When Shortness Of Breath Is Not Just Fatigue: Doctor Explains COPD Symptoms Most People Miss

Shortness of breath is often brushed aside as a sign of tiredness or ageing. Many people assume it is normal to feel breathless after climbing stairs or walking a short distance, especially during seasonal changes. However, this is not something to ignore. Even mild or occasional breathlessness can be an early sign of chronic obstructive pulmonary disease, commonly known as COPD. This condition is far more common than people realise and remains underdiagnosed in many parts of India. What makes it even more concerning is that a timely diagnosis could help prevent the long term decline that COPD brings, yet many people do not undergo the simple test that can detect it early.

A lung function test is a basic assessment that is often missing from routine health check-ups. Many individuals only turn to it when their symptoms become difficult to manage. By that time the disease may already have progressed. Acting early turns a preventable decline into a condition that can be managed with the right care. When a person experiences breathlessness, even if it comes and goes, it is a sign that the lungs need attention.

In the last three months at our outpatient department we have seen a marked rise in people arriving with complaints related to their breathing. The seasonal shift combined with worsening air quality has led to an increase of nearly forty percent in patients reporting breathlessness, cough or sputum production. This rise is seen in both men and women. People who smoke are at greater risk regardless of gender. The lungs react to the constant irritation caused by smoke and pollutants and this makes them more vulnerable to infections and inflammation.

COPD typically develops in people in their middle or older years but the process begins much earlier. Once a person is exposed to tobacco smoke or harmful environmental agents the decline in lung function starts quietly. The symptoms do not appear immediately. For many the first noticeable signs arise after five to ten years. Those who have heavy and continued exposure to tobacco, occupational dust or repeated serious infections in childhood or adulthood may develop symptoms earlier.

There is a common belief that only smokers get COPD. This is not true. The proportion of non-smokers with COPD varies widely across regions in India. Smoking is a major cause but not the only one. In many households biomass fuel used for cooking releases large amounts of smoke, and women who spend long hours in poorly ventilated kitchens breathe these fumes for years. Indoor and outdoor pollution adds to this load. Occupational dust from construction, factories and farmlands also harms the lungs. Fumes from chemicals, earlier lung infections including tuberculosis and repeated childhood respiratory illnesses all contribute to this condition. Even exposure to secondhand smoke places people at risk. Any person who lives or works in an environment where the air is contaminated can develop COPD.

In India some of the most common risk factors include tobacco in any form whether cigarette, beedi, smokeless products, hookahs or vapes. Household biomass fuel exposure is another major contributor. Indoor and outdoor pollution continues to rise in many cities and rural areas face their own challenges with smoke and dust. Occupational exposure in industries, prior lung infections and poor living conditions including lack of ventilation and undernutrition also play a role.

COPD is not only a disease of the lungs. It affects the whole body. People may experience worsening breathlessness, persistent cough and repeated lung attacks that require emergency care. Over time COPD can impact the heart, weaken muscles and bones and also influence brain health. It is a progressive and disabling disease that affects the quality of life of millions.

Air pollution is becoming a major factor in the rise and worsening of COPD. Continuous exposure to pollutants irritates even healthy lungs. Particulate matter such as PM two point five and PM ten can worsen symptoms in those who already have COPD and trigger attacks that often lead to hospital admissions. Long term exposure can speed up the decline in lung function and lead to new cases of COPD in people who previously had healthy lungs. With air quality levels regularly falling into the poor or severe category in many cities this risk is only increasing.

On this World COPD Day it is important to remember that shortness of breath is never simply age catching up or just a cough that will settle on its own. Breathlessness is a message from the body. If you or someone in your family is experiencing breathlessness, cough or sputum it is important to seek medical advice. A lung function test can help detect problems early and guide you towards the right treatment. Avoid all forms of tobacco. Reduce exposure to household smoke and outdoor pollution as much as possible. Keep your vaccinations updated to prevent infections and use inhaler therapy exactly as advised by your doctor.

Raising awareness is the first step to protecting our lung health. When we recognize that breathlessness is not normal we take the right action at the right time. This simple shift in understanding can prevent years of suffering and allow people to lead healthier and more active lives.

(By Dr Rahul Sharma, Additional Director - Pulmonology, Fortis Noida)

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