Reducing COPD risk and addressing COPD in Saint Lucia- a preliminary approach

Risk factors for COPD

There are environmental factors that can negatively impact the health, growth, survival and daily operations of a society. These factors can cause an individual to develop COPD and exist as physically, demographically, economically, culturally, technologically, politically or regulatorily characteristics.

Some of the contributing factors that cause and sustain COPD in Saint Lucia are smoking and exposure to secondhand smoke. Long term exposure to cigarette smoke can cause lung irritation and damage overtime.

Environmental factors whether at home or at work can increase the chances of the disease through long term contact with pollutants in these areas such as with chemicals, fumes and dust. People can be exposed to COPD from occupational hazards as they have increased exposure to fumes from work. These types of hazards lead to airway scarring, air flow obstruction and reduced lung function which are hallmarks of COPD.

Indoor pollution

Air quality is important for COPD individuals so they need clean and fresh air to maintain good health. Indoor air quality tend to be worse than the air quality outdoors.Indoor air pollution include mold, paint, building materials and furnishings such as new carpeting, perfumes, scented candles, hair sprays and cleaning products.

The fumes emitted are all notorious for being irritants to the respiratory tract so it is important to remove these products from breathing space. Remember to ensure proper ventilation when at home!

Outdoor air pollution

In Saint Lucia, manufacturing facilities and the electricity supplying power plant are all sources of outdoor air pollution as particles get emitted and travel throughout the atmosphere.

Fossil fuels and diesel exhaust are all dispersed into the environment and further contribute to the development of COPD. Daily sources of outdoor air pollution in Saint Lucia are emission of gases from vehicles and those from burning of garbage.

Increased risk

Development of COPD depends on the intensity of the toxicity an individual is being exposed to, the time period and an individual’s susceptibility level. Therefore the elderly, children and people with weakened immune systems are at greater risk of developing the disease. Pregnant women may pose a risk to the fetus as they inhale the harmful substances and this can be a precursor for the disease.

Cleaners are at an increased risk of developing COPD since they are exposed to harmful chemicals that can cause respiratory irritation if it is not environmentally friendly. Cleaners should wear personal protective equipment when using harmful chemicals to reduce direct exposure.

Genetics

Genetic factors may predispose people to COPD. Some individuals have a family history of asthma, get asthma themselves and later in life develop COPD. Asthma is a chronic lung disease that inflames and narrows the airways but treatment usually can reverse the inflammation and narrowing that occurs. 

Preterm babies usually need to have long-term oxygen therapy because their lungs are not fully developed so this therapy can cause lung damage that can increase the risk for COPD later in life.

Temperature changes

Air quality can be harmful when the temperature goes down. COPD patients should be especially careful during cold weather as their lungs can get irritated as the cold and dry air can tighten airway and cause difficulty with breathing.

How the government can reduce COPD

5 A’s for early detection

In an effort to reduce COPD, the government need to ensure that health care providers ensure the accurate diagnosis of conditions since COPD usually goes unrecognized until it is in the last stages.

The government can encourage health care workers to use the 5 A’s- ask, advise, assess, assist and arrange to help identify health risks and manage it. This encompasses asking the patients whether they are smoking or are exposed to environmental hazards that can cause the disease and advising them to limit those behaviors or exposures.

Along with other government agencies, the identified factors can be assessed. The patients willing to quit smoking can be referred to a counselor and then assistance be given to help them limit the practice. Arrangements such as follow up in person or by telephone need to be made to find ways to ensure continued avoidance of the exposure and behavior altogether.

Primary prevention

Approaches to address the COPD problem should focus on primary prevention as it would help prevent the disease from happening at all. More focus can be placed on disease prevention, health promotion and raising public awareness of COPD. People can be educated and empowered about health issues associated with smoking and poor air quality.

Community health fairs, posting of flyers in communities, public announcements and massive media campaigns on COPD would be essential. Ensure that announcements are both in English and Kweyol to aid with understanding.

People with presenting symptoms such as chronic cough, increase in sputum production and history of exposure to risk factors should be encouraged to report to health officials. The reports would help with early identification of the disease so the necessary treatment can be given.

Increasing public awareness would be effective as the public would better identify symptomatic people. It would then become the norm to seek medical attention when displaying these symptoms.

Empower families and caregivers caring for people with COPD

Educate families and caregivers on ways to care for COPD patients, how best to manage the disease and how to reduce the burden. Provide avenues for COPD patients and caregivers to seek clarity and share and receive up-to-date and reliable information.

