As already mentioned in the previous blog, air pollution and it’s risk for respiratory diseases is very urgent. Suspended particulate matter can eventually lead to respiratory illnesses. Two of those we will describe in more detail here, since it forms a double burden as well.

The first is Chronic Obstructive Pulmonary Disease (COPD), which is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma. This disease is characterized by increasing breathlessness, cough, mucus production and wheezing. More than 65 million people in the world are suffering from CPOD and experts predict that this number will continu to rise the upcoming 50 years. In 2015 3,2 million people died of COPD which makes it a serious health problem.

Second is tuberculosis; a respiratory infectious disease that can be picked up by a person through small particulate matter as we explained in the blog about the spread of TB through air pollution. Numbers of this disease are striking as well: a total of 1,5 million people died from TB in 2018. In the case of tuberculosis it was already known that bad air condition could be hazardous for the development of active TB. However, according to the WHO 43% of all deaths and disease from COPD are caused by ambient air pollution additionally. Symptoms of both diseases are quite similar and risk factors overlap as well. Common risk factors for both diseases are

• history of smoking tabacco
• low socioeconomic status (which can be associated with bed Household Air Pollution as wel due to bad isolation)
• compromised immune defense.

Especially older people who suffered from tuberculosis are more vulnerable to develop COPD since their health condition is more fragile.

The double burden occurs when patients who suffered from TB, have symptoms of having developed COPD . The exact factor that causes COPD to occur after TB is still not entirely clear. Scientist think COPD is most often a result because likely the body’s immune response against long-standing inflammation caused by tuberculosis. The disease is not always detected and therefore not treated well, since the symptoms can only be detected long after the lungs have been damaged severely. Unfortunately, even though TB can be treated successfully, patients often keep a persistent disfunction of their lungs. It is estimated that a severe post-tuberculosis pulmonary dysfunction can even increase the risk for death-from-respiratory-causes. The contribution of tuberculosis to COPD was often ignored but more studies are looking into the causes, effects of the disease on patients. This combination of diseases are important to pay attention to since they are together major causes of morbidity and mortality worldwide.