What are the risk factors for developing COPD (Chronic Obstructive Pulmonary Disease) in non-smokers?

From the Guidelines

Risk Factors for COPD in Non-Smokers

Occupational exposures and indoor air pollution are significant risk factors for developing COPD in non-smokers.

• Key risk factors include:
  • Occupational exposures to dust, fumes, smoke, and gas 1
  • Indoor air pollution from cooking fuels, especially in enclosed spaces with poor ventilation 1
  • Passive smoke exposure, which is strongly associated with chronic cough and sputum production 1
  • Genetic predisposition, such as alpha-1 antitrypsin deficiency 1
  • Environmental exposures, such as air pollution and agricultural occupation 1
  • Increasing age and male gender may also contribute to the risk of developing COPD 1

Pathophysiology

The pathophysiology of COPD involves a chronic inflammatory response and oxidative stress in the lungs, leading to abnormalities characteristic of the disease 1.

• Other pathobiological processes that may contribute to the development and progression of COPD include:
  • Genetic and epigenetically determined responses 1
  • Imbalance of proteinases and antiproteinases 1
  • Abnormal interaction between environment and microbiome 1
  • Alteration of the microbiome 1
  • Chronic immune response 1
  • Inappropriate control of programmed cell death 1
  • Accelerated lung aging 1
  • Pulmonary endothelial cell dysfunction 1
  • Abnormal ion transport due to CFTR dysfunction 1

From the Research

Risk Factors for COPD in Non-Smokers

The risk factors for developing Chronic Obstructive Pulmonary Disease (COPD) in non-smokers are varied and include:

• Air pollution 2
• Occupational exposures 2, 3
• Poorly controlled asthma 2
• Environmental tobacco smoke 2, 4
• Infectious diseases 2
• Low socioeconomic status 2
• Impaired lung growth during childhood 2
• History of asthma, tuberculosis, or respiratory infections during childhood 3
• Exposure to biomass 3
• Previous respiratory diseases of any type 3
• History of tuberculosis or rheumatoid arthritis 4
• Exposure to biomass fuels 4
• Second-hand smoking 4

Demographic Characteristics

COPD in non-smokers is more frequent in:

• Women 5
• Older ages 5
• Individuals with a slightly higher prevalence of comorbidities 5

Clinical Characteristics

COPD in non-smokers is associated with:

• Relatively mild chronic respiratory symptoms 2
• Little or no emphysema 2
• Milder airflow limitation 2
• Fewer comorbidities 2
• Frequent exacerbations 2