Not too long ago the statement was made that if a patient had chronic obstructive lung disease that it was related to cigarette smoking, period. And only with very rare incidence was it related to anything else. But again, we believe now that asthma in younger years can evolve into chronic obstructive lung disease. Irritation and inflammation from certain exposures such as factory work, certainly people who are firefighters, certainly people who’ve had single massive exposures to certain conditions can have damage in their bronchial tubes and can act like chronic obstructive lung disease such as an overwhelming pneumonia at one time in your life, or being in a fire where there is a lot of smoke inhalation.
It is important to recognize that certain genetic pre-dispositions such as deficiency of an enzyme called “alpha-1 antitripsym” can promote chronic obstructive lung disease and we used to think of that only associated with emphysema but it seems to be associates with other forms of chronic obstructive lung disease as well.
In many parts of the world, in fact in developing countries, inhalation of what we call “bio-mass fuels” is a leading cause of chronic obstructive lung disease, especially in women. People who live in homes where they heat their homes and cook with fuels of bio-mass such as wood or banana peels and corn cobs and other materials can develop chronic obstructive lung disease if they’re exposed to it too much. There seems to be some of that in certain parts of the United States as well, particularly if there is a genetic pre-disposition.
This is certainly not an all-inclusive list, but while cigarettes remain a leading cause, and likely the leading cause in the United States, it is certainly not the only cause. A careful history should be taken from any patient who has a syndrome which looks like chronic obstructive lung disease either clinically and/or on testing.