Health Conditions

What causes it?

Most cases of COPD are caused by repeatedly breathing in fumes or irritants that can cause damage to the lungs or airways. The lungs and airways are very sensitive and can be damaged easily.

COPD is most commonly caused by cigarette smoking, but cigars and pipe tobacco may also contribute to the development of COPD, especially when inhaled. The mechanism by which smoking worsens or causes COPD is multi-factorial. It is not the nicotine from cigarettes, cigars, and pipes that causes damage to the lungs, but instead, it's the additives and the smoke itself. There are 599 U.S. government approved additives for cigarettes. A short list includes ammonia, arsenic, hydrogen cyanide, and formaldehyde. These additives and smoke can decrease lung function, directly damaging the lungs, decreasing important enzymes, and constricting lung vessels (such as bronchioles, alveoli, and capillaries).

Besides cigarette smoke, other irritants such as chemicals or chemical fumes can lead to the development of COPD. Persons who work in environments that are overly dusty may also be prone to developing COPD. These irritants can cause the lungs to become inflamed and airways to narrow. Additionally, elastic fibers in the lungs that allow them to expand and retract can become damaged, which makes breathing more difficult.

In addition to smoking and other inhaled irratants, a deficiency in a genetic marker called alpha-1 anti-trypsin (AAT) has also been linked to COPD. AAT is a small protein that protects lung cells. A deficiency in AAT (caused by a genetic mutation) can result in lung cell damage and eventually COPD. A true AAT deficiency accounts for less than 1% of COPD cases.

Finally, chronic infections such as active tuberculosis (TB), recurrent pneumonia, or recurrent fungal infections in the lungs, can lead to COPD. Lung infections that occur repeatedly wear out the lung over time and may cause irreparable damage.