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All about emphysema

Just opened your eyes and can’t wait for your first cigarette of the day? If you’re lighting up without even thinking about it, maybe it’s time to start contemplating the harm that’s being done to your lungs. Emphysema is a progressive and irreversible lung disease. In 90% of cases, emphysema is caused by cigarette smoking.

What is emphysema?

  • COPD (Chronic obstructive pulmonary disease) is an umbrella term describing emphysema, chronic bronchitis, asthma and some forms of bronchiectasis.
  • The large airways of the lungs branch into thousands of thinner tubes. These thinner tubes end in small, round air-sacs called alveoli.
  • In emphysema, these air-sacs (alveoli) are damaged and lose their shape, becoming floppy, impairing the movement of oxygen and carbon dioxide at this level.
  • In addition, there can be increased mucous production causing a general clogging up of the airways, further affecting breathing

What causes emphysema?

  • Cigarette smoking, in the majority of cases
  • Long-term exposure to various inhaled toxins
    • Occupational dust
    • Inhaled chemicals
    • Air pollution
    • Passive smoke exposure
    • Smoke from indoor cooking and heating
  • Rarely, it’s caused by alpha-1 antitrypsin deficiency, a congenital condition

In the work environment, many dusts, fumes and smoke appear to be linked to an accelerated loss of lung function, including:

  • coal
  • silica
  • cadmium
  • cotton, flour and grain
  • organic and inorganic dusts
  • welding

Pneumoconiosis are a group of lung diseases caused by breathing in certain dusts and the lungs reaction to the dust.

The main pneumoconioses are caused by workplace exposure, especially in the mining sector, namely inhalation of asbestos fibres, silica dust, coal dust, amongst others. Other substances implicated include: aluminium, barium, iron, graphite, mica, talc, kaolin and cotton fibres.

What are the most common symptoms of Emphysema?

There is usually a slow progression of symptoms, over a period of time:

  • shortness of breath
  • cough (with or without mucous production)
  • wheezing
  • decreased exercise tolerance
  • frequent lung infections
  • weight loss
  • blueness of fingernails or lips
  • sleep disturbance
  • morning headache

How is emphysema treated?

  • Quitting smoking is essential
  • “Pulmonary rehabilitation” involves education, quitting smoking, proper nutrition, an exercise programme and learning special breathing techniques
  • Medication:
    • Bronchodilators (B2-agonists, anti-cholinergics). Mostly as inhalers. These help relax and open the airways. Occasionally specific bronchodilators are given orally.
    • Steroids. Inhaled, and occasionally oral. These reduce inflammation and swelling in the airways
    • Antibiotics. Given when infection is present
  • Vaccines – flu vaccine, pneumonia vaccine: to prevent lung infections
  • Oxygen therapy – supplemental oxygen is necessary in certain cases
  • Protein therapy – infusions for emphysema due to alpha-1 antitrypsin deficiency
  • Surgery – lung volume reduction surgery – lung transplant surgery