With smoking, air pollution, fume exposure from burning fuels as common risk factors, chronic respiratory diseases remain a prevalent problem in the Philippines with milder cases being undiagnosed, hence untreated. The Philippine College of Chest Physicians (PCCP) calls for increased awareness on prevention and early treatment
By Lyka Mae P. Chiang
Chronic respiratory diseases (CRDs) are diseases associated with the airways and structures of the lungs. Some of the most common are chronic obstructive pulmonary disease (COPD) and asthma. According to the World Health Organization (WHO), hundreds of millions of people suffer from CRDs worldwide.
The National Heart Lung and Blood Institute (NHLBI) reports that CRDs rank as the third leading cause of death next to heart disease and cancer. In the Philippines, the mortality attributed to CRDs has reached 16,407 in 2014, making it rank as the seventh among the top causes of death in the country.
With such an immense figure of Filipinos costing their lives due to these diseases, it really calls for an urgent action.
Pursuing its commitment to increase awareness on common pulmonary diseases in the country, the Philippine College of Chest Physicians (PCCP)—the nation’s premier organization of lung specialists—recently conducted the “Kilusang Malusog na Baga,” a mini-health fair which highlighted the importance of preventive healthcare to maintain healthy lungs.
Lung health fair
The fair, which took place last August 27 at the Quezon City Memorial Circle, tackled various topics related to the lungs, including chronic obstructive pulmonary diseases (COPD), asthma, smoking cessation, exercise, and improving lung health.
COPD is an umbrella term for progressive lung diseases such as chronic bronchitis and emphysema. With an overall prevalence rate of 14 percent among Filipino adults aged 40 and above, only 2 percent of the cases are diagnosed and properly treated.
The disease is characterized by an immense production of mucus, wheezing,shortness of breath, and chest tightening as a result of bronchospasm.
Chronic bronchitis occurs when there is an increased cough and mucus production caused by inflammation of the airways; while emphysema refers to the damage of the air sacs in the lungs, which traps the carbon dioxide inside leading to hypercapnea, and reduces the amount of oxygen that reaches the bloodstream causing hypoxemia.
Dr. Glynna Ong-Cabrera, member of the Council on COPD and Pulmonary Rehabilitation of the PCCP, says that in most developed countries, cigarette smoking is the primary cause of COPD; however, other factors can also contribute to the disease. In fact, roughly 25 percent of COPD patients are non-smokers.
In developing countries, people exposed to fumes from burning fuels used for cooking are at high risk of the disease. Moreover, long-term exposure to lung irritants—such as pollution, chemical fumes, or dusts—may also lead to COPD. In some cases, it can be inherited through a rare genetic condition called alpha-1 antitrypsin (AAT) deficiency.
According to Dr. Cabrera, a person with COPD gets tired easily even when doing simple activities like bathing, eating, or walking as it affects one’s functional capacity. She also notes that poorly managed COPD may result to frequent exacerbations and significant damage in the lungs over time.
“If COPD becomes severe, he [the patient] may also develop a heart condition called cor pulmonale, wherein the right side of the heart enlarges due to exposure to low levels of oxygen in the blood,” says Dr. Cabrera.
Even if the disease is not fully reversible, the patient can increase his quality of life with proper treatment. Dr. Cabrera states that a person with COPD must avoid smoking at all cost and must be compliant with medications prescribed by their pulmonologist. She also cites some of the treatment procedures available for COPD.
“Bronchodilators are the main medication usually prescribed. Since COPD also causes muscle atrophy or deconditioning, it is advised that COPD patients undergo pulmonary rehabilitation. Pulmonary rehabilitation programs comprise of education regarding COPD and exercise training,” explains Dr. Cabrera.
Since COPD patients are prone to developing infections, they are also advised to get annual flu vaccines and have their pneumonia vaccination as well.
The 2007 WHO Global Surveillance Report shows that there are 300 million people who suffer from asthma, with 250,000 deaths recorded every year.
Asthma is a chronic inflammatory condition affecting the size and shape of the airways of the lungs. Like COPD, its symptoms include difficulty of breathing, coughing, wheezing, and chest tightening.
Sudden worsening of these symptoms is considered as asthma attack, which often occurs at night or early morning as a result of bronchospasm or the tightening of muscles around the airways. Asthma attacks can be triggered by infections, exercise, changes in weather, laughter, and irritants such as car fumes, cigarette smoke, or strong odors.
Allergens such as pollen, spores, dust mites, and pet dander may also trigger asthma, that’s why it is vital that the patient knows his allergies in order to avoid having contact thus minimizing triggers. Consulting a physician that can conduct procedures such as skin testing can help properly identify the allergies of a patient.
Although not curable, there are preventive measures and treatments available for the management of the condition.
Prevention of asthma attacks can be easily done by regularly taking the prescribed medications by the pulmonologist, quitting smoking, keeping distance from triggers, and getting annual flu shots.
However, in case of an asthma attack, the patient is advised to follow the “red zone” or the emergency instructions provided in the asthma action plan immediately. If experiencing trouble in breathing, walking, or talking, or the lips and fingernails are turning blue, the patient must then be brought to the nearest ER.
Asthma can be treated with two types of medications—the controllers and the relievers. Controllers are longterm control medicines that reduce airway inflammation and prevent asthma symptoms, while relievers are quick-relief or rescue medications that relieve asthma symptoms that may flare up during an exacerbation.
In addition to this, living a healthy lifestyle including adequate exercise and proper diet may benefit an asthmatic patient. Although also a trigger, exercise may improve the overall health of an asthmatic person if done properly. If an asthmatic patient plans to undergo physical activity, he is advised to take his reliever medications and warm up prior to exercising.
In its bid to combat CRDs, the PCCP also extends an anti-smoking campaign to the public. Cigarette smoking is widely spread with an estimated 1.3 billion smokers worldwide, with 4.9 million users dying of tobacco every year.
In the Philippines, over half of the household population practices habitual smoking. Hence, the vast mortality rate attributed to CRDs.
Roughly 600 ingredients are found in a cigarette which creates more than 7,000 chemicals when burned, and 69 of these chemicals are a culprit for cancer and many are poisonous—namely acetone, ammonia, butane, lead, nicotine, tar, among others.
Moreover, smoking is also a major risk factor for heart failure, strokes, hypertension, and liver and lung diseases.
Several countries, including the Philippines, have taken measures to control tobacco consumption with usage and sales restrictions as well as warning messages printed on packaging. Just recently, President Rodrigo Roa Duterte also implemented a nationwide ban on smoking in public and enclosed places.
Moreover, the Department of Health (DOH) spearheaded the National Smoking Cessation Program (NSCP) in the country, which aims to promote and advocate smoking cessation among Filipinos and provide smoking cessation services to current smokers interested in quitting the habit.
Some of the services covered by the NSCP include risk assessment, tobacco use assessment, brief intervention advice, and nicotine replacement therapy.
The PCCP also urges smokers to reach the national quitline by dialing 165-364 for smoking cessation counseling or texting “STOPSMOKE” to 29290-165-364.
With report from Precious B. Liason
“Even if the disease is not fully reversible, the patient can increase his quality of life with proper treatment”