Training exercises

The government can make treatment more possible through a better health care system which includes training exercises for COPD patients. This could help relieve symptoms and promote more physical activity.

A COPD specialist or physiotherapist could do home visits to ensure that patients and caregivers are practicing proper self-care, nutrition and exercises to reduce symptoms. Home visits would also be useful to reduce hospitalization as patients and caregivers become more knowledgeable on home care.  

Vulnerable groups can be assessed and the risk factors that can predispose these individuals to developing COPD be highlighted in an effort to reduce it.

Smoking cessation is the most effective way to reduce COPD.  Smoking cessation programs can be made more available for people who are trying to quit. COPD patients can be peered with a coach to track progress, help prevent a smoking relapse and to improve smoking reduction strategies.

Accessible services

The government can ensure that environmental, educational and basic medical services are accessible to everyone and are readily available so it can be utilized when needed. Family support needs to be encouraged to help limit relapse to smoking and people can be referred to support groups for additional support. Funds could be made available for COPD patients to get money to purchase oxygen concentrators and relevant home based medical supplies.

Implementing workplace indoor quality assurance policies

Policies need to be developed for the country and work environments so the air quality can be more friendly. These can include policies to help limit smoking indoors and smoking in public to help combat the problem.

The policies can help reduce exposure of unsanitary and poor air quality as environmental air pollution can contribute to COPD. People can also be made aware of reducing total exposure to occupational dust, tobacco smoke and indoor and outdoor air pollutants.

Adjusting work environment for COPD patients

The work environment should be assessed to identify factors that would limit the full work performance of COPD patients and corrective measures taken. The work environment should be made conducive for COPD patients. This would help ensure that they continue their job, maintain their identify outside of their diagnosis and remain functioning members of society.

It may be a challenge for COPD workers to perform their duties. They may experience exertion with physical activity but with good mental health and support, workers can effectively and efficiently carry out their daily activities.

Immunization

Immunization campaigns should be done. Vaccines can be given for common respiratory illnesses as these illnesses can predispose people to the development of COPD and further suppress the respiratory system.

Monitoring and evaluation

The government needs to then evaluate the effectiveness of health services by monitoring it through use of surveillance. Gaps should be identified and adjustments made where necessary.  Research for new innovative ways to help solve the rising COPD problem can also be done as research can provide useful data that can be used in the future to help limit the disease.

Reems Sonson

Our Tropical Living

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Stay tuned for the next blog post on the management of COPD.

This is not a paid or sponsored blog post. This blog post is not affiliated with any hospital. I am merely sharing my knowledge and expertise from working with COPD patients and my research from holding a master’s degree in Public Health with my thesis being on tobacco use.

This blog post is not intended to be a substitute for professional medical advice, diagnosis nor treatment. Please seek advice from your medical provider for further information and clarity on COPD.

Living with Chronic Obstructive Pulmonary Disease (COPD) in Saint Lucia

Tobacco smoke causes toxic effects on the lungs and could lead to COPD. With the rise in both indoor and outdoor air pollution, COPD is no longer limited to cigarette smoke. Environmental factors can contribute to the development of COPD because the quality of air that we breathe is a major component of COPD.

COPD is a debilitating and progressive disease that causes loss of the normal elasticity of the lungs. COPD affects quality of life, decreases functional status and increases risk for heart failure, lung cancer and death.

COPD is often underdiagnosed and undertreated. People with COPD may display little symptoms at first and symptoms common to other illnesses so it may go unrecognized. There is no cure for COPD but interventions can help reduce symptoms, improve well-being and prevent death. Caring for loved ones with COPD can be a burden to families both physically, emotionally and financially.

Let us educate, empower, engage and encourage people with COPD. Let us share our knowledge.

What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs (Mayo Clinic, 2022). COPD includes conditions such as bronchitis (prolonged cough and sputum production), asthma (swelling in the airway) and emphysema (a lung condition that leads to shortness of breath).

Causes of COPD

Some of the main causes of COPD are smoking constantly for prolonged periods of time, being a past smoker and exposure to second-hand smoke. Air pollution, dust, chemicals and fumes are also causes of COPD.

Some people genetically lack the enzyme Alpha-1 antitrypsin (A1AD) and develop COPD at an earlier age than smokers. Sometimes the etiology of COPD is unknown.

