What Causes COPD?

Category: News

radiological chest x-ray film

According to the Centers for Disease Control, COPD, or Chronic Obstructive Pulmonary Disease, is the fourth leading cause of death in the United States. More than 15 million Americans are affected by COPD, and more than 150,000 Americans die due to COPD annually. That is one death every 4 minutes. COPD refers to a group of respiratory diseases such as chronic bronchitis and emphysema. COPD primarily affects middle-aged and elderly individuals; however, that does not mean that atypical cases in younger individuals do not occur. 

The primary cause of COPD is first- or second-hand tobacco smoke exposure. Tobacco smoke is considered to be the cause of 9 out of 10 cases of COPD. Although tobacco smoke is the most common cause, it is not the only cause. Air pollutants, fumes from work, and genetics can play a role in COPD formation as well. 

The American Lung Association states that some risk factors for developing COPD that are not from tobacco use are:

  • Air pollution exposure
  • Working with chemicals, dust, and fumes, generally in the workplace
  • Some genetic conditions, such as Alpha-1 deficiency
  • A history of respiratory infection in childhood

Individuals suffering from COPD are at a higher risk of developing other health concerns as well. Comorbid conditions have been found to occur at a higher rate in individuals with COPD than in individuals diagnosed with other medical concerns. It is common for individuals with COPD to also suffer from:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Diabetes
  • Osteoporosis
  • Depression
  • Arthritis
  • Sleep Apnea
  • Cancer
  • Other medical problems

Some experts believe that these higher rates of comorbidity are due to the inflammation of the lungs and in the blood. There is evidence to support that this inflammation can cause some damage to the heart, muscles, and bones of individuals with COPD. 

There are some things you can do to limit your risk of developing COPD and effective management:

  • Stopping smoking is the number one way to prevent COPD.
  • Early diagnosis is instrumental in symptom management and slowing the progression of the disease. 
  • Vaccination and prevention of infections: 
    • Influenza vaccine
    • Pneumococcal vaccine
    • Antibiotics
  • Environmental protection
    • Promote good airflow in your environment
    • Use pump sprays
    • Do not use plug-in air fresheners
    • Implement more natural cleaners
    • Avoid shaking out rugs, vacuuming, sweeping, and dusting
    • Change filters in dryers, refrigerators, furnaces, and heating vents often
    • Limit fireplace usage
    • Limit the use of sponges or replace them frequently
    • Prohibit smoking in the home
    • Remove clutter to avoid dust accumulation
    • Wash bed linens weekly to minimize dust mites
    • Install an air filtration system
    • Limit your exposure to household chemicals such as cleaning products, paints, and varnishes
  • Exercise
  • Healthy Diet

What are the stages of COPD?

Elderly man using oxygen mask

The severity of COPD stages is determined by the results of a spirometry/lung function test. This test implements a comparison between healthy individuals in your age category, race, and height. During a spirometry test, the technician will ask you to take a deep breath and blow all of the air from your lungs as quickly as possible into a mouthpiece. You will then continue to blow into the mouthpiece for as long as possible. 

The machine then calculates two numbers, the amount of air you blew out initially and the amount of air you were able to blow out continuously. These values are then compared to individuals of your same age, race, and height who have healthy lungs. These values are referred to as FEV1 and FVC. Based on your results, a medical professional will indicate which stage of COPD you fall into. These stages are classified with a number from Grade 1 to Grade 4, and a letter from Group A to Group D. This information helps your physician determine how to monitor and treat your COPD. The grades can be described as Mild (Grade 1), Moderate (Grade 2), Severe (Grade 3), and Very Severe (Grade 4). These grades indicate how obstructed your airways appear to be. 

Your COPD group is determined by an assessment of your symptoms. An assessment describes your range from mild to severe and your risk of having a flare-up. This risk is measured by the number of past flare-ups you’ve experienced. If you have experienced no flare-ups in the previous year, you would be classified as low. If you have experienced only one flare-up but did not require medical attention, you would still be considered low. If you have been treated in the hospital within the last year due to a flare-up, you would be classified as high-risk. An individual who experiences two or more flare-ups within a year, even without hospitalization, would be considered high-risk as well. Groups are categorized as:

  • Group A: low risk, fewer symptoms
  • Group B: low risk, more symptoms
  • Group C: High risk, fewer symptoms
  • Group D: High risk, more symptoms

COPD stages:

  • Stage 1: Mild – Common for there to be no noticeable symptoms.
  • Stage 2: Moderate – You may suffer from persistent coughing and phlegm, an increase in shortness of breath, fatigue, or wheezing.
  • Stage 3: Severe – Symptoms you had earlier progressed and worsened. Flare-ups occur more often than they did previously. You may experience more respiratory infections. Chest tightness and wheezing are not uncommon when performing day-to-day tasks. Swelling in ankles, feet, and legs may also be present. 
  • Stage 4: Very Severe or End Stage – Stage 3 symptoms intensify and become more constant. Simple breathing takes effort. Flare-ups may become more severe and frequent. You may experience crackling when you breathe, increased heart rate, weight loss, or pulmonary hypertension. 

How is COPD Treated?

COPD treatment is primarily symptom management. Common symptom management treatments include:

  • Bronchodilators (inhalers)
  • Anti-inflammatory medications
  • Oxygen 
  • Antibiotics
  • Vaccinations
  • Rehabilitation
  • Anticholinergics

COPD treatment is something you and your doctor will discuss and decide on together. There is no cure for COPD; however, no cure is not indicative of a shorter lifespan. If appropriately managed and lifestyle changes are implemented, an individual with COPD can still live a long and full life. Treatment is intended to slow the rate of progression and manage the unpleasant symptoms associated with COPD. If you or a loved one have experienced any of the stated symptoms and may be concerned that you may be suffering from COPD, speak to your doctor. Early intervention could mean more effective treatment and slower progression.           


Ambrosino, N. & Bertella, E. (2018). Lifestyle interventions in prevention and comprehensive management of COPD.

American Lung Association. (2021). COPD Causes and Risk Factors. 

Centers for Disease Control and Prevention. (2021). COPD

Cleveland Clinic. (2022). Chronic Obstructive Pulmonary Disease (COPD).

COPD Foundation. (2020). Stages of COPD

COPD Foundation. (2020). What Causes COPD?  

Global Allergy and Airways Patient Pathway. (2021). Four Stages of COPD.