Cape Town tops COPD list

Cooking with biomass fuel increases the risk of COPD © Thanamat Somwan 123RF.com

According to 2015 data conducted by the Chest Research Foundation, South Africa has the highest incidence of COPD across the 24 countries surveyed. Of over 30,000 adults (aged 55 and over) polled globally, 19% of the respondents in Cape Town alone exhibited symptoms of the condition.

Under-diagnosed

COPD is not simply a "smoker's cough" but an under-diagnosed and life-threatening lung disease, characterised by chronic airflow obstruction resulting in shortness of breath and persistent cough. The more familiar terms of 'chronic bronchitis' and 'emphysema' are no longer used, but are now included within the COPD diagnosis.

Dr Sundeep Salvi, director of the Chest Research Foundation, says: “This conveys a message to all stakeholders that it is time to wake up in Africa, and particularly in South Africa, when it comes to the rise of COPD in the region. We are seeing a similar transition in many other developing countries such as India with infectious diseases like tuberculosis (TB) on the decline and non-communicable diseases such as COPD on the rise.”

Dr Salvi explains that, in the past, the cause of COPD was predominately associated with tobacco smoke, but other, more practical factors, are contributing to the increase of COPD in South Africa. These include:

Using biomass fuel

Half of the world’s population currently uses biomass fuel for cooking and South Africa is no exception. The smoke that comes out of a kitchen during cooking times produces very high levels of smoke particles which, when deposited in the lungs, gives rise to the development of COPD. Recent data points to the smoke being generated at approximately 600-800 micrograms per cubic metre.

Mosquito coils

The coil is a cheap and effective method of combating mosquitoes, especially in tropical regions, but they produce an enormous amount of smoke. A recent study indicated that burning a coil for seven hours produces smoke equivalent to 100 cigarettes.

Unknowingly, people have been inhaling significant amounts of smoke while sleeping. The Chest Research Foundation recently simulated a closed window bedroom setting (which 60-70% of homes do) and the levels of smoke recorded reached levels of 2,200 micrograms per cubic metre. To put into context, the safety limit prescribed by the World Health Organisation is 50 micrograms per cubic metre.

Burning incense

Data is still being compiled as sticks vary in size and design per region, but in a recent test, one incense stick was recorded at smoke levels of 20,000 micrograms per cubic metre.

Early diagnosis essential

According to Paul Miller, CEO of Cipla SA, “Clearly this new research by the Chest Research Foundation is something that many were not aware of before and indicates the risk factors that exist for COPD beyond traditional smoking. For example, of the Capetonians surveyed who demonstrated COPD symptoms, half were non-smokers.

“Patients who have had TB of the lungs in the past also have a significantly increased risk of having COPD, and this is particularly relevant in South Africa as the country has one of the most serious TB epidemics in the world.”

“It is also important to note that COPD not only effects the lungs, but also the heart, circulatory system, kidneys, muscles and bones. Therefore it is important to diagnose COPD as soon as possible,” concludes Dr Salvi.