On our cover this month is a color-enhanced X-ray of the chest of an 83-year-old man, showing signs of chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States. The X-ray shows both the extent of lung fibrosis (yellow) and the emphysema that results once the alveoli are damaged (red). Based on an analysis from the Centers for Disease Control and Prevention, the American Lung Association (ALA) estimates that more than 13 million American adults have the disease.
According to the ALA, smoking is the primary risk factor for COPD and the cause of approximately 85% to 90% of COPD deaths. Other risk factors include exposure to air pollution, secondhand smoke, and occupational dusts and chemicals; heredity; and a history of childhood respiratory infections. Smokers are about 12 to 13 times more likely to die from COPD than nonsmokers, and for eight consecutive years more women than men have died from COPD.
The cost of COPD is high, both to the health care system and to those with the disease. A recent ALA survey found that half of all COPD patients say their condition hampers their ability to work. They also report restrictions in regular physical activity, household chores, sleeping, and family and social activities.
To learn about exacerbations of COPD, which are characterized by an increased severity of symptoms, and both increase the risk of death from COPD and reduce the patient's quality of life, see “COPD Exacerbations” in this issue.—Michael Fergenson, senior editorial coordinator