Pamela Kirkpatrick: COPD sufferers need support to help them stay in work for longer

Long-Term Conditions (LTC) are persisting health conditions that can't currently be cured but can be well controlled by medication and therapeutic interventions. Examples of LTC's include diabetes, heart disease and chronic obstructive pulmonary disease (COPD). The diagnosis of the breathing condition COPD includes conditions such as chronic bronchitis, emphysema, and chronic asthmatic bronchitis and is expected to become the world's third leading cause of death by 2030 after heart disease and stroke.

Pamela Kirkpatrick is a Senior Lecturer and researcher in the School of Nursing and Midwifery at Robert Gordon University, Aberdeen.

COPD is a chronic airflow obstruction that is progressive and debilitating. Its emergence is slow and insidious and often diagnosed in mid-life. Many people diagnosed with COPD attribute some of the symptoms including breathlessness, coughing, wheezing, increased mucus production and fatigue to the natural ageing process. Although lung volume declines gradually from the age of around 70 the symptoms experienced with COPD is not a normal part of ageing and should be investigated at the earliest opportunity by a doctor.

Long-term and cumulative exposure to irritants causes inflammation in the delicate and sensitive lining of the lungs and subsequently results in the narrowing of small airways and then a breakdown of the lung tissue. COPD was known as the “old man’s smoking disease” but it affects more and more women and incidence is increasing in many countries due to the rise in smoking and air pollution. In some cases though it is caused by genetic factors and not related to smoking or pollutants.

People with COPD often experience exacerbations of the condition which can lead to chest infection and hospitalisation. One of the worst aspects is the variability of the condition week by week, day by day and even throughout a single day. The triggers to coughing and extreme breathlessness includes extremes in air temperature, air quality (smog, vapours, fumes, smoke from indoor fires/cooking, dust, pet dander, mold) chemicals (cleaning products, paints and textile particles) and scents (candles).

It is important to protect your lungs from the irritants that can cause permanent lung damage and the younger you do this the better. Especially vulnerable are people continually and intensively exposed to dusts and powders in air particles such as in construction, mining and other jobs where chemicals and particles fill the inhaled air. Smoking tobacco has a big implication and a high proportion of people that are heavy smokers over a period of time have a degree of lung damage as a result.

You only have one set of lungs so to keep them healthy you can limit the time you are in polluted areas, vent indoor smoke and wear masks when working in hazardous air environments. Also, stop smoking – even people with moderate and severe respiratory disease (and COPD) can improve their symptoms and outlook by stopping smoking and exercising their lungs in fresh air. Formal pulmonary rehabilitation programmes designed to improve lung function through exercise and general fitness tolerance can be hugely beneficial in enhancing the health of those with COPD. If you do have a lung condition avoid being around those with colds and chest infections this winter and remember to have the FLU vaccination.

According to the GOLD guidelines COPD can be categorised as mild, moderate, severe and very severe. Everyone with COPD can work to some extent depending on the severity of the symptoms, job requirements, frequency of exacerbations and the degree of flexibility and adaptation that can be built into their role. However, recent research has revealed that around 40 per cent of people with COPD leave the workplace before their planned retirement age and means that there’s a considerable loss of skills and experience to society and also that individuals with COPD suffer financially, may lose their sense of purpose in relation to their profession and skills in the workplace and can become socially isolated as a result.

A research study based at Robert Gordon University is currently drawing to a close, with the aim of finding out what people with COPD experience in trying to sustain their employment and also understand what it’s like to stop working because of COPD. It aims to make future recommendations for ways of improving people’s experience and helping them stay working for longer through being aware of and using flexible working policies, supporting people with COPD to work well and modify their careers and use the Equality Act 2010 to ensure fairness in the workplace.

So, if you work with a colleague with a COPD spare a thought for them and offer your support for what is largely a hidden condition. They are likely to be working very hard on a day-to-day basis to achieve what they do. You never know, you may need similar support in the future.

Pamela Kirkpatrick is a Senior Lecturer and researcher in the School of Nursing and Midwifery at Robert Gordon University, Aberdeen.