Géraldine is 54 years old and discovered in 2022, thanks to a Covid-19 infection, that she had “COPD”, that is to say that she suffered from chronic obstructive pulmonary disease. She lives in Bordeaux and the diagnosis that comes out only half surprises her. “I immediately put it down to pollution, when I arrived in Bordeaux, after an hour or two, I started to cough, as if I had prickles in my throat which were blocking my mouth. breathing. I feel a permanent weight on my chest, something oppressive. »
Environment and respiratory health, what do the French think?
Air pollution is an invisible deadly danger… According to the World Health Organization (WHO), nearly 7 million premature deaths are attributed to exposure to air pollution, both indoor and outdoor. . Moreover, 99% of the world’s population breathes air whose quality exceeds the thresholds recommended by the WHO. In France, more than 10 million people suffer from respiratory pathologies, placing them third among causes of death in the country. However, air quality definitely plays a major role in their worsening.
So she coughs, all day long, she coughs and gets exhausted. Sometimes there are healthy breaks of an hour or two. The patient confirms that her condition improves when she leaves the city, finds herself by the sea, in the countryside, in an environment where the air is drier and purer. “I was a smoker, it’s true, but I also had pneumonia when I was a child,” she explains. Tobacco is not the only cause, even if doctors expect it. » From now on, Géraldine is followed in a specialized department in Bordeaux, her lung capacity is reassessed every six months. “What makes me feel better? Get out of the very polluted Bordeaux area. And the aerosol that sends oxygen and Ventolin into my lungs, when I’m in crisis…”
November 21 will be World COPD Day, the disease of the century. Between 5 to 10% of the population is affected, however, “only a quarter of patients know it,” notes Professor Maeva Zysman, pulmonologist at Bordeaux University Hospital and researcher at the Inserm COPD unit. “It is a disease of the lungs and airways, the bronchi and bronchioles are permanently blocked. Consequently, the passage of air is slowed down and the oxygenation of the blood is disrupted,” describes the doctor.
“We diagnose based on patient complaints, permanent shortness of breath, persistent cough, via a respiratory capacity test, in addition to imaging. These patients, in general, have been ill for a long time, treated regularly with antibiotics and cortisone. It is a disease that is diagnosed late, in adulthood. And the major cause remains tobacco. Moreover, women who have started smoking as much as men are now much more affected by COPD, because they tolerate tobacco less well, due to the smaller size of the lungs, and undoubtedly their hormonal system. »
Environmental exposure
The incidence of the disease is certainly increasing, but so are the treatments. COPD is becoming a public health issue, it generates more than 100,000 hospitalizations lasting more than eight days each year in France. “It is a chronic disease from which there is no cure,” says Professor Zysman, and which can cause premature death. 3.5 million sick people in France, many of whom could miss out. “Stopping smoking is the first prevention,” assures Maeva Zysman. However, environmental exposure accounts for 15% of COPD diagnoses, notably exposure to household products, agricultural pesticides, etc..”
According to the doctor-researcher, air pollution and in particular exposure to fine particles are not the cause of the disease, but the cause of the worsening of COPD symptoms. “There are also early determinants, premature births, exposure to pollution, particularly when parents smoke,” she explains. Children who have suffered from asthma or cumulative respiratory illnesses have a much greater risk of later developing COPD. Hence the importance of monitoring them, protecting them and ensuring that they are well cared for when they are small. »
COPD: a first biotherapy allows you to gain respiratory capacity
Described as the “silent killer,” chronic obstructive pulmonary disease (COPD) is a lung disease characterized by inflammation and progressive obstruction of the bronchi. In France, 5 million people are affected by COPD, two thirds of whom are unaware that they suffer from it. In 85% of cases, tobacco plays a central role in the occurrence of this disease, which should not overshadow other causes, such as indoor, industrial and atmospheric pollutants.
Therapeutic hopes
Treatments for COPD initially focus on improving respiratory functions in order to slow the inevitable progression of the disease towards chronic respiratory failure. Stopping smoking, prescribing bronchodilators and anti-inflammatories, not forgetting the practice of physical activities are generally recommended to slow down the progression process.
“New molecules that target inflammation are currently undergoing clinical trials,” adds Professor Zysman, “using subcutaneous injections. For the most advanced cases, the endoscopic technique allows valves to be implanted in the bronchi. Alternatively, stimulating lung regeneration from lung stem cells is a solid research prospect. »
On November 21, the University Hospital teams will be on the Allées Tourny de Bordeaux to assess the respiratory capacity of those who wish to do so and provide information on COPD.