Common signs and symptoms

Symptoms can range from being mild to very severe, vary from person to person and depends on the severity of the condition. In the early stages, symptoms can be mild but vary from moderate to severe overtime. COPD is characterized by difficulty breathing during exertion, chronic cough and increased mucus production.

Anxiety, depression, heart failure and lung cancer are common. Some people present with wheezing, fatigue, frequent lung infections, chest tightness and decreased appetite accompanied by weight loss.

In the long run, people with COPD go into cor pulmonale (right sided heart failure), end stage lung disease and die.

Early detection

Early diagnosis and treatment of COPD are the key to reducing disease progression and complications, living better, improving quality of life and living longer with the disease.

COPD in Saint Lucia

COPD is a major public health issue in Saint Lucia as people being diagnosed with COPD is on the rise. The combined use of tobacco and marijuana is a growing and contributing factor.

There have been an increase in people in their 30s with full-blown COPD that require continuous oxygen. Basic activities such as moving from bed to chair causes extreme shortness of breath. As a result, these individuals have to gasp for air, use more respiratory effort and quickly go into moderate to severe respiratory distress.

They become dependent on oxygen so require it to perform all activities of daily living even when at home. Some COPD patients cannot purchase home oxygen cylinders and have to seek assistance from the government. Owning an oxygen cylinder means having to refill it every time it is empty, this is another burden as most times help is also required for oxygen refills.  

Heightened hospitalization and social case

Globally, majority of the cases admitted for COPD are men who are chronic smokers and a few individuals mostly women develop COPD with no known etiology. Hospitals have been burdened by the amount of patients who have become social cases. These patients live in the hospital since they are unable to care for themselves at home, are financially deprived and have no one to care for them upon discharge.

Some patients who suffer from COPD have good family support so go home to good care. Whilst other families explain that they are unfit to care for their loved ones and the patients altogether do not want to go home for fear of neglect and death.

This has caused increased costs for hospital administrators since more staff are needed to care for these patients who typically require extensive care, constant monitoring and assistance.

There has been a reduction in the availability of beds to house patients who actually need medical attention since the COPD patients take up the limited bed space. Most of the smokers suffer from permanent lung disease as a direct result of the toxic effects of tobacco smoke so require lung transplant.

Lung transplant is an expensive intervention that is not performed in some countries so individuals are placed on continuous low flow oxygen to help sustain life. Some patients are able to fly to other countries to have the procedure done.

Long-time COPD patients are “recurring decimals” due to the constant emergency room visits, admissions and longer hospital stays. Some patients become afraid to stay away from the hospital so refuse discharge and some return the same day they are discharged.

Many people who suffer from COPD become incapable of working especially if they are dependent on oxygen, tire easily and have constant and prolonged hospital stays. They lose their jobs overtime and become unable to provide an income to care for themselves and their family.

Rippling effect

The effects of COPD have a rippling effect. The patient becomes depressed, feels helpless and hopeless and have deceased quality of life. The family spends lots of money in hospital bills and treatment and worry about their loved one. The employer loses a worker. The government and tax payers bear the overall cost of care.

Funds have to be allotted by the government to care for COPD patients. The finances given to care for these individuals could be invested in other areas. The government must also pay the nursing homes for the patients who have become a social case. Therefore, there is an opportunity cost for the government.

The patients are referred to the social worker so a nursing home can be obtained. These individuals then fill the nursing homes and deprive those we actually need the home of the chance of getting a spot.

Also, a sick and dying population means reduced workforce and decreased economic output and revenue for the country.

Patient education

It is important for people to be aware that their risk for developing COPD increases with the amount of tobacco smoked each day along with the number of years. Efforts should be made to limit consumption and exposure to COPD triggers.

This blog post is dedicated to all the COPD patients I have nursed.

Add your email address to the subscribe bar then confirm the subscription in your inbox to get updates on my new blog post!

Stay tuned for the next blog post on the management of COPD.

Reems Sonson

Our Tropical Living

Come live and love island life

Follow, like, share, comment and subscribe

https://www.youtube.com/results?search_query=reems+sonson

https://instagram.com/reemssonson

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This is not a paid or sponsored blog post. This blog post is not affiliated with any hospital. I am merely sharing my knowledge and expertise from working with COPD patients and my research from holding a master’s degree in Public Health with my thesis being on tobacco use. This blog post is not intended to be a substitute for professional medical advice, diagnosis nor treatment. Please seek advice from your medical provider for further information and clarity on COPD.

Reference: Mayo Clinic. (2022). COPD. Retrieved from https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679