SELF-HELP PREVENTION: BRONCHITIS AND EMPHYSEMA

What are they?

Bronchitis is an inflammation of the air passages of the lungs and emphysema is a condition in which the tiny air sacs (alveoli) at the ends of the passages become distended and weakened. They are usually thought of together because they so often occur alongside one another.

Bronchitis usually starts with a cold on the chest, often with a sense of ‘rawness’ behind the chest bone, tightness in the chest or pain or irritation between the shoulder blades. There is often a dry cough and a moderate fever. Gradually the cough becomes looser and the sufferer starts to produce phlegm. This cough and phlegm can continue for weeks. This type of bronchitis is called acute but it can keep on recurring and become chronic. When it becomes chronic the lungs begin to shrink and permanent damage reduces their efficiency.

Chronic bronchitis is extremely common, especially in the UK. About one in twenty of all deaths are caused by bronchitis and emphysema. The total number of deaths is the same as that caused by lung cancer. These conditions also result in the loss of about 300 million working days each year.

What causes them?

• Cigarette smoking. There is no doubt that the largest single culprit is smoking, though it should also be borne in mind that deaths from these conditions are more common in parts of the country where air pollution is high. No one knows why all smokers do not get the disease but some studies suggest a hereditary link. This has been traced to a deficiency of alpha 1-anti-trypsin in the blood of susceptible people. Such people are then especially sensitive to cigarette smoke and infection.

• Physical variations. The north of England has more bronchitis and emphysema than does the south and it appears that the wetness of the atmosphere could have something to do with it.

• Certain occupations are particularly connected with these diseases. Workers in the linen and cotton industry and those who are exposed to cadmium are especially at risk.

• Poor personal resistance to infections. This is caused by poor diet, bad breathing, poor posture, lack of exercise and smoking.

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