Exclusive: Understanding Chronic Lung Diseases And Co-Morbidities

Each breath of fresh air, as one goes on a short stroll in a park or when you take an exhilarating hike in the mountains, is a simple pleasure that is often taken for granted. Your lungs work tirelessly to ensure that every breath you take is filled with ‘life force’, allowing the body to feel energised. Yet, in our fast-paced lives, we often overlook the significance of clean air until this very act of breathing becomes a daily struggle. Col (Dr) MP Cariappa, Public Health Specialist, Advisor, Tata Trusts shares inputs on understanding chronic lung diseases. He is also affiliated with the Vijayavahini Charitable Foundation (VCF) and Collectives for Integrated Livelihood Initiatives (CINI). 

Early signs of distress 

Caring for your lung health goes beyond simply avoiding infections; it is more about enhancing the overall quality of life and working towards health and well-being. Breathlessness or unexplained fatigue may be indicators of underlying issues. A persistent cough lasting more than two weeks, especially if accompanied by mucus or blood, warrants immediate medical attention. Don’t dismiss these off-hand. Recognizing the subtle signs indicating that the lungs may be under attack, is essential for an early diagnosis and initiating timely treatment. 

Lung diseases are diverse, ranging from chronic disorders to acute infections. Chronic Obstructive Pulmonary Disease (COPD) is a progressive and irreversible condition which impairs airflow and is often a result of long-term exposure to harmful substances from tobacco smoke and air pollution. Asthma and bronchitis involve airway inflammation and narrowing, causing wheezing and breathlessness. Pneumonia leads to fluid accumulation in the lungs. Cystic fibrosis and pulmonary fibrosis are genetic conditions causing mucus buildup and lung scarring, respectively. Infections such as COVID-19 and influenza can cause severe respiratory issues while tuberculosis (TB) can form cavities in the lung tissue. Lung cancer is also a common public health problem in India, where it records a 5.8% annual incidence. 

Co-morbidities complicate existing conditions

Lung diseases often occur alongside other health issues or co-morbidities. Chronic health issues, particularly cardiovascular diseases, become more common as people age. Lung diseases intersect with conditions such as cardiovascular disease, diabetes, obesity, depression, and sleep disorders, impacting patients’ health and complicating treatment. 

Patients with COPD often present a significantly higher prevalence of cardiovascular comorbidities, with heart diseases occurring in 14–33% of cases. COPD frequently coexists with diabetes, osteoporosis, depression, and sleep disorders, further complicating management. In older adults, asthma is exacerbated by chronic conditions such as cardiovascular disease, diabetes, and obesity, leading to worsened pulmonary function and an elevated risk of hypertension. Tuberculosis, with its pulmonary and extrapulmonary manifestations, and disorders like bronchitis are also commonly associated with gastroesophageal reflux disease, hypertension, and diabetes. 

COVID-19 exacerbated problems, leaving many survivors with lasting respiratory problems, with a study by Christian Medical College Vellore highlighting that Indians reported greater impairment of lung function and co-morbidities (which commonly included diabetes, hypertension, and chronic kidney disease) than those in regions like Europe and China. 

Understanding the intricate relationship between lung diseases and co-morbidities is key to improving health outcomes. While health systems largely focus on individual diseases, it is essential to move towards a more integrated approach to management of health. 

Simple steps to protect long-term lung health

Taking proactive steps to care for the lungs is not only about addressing issues when they arise, by appropriate medical care, but also about preventing them in the first place. 

Quitting Smoking: It is one of the simplest yet most effective changes you can make to your life. Avoiding passive smoking (i.e. second-hand/third-hand exposure to tobacco) is equally important. Vaping and e-cigarettes are as bad as tobacco when it comes to causing harm to your lungs and must be strictly avoided to promote lung health.

Minimizing Exposure to Air Pollutants (air pollution, industrial emissions, and household pollutants): Utilizing air purifiers wherever required, avoiding heavy traffic, urban re-forestation, and advocating for cleaner air policies can help minimize exposure to pollutants that harm your lungs. Maintaining indoor air quality by ensuring good ventilation in homes and workplaces is essential. 

Making Healthy Lifestyle Choices: You can safeguard your health by choosing to exercise regularly and consuming a balanced diet rich in fruits, vegetables, and lean proteins. 

Practicing Respiratory Hygiene: Regular handwashing, wearing masks whenever required indoors, and practising cough etiquette can minimize the spread of infectious respiratory diseases such as influenza and pneumonias. Regular vaccinations can also provide protection against these diseases.

Regular health check-ups and screenings: They can help in the early detection of lung diseases, thereby facilitating timely intervention and management. High-risk individuals, such as smokers and those with a family history of lung diseases, should undergo periodic screenings.

Prompt initiation and completion of full course of treatment of infections such as tuberculosis and pneumonia is essential to prevent long-term damage to the lungs. Adherence to medication regimes and completion of antibiotic courses are crucial in managing infectious respiratory diseases. Avoid Self Medication. Vaccinations for illnesses such as influenza and pneumonia provide much-needed protection against respiratory infections. 

Simple lifestyle changes, vigilance for early signs of ill health, and a proactive approach to personal health and wellbeing can make a difference to you. Keep your lungs healthy and strong—help them stay in the pink of health.