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When Non-Smokers Get COPD

When Non-Smokers Get COPD

How genetics and environmental factors increase the risk of COPD.

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory illness that makes it difficult for a person to breathe. COPD is actually an umbrella term for several chronic respiratory illnesses. The two major forms of COPD are chronic bronchitis and emphysema, and people who have COPD may have either of these illnesses or a combination of both.

While cigarette smoking is the primary risk factor for COPD, it is not the only risk factor, and as many as 20 percent of people who have COPD are nonsmokers. Aside from smoking, there are a number of other factors that can put a person at risk for COPD.

Environmental risk factors
Environmental risk factors are elements of your surroundings that can contribute to your risk of a disease or medical condition. Some environmental risk factors for COPD include:

  • Secondhand smoke. Tobacco smoke can be a risk factor, even if you’re not the one who is smoking. Living in a home where people smoke, frequenting places that people smoke or working in a place where people smoke also exposes your body to the harmful effects of smoking.
  • Coal or wood smoke. An estimated 65 million people worldwide are afflicted by COPD, including many people in parts of the world where wood or coal fires are used for cooking and heating. Long-term exposure to this type of smoke can contribute to COPD.
  • Dust, chemicals, fumes and particulates. Cement dust, diesel exhaust, asbestos, fumes from welding/cutting gasses, silica, coal dust, spray paint, industrial chemicals (such as those used in the production of rubber, textiles and plastics) and other agents that can be found in many work environments have been associated with COPD.

Childhood risk factors
A person’s medical history can also contribute to the development of COPD. Research has shown that people who have a history of respiratory illness and infection during childhood—such as asthma, pneumonia and bronchitis—are at an increased risk of developing COPD later in life. Children or parents who smoke are also at a greater risk of developing COPD.

Genetic risk factors
Genetics are another risk factor for COPD, and research supports the idea that COPD runs in families. One inherited genetic disorder in particular—alpha 1-antitrypsin deficiency (A1AD)—has been identified as a significant risk factor for COPD. However, this disorder is rare, and only accounts for 1 to 2 percent of cases of COPD.

Why does A1AD cause COPD? The disorder prevents the body from using the alpha 1-antitrypsin protein, which protects the lungs from inflammation and infection. A1AD results in a breakdown of protein in lung tissue, and is also a risk factor for liver disease. Blood work can help identify A1AD by looking at the levels of alpha 1-antitrypsin protein in the blood or looking for alpha 1-antitrypsin proteins that are abnormal in shape.

Medically reviewed in August 2018.

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