
- Outdoor air pollution: Long-term exposure to pollutants is linked to a higher risk of developing COPD.
- Indoor air pollution: Smoke from solid fuels (such as wood, coal, or biomass) used for cooking or heating.
- Respiratory infections: Certain infections can increase the risk of COPD.
- Genetic factors: For example, alpha-1 antitrypsin deficiency, a hereditary disorder that reduces the lungs’ natural protection and increases COPD risk.
Long-term exposure to these factors, together with work-related risks and genetic predisposition, can lead to develop COPD in people who have never smoked.
Do pollution and work-related factors increase the risk of COPD?
Both pollution and work-related factors have a significant impact on COPD. After tobacco use, air pollution is the next most important factor in its development.
The impact of pollution:
Long-term exposure to pollutants such as fine particles (PM2.5) and nitrogen dioxide (NO₂) is linked to a higher risk of developing COPD.
High levels of pollution can also worsen symptoms, reduce lung function, and increase the risk of hospitalisation.
The impact of work:
Exposure to dust, gases, vapours, or harmful chemicals at work is also a major risk factor for developing COPD.
Reducing exposure and adopting protective measures can help reduce this risk. The use of masks, along with ventilation or air purification systems, can help protect the respiratory system.
Which exercises are safe for people with COPD?
It is recommended to follow a programme that includes aerobic exercise, strength training, and flexibility exercises to improve functional capacity and quality of life.
The most recommended exercises are:
Aerobic exercises
- Walking: The easiest and most effective way to increase endurance.
- Stationary cycling: A safe alternative for aerobic training.
- Interval training: Alternating short periods of exercise with rest can be effective for patients limited by symptoms.
Strength training
Improves muscle strength and makes daily activities easier. It can be done using:
- Light weights
- Resistance bands
- Bodyweight exercises, such as squats or climbing stairs
Essential safety measures during exercise
To ensure that physical activity is safe for people with COPD, the following precautions are recommended:
- Monitor oxygen saturation and keep it above 88–90%.
- Adjust the intensity of exercise based on the level of breathlessness.
- Carry out an initial assessment and adapt the exercise programme to each person.
