Breathe Easy Week 17-23 June 2019

Posted by Heather Doggett on 12 June 2019

Lung disease refers to a wide range of conditions that affect the lungs, the organs through which we breathe. There are several causes of lung disease. Smoking is the main cause for the two biggest killers, lung cancer and chronic obstructive pulmonary disease (COPD). Pneumonia, the third biggest cause of death from lung disease, is caused by infection. Other diseases may result from exposure to harmful substances, such as asbestos, which causes lung fibrosis and mesothelioma. Cystic fibrosis, on the other hand, is a genetic disorder that is inherited. Living with a lung disease can mean that you can’t leave your home, walk more than a few paces or dress yourself. Some diseases, like asthma, can usually be managed effectively with the right treatment.

The British Lung Foundation state surveys of the general population suggest that approximately 12.7 million people in the UK (approximately 1 in 5) have a history of asthma, COPD or another longstanding respiratory illness. Half of these (about 6.5 million people) report taking prescribed medication for lung disease in the last year.

Estimates based on general practice records suggest that 8 million people have been diagnosed with asthma, 1.2 million with COPD, and over 150,000 with interstitial lung diseases (pulmonary fibrosis or sarcoidosis), with numbers generally similar for males and females. https://www.nhs.uk/conditions/sarcoidosis/

From GP records, an estimated 86,000 people in the UK have been diagnosed with lung cancer, and over 5,000 (mainly men) have been diagnosed with mesothelioma. https://www.nhs.uk/conditions/mesothelioma/

Estimates of numbers of people who developed a lung disease in 2012, based on general practice records, suggest that there were about 160,000 new cases of asthma, with numbers slightly higher among females than males, and over 110,000 people who developed COPD, with more males than females. There were about 10,000 new cases of pulmonary fibrosis and 4,500 of sarcoidosis.

According to GP statistics, there are over 32,000 new cases of lung cancer and over 2,000 new cases of mesothelioma annually. However, these are likely to underestimate the true incidence of cancer, because the diagnosis may be made in hospital during terminal illness, or post-mortem.

According to cancer registration statistics, during 2011 there were 43,463 new cases of lung cancer (23,770 among males and 19,693 among females), and 2,570 new cases of mesothelioma (2,172 among males and 398 among females).

Somebody dies from lung disease in the UK every 5 minutes.

About 10,000 people in the UK are newly diagnosed with a lung disease every week.

Approximately one in five people in the UK has developed asthmaCOPD or another long-term respiratory illness. Half of them are currently on treatment (mainly inhalers) for lung disease.

Lung diseases are responsible for more than 700,000 hospital admissions and over 6 million inpatient bed-days in the UK each year.

Asthma is a common, long-term disease that requires ongoing management. If you have asthma, you have very sensitive airways – the tubes that carry air in and out of your lungs. Certain triggers can cause your airways to become inflamed and tighten when you breathe. Triggers can include stress, exercise, cold air, and breathing in particular substances such as smoke, pollution or pollen. We do not know for certain what causes asthma, although we do know that many things can make it worse. Asthma often runs in families and people who have allergies – especially those under the age of 16 – are at a higher risk. Some people can develop asthma by repeatedly breathing in certain substances, especially while they’re at work. Many chemicals and types of dust and moulds can cause asthma. Asthma is usually treated with medication taken through an inhaler.

Bronchiectasis can occur if your airways (bronchi) become damaged, causing them to become wider than normal. When this happens, they cannot clear the mucus that keeps them moist, and trap the dust and germs you breathe in. Mucus builds up and the airways can become infected by bacteria. If bacteria survive, the airways become inflamed and further damaged. Once the damage has occurred, it is permanent. The known causes of damage include severe lung infection, lack of immunity to infection and severe allergic response to moulds. Bronchiectasis is not caused by smoking, but smoking can worsen the symptoms. Bronchiectasis is sometimes linked with COPD, as they are both long-term obstructive lung diseases and can co-exist. However, they are two separate diseases. Treatment helps prevent further damage and infections and reduces symptoms. Very occasionally, the damaged areas can be removed with surgery.

Chronic obstructive pulmonary disease (COPD) is the name used to describe a number of conditions including emphysema and chronic bronchitis. Emphysema affects the air sacs (alveoli) in your lungs, and chronic bronchitis affects your airways (bronchi). If you have COPD, you might have just one of these conditions, or you might have more than one. Most COPD patients have varying degrees of both emphysema and chronic bronchitis. With COPD, your airways become inflamed and the air sacs in your lungs are damaged. This causes your airways to become narrower, which makes it harder to breathe in and out. These breathing difficulties can affect many aspects of your daily life. Smoking is the main cause of COPD in at least 80% of cases. It can also be caused by long-term exposure to fumes and dust from the environment or your place of work. You can also inherit COPD through a genetic condition called alpha-1 antitrypsin deficiency, although this is very rare. There is no cure for COPD, but it can be managed. There are many treatments available and self-management can improve your symptoms and reduce flare-ups.

