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The COPD capital of the world

India is the capital of the world when it comes to chronic obstructive pulmonary disease (COPD), but awareness is low. 

COPD refers to a number of progressive lung diseases, hallmarked by worsening damage to the lungs over time. Cases of COPD have increased sharply in India in recent decades, increasing from 28.1 million cases in 1990 to 55.3 million cases in 2016. The disease kills more than a million people every year. 

Historically, COPD has been regarded as a disease of smokers but this is no longer strictly the case in India: rising levels of air pollution are driving an uptick in COPD cases among people who have never used tobacco. “It is reported, at least one-fourth of patients suffering from COPD had never smoked,” Dr Sundeep Salvi, director of the Pune-based Chest Research Foundation, said at the recent Health Convention in Delhi. “A Burden of Obstructive Lung Disease (BOLD) study also reports of a high prevalence of COPD in non-smokers.” 

This trend is apparent across the spectrum of lung conditions. Lung cancer cases are spreading rapidly among non-smokers. Research suggests that long-term exposure to air pollution ups the risk of developing emphysema in a similar way to smoking. 

India is home to seven of the world’s ten most polluted cities, making rising rates of lung conditions such as COPD unsurprising. However, what is also concerning is the low awareness of the disease. 

According to a report in The Economic Times, 99.15 percent of people have never heard of the term COPD. For Dr Salvi, this must be addressed in-line with efforts to expand treatment in the form of a National Control and Prevention programme. 

“The programme should be entitled towards early diagnosis of COPD and correct use of Spirometry [the most common lung function test for COPD diagnosis], Dr Salvi said. Other focuses should include “preventing COPD by reducing exposures to risk factors, right treatment by inhalation medicines as they are safe and very effective and finally treating it better by making drugs available, affordable and accessible.”

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