Changing dynamics of Chronic Obstructive Pulmonary Diseases in India. Bhatia A., Joshi S. Med J DY Patil Vidyapeeth 0:0:0. 22-02-2021 web publication.

Rapid urbanization, social and economic development, industrialization, dynamic age structure, and changing lifestyles bring India to a position of an increasing burden of noncommunicable diseases including chronic obstructive pulmonary disease (COPD).

The prevalence of COPD in India increased from 3.3% in 1990 to 4.2% in 2016. Of the disability-adjusted life years due to COPD in India in 2016, >50% were attributable to air pollution, with the rest of majority comprising tobacco use and occupational factors.[1] There are myriad of peculiarities of COPD in the Indian context. Smoking habits ranging from bidis, hookas in rural areas to filter cigarettes and vaping in cities vary large and wide. Exposure to biomass fuels such as crop burning, woods, or animal dung leads to COPD in large proportions. The prevalence among nonsmoking females may be higher considering the rural poor staying in ill ventilated houses using dry wood as fuel. In addition, the particulate pollution from these residues is leading to public health emergencies in far off cities which may eventually result in increasing prevalence of COPD in future.

Considering these risk factors, socioeconomic factors are bound to result in variations throughout the country. We, however, have to recognize that the prevalence estimates of COPD are not totally accurate. Most of the studies done are based on questionnaires and crude spirometry levels. The country needs to have a robust and accurate reporting system to do targeted interventions for the management of COPD.