Doctors are worried about the increasing prevalence of chronic obstructive pulmonary disease (COPD) cases in the city.

“ The rise in sale of cigarettes in Pune is a cause for concern, especially when air pollution has increased significantly. We have observed several cases of chronic obstruction of the flow of air through the airways and out of the lungs. The obstruction is usually permanent and progressive as the disease gets worse with time,” says Sandeep Salvi, director of city-based Chest Research Foundation.

Smokers are not only damaging their lungs, but also their knees and hearts. Doctors have found that chronic obstructive pulmonary disease makes people prone to osteoporosis andother medicalconditions.

Air pollution, both indoor and outdoor, has been recognized over the past several decades as an important threat to pulmonary health and a significant contributor to COPD. Various surveys in the last few years have put Pune in the list of most-polluted cities in the country, but the PMC and its elected members have failed to draft a comprehensive policy to assess pollution and its impact on citizens.

“We are conducting a targeted COPD population study in Pune, focusing on IT professionals. This disease is going to be a major challenge to the city’s health as the overall trend is serious and there is no system in place to check the ever-growing number of smokers,” said Salvi.

Worldwide, one in 10 adults over the age of 40, may have COPD. In India, nearly 3 million people die of it every year. According to the World Health Organization, COPD is the fourthleading causeof deathsworldwide,surpassedonly by heart attack, stroke, and acute lung infections. It kills more people than cancer, and as many people asAIDS.Researchers at the Indian Institute of EnvironmentalMedicine(IIEM) puttheurban and rural prevalence of COPD at 7-8%.

“It is time for the PMC and NGOs to come together and check the rising trendof smoking.Wewould raise the issue in the general body (GB) meeting,” said corporator and Congress leader in PMC, Aba Bagul.

Says Salvi, “Another trend is the steady rise in number of women smokers, who consider it more as a fashion statement. Besides, growing number of hookah parlours are worsening the COPD scenario.” S K Jindal, a medical professional with the Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research in Chandigarh, said that COPD was so far under-diagnosed in India. In his study, ‘Emergence of chronic obstructive pulmonary disease as an epidemic in India', Jindal says, “COPD is now recognised in 4-10% of the adult male population. In non-smokers, especially women, an exposure to indoor air pollution is an important factor. The exposure to environmental tobacco smoke is an established cause. On an average, an Indian COPD patient spent about 15% of his income on smoking products and up to 30% on disease management.”

Exposuretodomesticcombustion, especially solid(or biomass)fuelssuch asdrieddung,wood andcrop residue, is an importantcauseof chronicbronchitis andCOPD among women.Respiratory difficultieswerefound among 13%of the 3,608 non-smoking women who cooked regularly, especially in poorly ventilated houses.

Chronic obstructive pulmonary disease or COPD is caused due to persistent obstruction of the flow of air through the airways and out of the lungs. The obstruction is usually permanent and progressive as the disease gets worse over the time.

Smoking is responsible for 90% cases. Air pollution (indoor and outdoor) can cause problems for people with lung diseases.

Breathlessness, abnormal sputum and chronic cough. Daily activities, such as walking up a short flight of stairs or carrying a suitcase, can become very difficult as the condition progresses.

It is is not curable. Treatment can help control its symptoms and improve the quality of life for people with the illness.

Earlier, it was more common among men, but because of increased tobacco consumption among women in highincome countries and exposure to indoor air pollution in low-income countries like India, the disease now affects men and women almost equally. COPD develops slowly and is, therefore, usually diagnosed in people aged 40 or above.