COPD jumps to number 2 in killer disease list

By Vikas Vaidya

The Chronic Obstructive Pulmonary Diseases (COPD) which was on number 5 in the list of killer diseases in India in 1990 jumped to number 2, just behind heart ailment. This is the study done by Maharashtra Government itself. In 1990, Tuberculosis was on number one in the killer disease list while heart disease was on number 3 with Pneumonia standing on number 2. The scenario has changed.
    In Europe and America main cause of COPD is smoking and they are concentrating to reduce smoking mainly in young people through awareness drive. But in India there are so many other causes are known besides smoking. As per statistics of Chest Research Foundation India there are 110 million smokers in India and out of which 12 million are female. It also says 56 % of non smokers suffer from COPD. So what are the other causes – outdoor air pollution, biomass fuel, mosquito coils, vehicle emission, burning of dry waste in open, construction pollution, emission of thermal power plants, industries, coal mines, pesticides and so on.
According to an Indian Council of Medical Research ( ICMR ) report India is the fourth largest producer of cigarette and bidi production.There are 18.4 crore tobacco users in India with 4 crores using cigarette, 8 crore using bidis and 6 crore using chewable forms of tobacco. Nearly 45% of Indian men and 12%women use some form of tobacco. COPD caused by smoking is a progressive self inflicted debilitating disease which is second top most cause of death in India  and number 1 killer in our state of Maharashtra.
More than 75% of cases of Asthma and COPD have never undergone spirometry and are treated empirically by just keeping stethoscope on chest which is highly unreliable, pointed Dr Swarnakar.
Dr Rahul Kodgule, faculty from Chest Research Foundation, Pune said, “The need is for early diagnosis by Spirometary test, multidisciplinary approach, prevention by removing causative factors, awareness program by media and affordable treatment. Countries and causes can be different but problem is same. What is required is PPP (Patient Professional Partnership) along with Government and NGOs.”
Dr Rajesh Swarnakar, Pulmonologist and Director of Getwell Hospital said “The estimated morbidity of Chronic Respiratory Diseases like asthma and COPD by 2016 will be 57.2 million which is more than that caused by Cancer, Ischemic Heart Diseases, brain stroke and Diabetes put together. The resulting economic burden of COPD and Asthma is whooping 30,000 and 10,000 crores. If we follow spirometry based treatment of Asthma and COPD the morbidity and resulting economic burden of these diseases can be drastically reduced.”
Dr Rahul Kodgule said, “If we look at the number of mortality of various diseases, cause of deaths being injuries topped the table with 7.49 lakhs mortality followed by 5.77 lakhs deaths caused due to respiratory diseases. As per study conducted by World Health Organisation (WHO) in the year 2008, COPD will be the number one cause of death in 2015. There will be huge gap between number one killer as COPD and diabetes which will be at number 2. Because of increase in population and vehicles the air pollution level has gone up. Apart from this, the eating habit of children, sedentary lifestyle making the problem more difficult. Junk food like pizza, burger being eaten by the children while watching TV.”
The hygiene factor also plays an important role. Cleaning of the body and proper washing of the hands from time to time is very important. Apart from exposure to biomass smoke the other pollutant factors include burning of mosquito coil, indoor fungus like uncleanliness. These factors lead to Asthama, COPD, Respiratory Tract Infection, Poor Lung Growth, Lung cancer.
To tackle these issues Indian Chest Society has designated 9 centers all over India to train technicians and doctors by running certified courses every year endorsed by the society. Nagpur has such recognized centre at Department of Respiratory Diseases at Getwell Hospital with Dr Rajesh Swarnakar, Pulmonologist and Director of the hospital as its course coordinator.
Dr Rahul Kodugale said, “Unfortunately Government has still not started a national program to control COPD. The international guidelines to treat asthma and COPD are based on results of spirometry which we hardly do which is akin to treating diabetes without checking blood sugar level or treating hypertension without seeing patient’s blood pressure.”