Cystic fibrosis is a life-shortening, inherited disease that affects many organs including the lungs. It causes the body to produce thick mucus, which affects the lungs and digestive and reproductive systems in particular. One in 25 people carries a faulty cystic fibrosis gene. For someone to be born with cystic fibrosis, both parents must carry a faulty gene. There are specific treatments used for rare gene variants, but treatment for the lung manifestations otherwise consists of physiotherapy and antibiotics.

Most lung cancers develop in the airways that carry air in and out of your lungs, but they can also start in the lung tissue itself. Primary lung cancer starts in your lung. Secondary lung cancer starts in another part of your body and spreads to affect your lung. Over 85% of cases of primary lung cancer occur in people who smoke or who used to smoke. Breathing in other people’s smoke over a long period of time can also increase your risk of getting lung cancer, as can being exposed to radon (a radioactive gas found in granite regions), and harmful dust and fumes in the workplace. Non-smokers are more likely to develop adenocarcinoma, a particular type of lung cancer. Much progress has been made in the treatments available for people with lung cancer. Now people are usually given more than one treatment at a time, or several courses of treatment.

Obstructive sleep apnoea (OSA) is a breathing problem that happens when you sleep. It occurs as the muscles in your throat relax as you sleep, causing the throat to close. When this happens you stop breathing for a time, which is known as an apnoea. If you have severe OSA, you may experience hundreds of apnoeas a night. This can severely disrupt your sleep, which in turn can make you feel very sleepy during the day. Lifestyle changes can help manage the symptoms of OSA, and there are effective treatments for moderate to severe OSA

Pneumoconioses are a group of lung diseases caused by inhaling dusts. Relatively common types of pneumoconioses include asbestosis, caused by breathing in asbestos fibres; coal worker’s pneumoconiosis, caused by breathing in coal mine dust; and silicosis caused by breathing in respirable crystalline silica found in various stone rocks, sands and clays. Breathing in dusts over the long term (such as through occupational exposure) can cause fibrosis, or scarring, of lung tissue. This results in breathing problems and severe shortness of breath. Another lung disease caused by inhaled substances is pneumonitis, a condition that causes inflammation of the lung tissue in response to the inhalation of an external agent. One example of pneumonitis is hypersensitivity pneumonitis due to organic dust. A form of this is commonly known as “farmer’s lung”, mainly caused by an allergic reaction to mould spores or other agricultural products.

Pneumonia is an inflammation of one or both lungs, usually caused by an infection. The inflammation causes the air sacs (alveoli) inside your lungs to fill with fluid. This makes it harder for the lungs to work properly. Your body sends white blood cells to your lungs to try to fight the infection. Although this helps kill the germs, it can also make it harder for your lungs to pass oxygen into your bloodstream. Many different kinds of bacteria, viruses and, occasionally, fungi can cause pneumonia. Some people with mild pneumonia can manage the condition at home with antibiotics. However, some need to go to hospital. People who have been admitted to hospital with other medical problems and then develop pneumonia have a high risk of becoming very ill and may need different, more powerful antibiotics. Many, particularly younger people, will recover from pneumonia and return to good health. Other forms of LRTI include bronchiolitis, which commonly affects babies and children under two years old.

Tuberculosis (TB) is a disease caused by a germ called Mycobacterium tuberculosis. It can affect any part of the body, commonly the lungs, and is caught from other people. The TB germs might cause one or many holes in one or both lungs. You are most at risk of developing active TB if your immune system is damaged. You are also at high risk if your immune system works less well following an organ transplant or treatment for conditions such as cancer and rheumatoid arthritis. TB can be completely cured if you take a course of tablets for at least six months. Most people should be treated at home only.

Tips for keeping your lungs healthy

Stop smoking and avoid second-hand smoke or environmental irritants

Every time you smoke a cigarette, you inhale thousands of chemicals into your lungs, including nicotine, carbon monoxide, and tar. These toxins damage your lungs. They increase mucus, make it more difficult for your lungs to clean themselves, and irritate and inflame tissues. Gradually, your airways narrow, making it more difficult to breathe.

Smoking also causes lungs to age more rapidly. Eventually, the chemicals can change lung cells from normal to cancerous.

