Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease, or COPD, has skyrocketed over the past 35 years. Dr. Matthew Schreiber discusses what it means for D.C., and how you can be as healthy as possible if you have the disease.

 

TRANSCRIPT

Intro: MedStar Washington Hospital Center presents Medical Intel where our healthcare team shares health and wellness insights and gives you the inside story on advances in medicine.

Host: Thanks for joining us today. We’re talking to Dr. Matthew Schreiber, associate director of the Medical ICU and an attending physician in Pulmonary Disease/Critical Care Medicine at MedStar Washington Hospital Center. Welcome, Dr. Schreiber.

Dr. Schreiber: Well, thank you for having me.

Host: Today we’re talking about a September 2017 report that showed that the number of Americans who died from chronic respiratory diseases, particularly chronic obstructive pulmonary disease known as COPD, skyrocketed over the past 35 years. In 2014, 53 people out of every 100,000 died of a chronic respiratory illness, up from 41 in 1980, a 31% spike. 85% of those deaths were from COPD, which is now the third leading cause of death in the U.S. Dr. Schreiber, how does Washington, DC compare to the national rates of chronic respiratory diseases and COPD?

Dr. Schreiber: Well, Washington DC, if you were to just look at it as a city, it’s doing great. The CDC and the NIH did a report starting in 2011 that talks about state by state, how much COPD is there, and I think when you’re talking about chronic respiratory diseases, COPD is really kinda the marker for what you’re talking about. There are a ton of different things that are chronic diseases in the lung, but the biggest bulk of them is going to be COPD, and even if someone had asthma their whole life, they can later have COPD, because of the chronic nature of that destructive disease.  Coming back to what you asked, DC is ranking in with only 4.6% of its residents having COPD and that’s actually pretty darned good, if you look at our neighboring states. It’s 5.9% in MD; 6.1% in VA; and 8.9% in WV. If you dive into the data a little bit deeper though, DC is a tale of two cities. There are a number of things that the CDC and the NIH found had associations with being diagnosed with COPD, and what they found was that in Washington, you had 2.1% of white respondents saying they had COPD, but up to 6.7% in the African American population, and they didn’t report on other ethnic backgrounds. So, 4.6 sounds awfully nice, it’s at the low end of the national levels, but then when you start breaking that down, there are definitely some groups in our district who are suffering from this condition, uh, at higher than average levels for the nation. If you look at people who are unable to work, and this might be because of their lung disease, but, of course, being unemployed can have any number of reasons—19.9% of folks that were unable to work reported being diagnosed with COPD. If you had less than a high school education, 9.6%. Nearly 1 out of 10 people with less than a high school education had been diagnosed with COPD, and age was a big factor. If you looked at folks 18-44, it’s down to 2.2%, but once you’re over 75, almost 10. So, even though you could say we’re doing great, being at the low end of the national level, we’ve got some work to do.

Host: Why would there be such disparity between the education and the types of work that people are doing? Is there some kind of a cause environmentally?

Dr. Schreiber: COPD is a condition that no one can say they know absolutely what causes it. There’s a number of theories behind it. What I can tell you is COPD is exactly what the name says. It’s chronic, so once you have it, you have it. It doesn’t get cured, it doesn’t go away, it might not progress very fast, but you have it, and it’s all about obstruction. The ‘O’ in the name says the whole thing. People with COPD have trouble moving the air in and out of their chest. And so, if you can’t move the air out, and you’re trying to do some activity or exercise, the faster you’re breathing, the more air that you’re breathing in that you can’t then get out, and you get short of breath. And it’s pulmonary disease, lung disease. So, if you look at it as a pure aspect like that, this could be caused by inhaling something that can damage your lungs over and over again. Cigarettes are the model example for that, and in truth, this seems like common knowledge to a lot of people now, it’s new. We didn’t have studies that showed cigarettes caused things like lung cancer until the 1950s. And we didn’t have a surgeon general’s warning about the damages of smoking until the 1960s and 70s, so progress has been made. But you’ve got a lot of history in the Un