According to the Centres for Disease Prevention and Control (CDC) , more than 10 times as many U.S. citizens have died prematurely from cigarette smoking than have died in all the wars fought by the U.S. during its history. In addition, smoking causes about 90 percent of all lung cancer deaths in men and women. More women die from lung cancer each year than from breast cancer.

No matter how old you are or how long you’ve been a smoker, quitting can help. The American Lung Association (ALA) states that within just 12 hours of quitting, the carbon monoxide level in your blood drops to normal. Within a few months, your lung function begins to improve. Within a year, your risk of coronary heart disease is half that of a smoker’s. And it only gets better the longer you stay smoke-free.

Quitting usually takes several attempts. It’s not easy, but it’s worth it. Combining counselling and medication may be the best way to succeed.

Breathe Deeply

If you’re like many people, you take shallow breaths from your chest area, using only a small portion of your lungs. Deep breathing helps clear the lungs and creates a full oxygen exchange.

In a small study published in the Indian Journal of Physiology and Pharmacology, researchers had a group of 12 volunteers perform deep breathing exercises for 2, 5, and 10 minutes. They tested the volunteers’ lung function both before and after the exercises.

They found that there was a significant increase in vital capacity after 2 and 5 minutes of deep breathing exercise. Vital capacity is the maximum amount of air the volunteers could exhale from their lungs. The researchers concluded that deep breathing, even for just a few minutes, was beneficial for lung function.

The ALA agrees that breathing exercises can make your lungs more efficient. To try it yourself, sit somewhere quietly, and slowly breathe in through your nose alone. Then breathe out at least twice as long through your mouth. It may help to count your breaths. For example, as you inhale count 1-2-3-4. Then as you exhale, count 1-2-3-4-5-6-7-8.

Shallow breaths come from the chest, and deeper breaths come from the belly, where your diaphragm sits. Be aware of your belly rising and falling as you practice. When you do these exercises, you may also find you feel less stressed and more relaxed

Get vaccinations like the flu vaccine and the pneumonia vaccine

Infections can be particularly dangerous for your lungs, especially as you age. Those who already have lung diseases like COPD are particularly at risk for infections. Even healthy seniors, though, can easily develop pneumonia if they’re not careful.

The best way to avoid lung infections is to keep your hands clean. Wash regularly with warm water and soap and avoid touching your face as much as possible.

Exercise more frequently, which can help your lungs function properly

Besides avoiding cigarettes, getting regular exercise is probably the most important thing you can do for the health of your lungs. Just as exercise keeps your body in shape, it keeps your lungs in shape too.

When you exercise, your heart beats faster and your lungs work harder. Your body needs more oxygen to fuel your muscles. Your lungs step up their activity to deliver that oxygen while expelling additional carbon dioxide.

According to a recent research, during exercise, your breathing increases from about 15 times a minute to about 40 to 60 times a minute. That’s why it’s important to regularly do aerobic exercise that gets you breathing hard.

This type of exercise provides the best workout for your lungs. The muscles between your ribs expand and contract, and the air sacs inside your lungs work quickly to exchange oxygen for carbon dioxide. The more you exercise, the more efficient your lungs become.

Creating strong, healthy lungs through exercise helps you to better resist aging and disease. Even if you do develop lung disease down the road, exercise helps to slow the progression and keeps you active longer

Improve indoor air quality

Exposure to pollutants in the air can damage your lungs and accelerate aging. When they’re young and strong, your lungs can easily resist these toxins. As you get older, though, they lose some of that resistance and become more vulnerable to infections and disease.

Give your lungs a break. Reduce your exposure as much as you can:

Avoid second-hand smoke and try not to go outside during peak air pollution times.

Avoid exercising near heavy traffic, as you can inhale the exhaust.

If you’re exposed to pollutants at work, be sure to take all possible safety precautions. Certain jobs in construction, mining, and waste management can increase risk of exposure to airborne pollutants.

Indoor pollution can be typically worse than outdoor. That, plus the fact that many spend most of their time indoors these days, increases exposure to indoor pollutants.

Here are some tips for decreasing indoor pollutants:

  • Make your home a smoke-free zone.
  • Dust the furniture and vacuum at least once a week.
  • Open a window frequently to increase indoor air ventilation.
  • Avoid synthetic air fresheners and candles that can expose you to additional chemicals like formaldehyde and benzene. Instead, use an aromatherapy diffuser and essential oils to more naturally scent the air.
  • Keep your home as clean as you can. Mould, dust, and pet dander can all get into your lungs and cause irritation.
  • Use natural cleaning products when possible and open a window when using products that create fumes.
  • Make sure you have adequate fans, exhaust hoods, and other ventilation methods throughout your home.

Gill Cooksey OHA