Chronic lower respiratory disease (CLRD) is a group of conditions that

affect the lungs and are considered the fourth-leading cause of death in the
United States. CLRD encompasses chronic obstructive pulmonary disease
(COPD)—which includes emphysema and chronic bronchitis—as well as
asthma, pulmonary hypertension, and occupational lung diseases. The
conditions are most common among smokers, but everyone should
understand their risks.

Chronic respiratory diseases are chronic diseases of the airways and other
parts of the lung. Some of the most common are asthma, chronic
obstructive pulmonary disease (COPD), lung cancer, cystic fibrosis, sleep
apnea, and occupational lung diseases. Respiratory diseases affect all
ages-children, teens, adults, and seniors. Most of these diseases are
chronic in nature and all have a major impact not only on the individual with
the disease, but on the family, the community, and the health care system.
The two most important risk factors for chronic respiratory diseases are
tobacco smoke (through personal smoking and exposure to second-hand
smoke) and indoor and outdoor air quality. Those who smoke cigarettes
increase their risk of developing lung cancer, Chronic Obstructive
Pulmonary Disease (COPD) and asthma. Exposure to second-hand smoke
affects all Canadians, causing cancer in adult non-smokers, sudden infant
death syndrome in newborns and worsening symptoms of those with
asthma or COPD. All Canadians are affected by the quality of air they
breathe. However, the effects are more severe in those with lung disease.
People who have chronic respiratory disease should refrain from smoking
(or being exposed to second-hand smoke) and as much as possible ensure
a high quality of the air they breathe.

Cigarette smoking is the major cause of these illnesses, accounting for

about 80 percent of cases. However, exposure to air pollutants in the home
and workplace, genetic factors, and respiratory infections can also play a
role in the development of chronic lower respiratory disease, according to
the Centers for Disease Control and Prevention (CDC).

As mentioned, chronic lower respiratory disease is an umbrella term

for diseases of the lungs. Typical symptoms across most of these
conditions include:2

 Shortness of breath
  Wheezing
 Increased mucus (sputum) production
 Chronic cough
 Racing heartbeat
 Fatigue

Additional symptoms may vary depending on the root condition:

 Chronic obstructive pulmonary disease (COPD) : COPD is

characterized by a limitation of airflow into and out of the lungs.
Symptoms include chronic cough, shortness of breath, phlegm
production, and chest tightness.
 Emphysema: In people with emphysema—a type of COPD1—some
of the air sacs in the lungs are damaged. Symptoms include chronic
cough, shortness of breath, phlegm production, frequent respiratory
infections, chest pain, and cyanosis.
 Chronic bronchitis: When the lining of the lungs' airways are red
and swollen, that is one sign of chronic bronchitis, another type of
COPD.1 Other symptoms include mild fever, runny nose, sore throat,
chest and nasal congestion, and a productive cough that turns into a
dry, wheezing cough.
 Asthma: Asthmatic airways are highly sensitive to certain triggers
(smoke, pollen, infections, etc.) and may be plagued by symptoms
such as wheezing, coughing, shortness of breath, and chest
tightness. Symptoms are not constant and may increase during
asthmatic episodes.
 Occupational lung diseases: Smoking, secondhand smoke, radon,
air pollution, and on-the-job exposure to substances such as
asbestos may result in symptoms varying in severity from recurrent
respiratory infections to coughing up blood.

CLRDs are primarily diagnosed via a thorough physical exam, intake

history, and an assessment of lung function, but each condition may
require more specific testing in order to narrow down the diagnosis.

The primary tests used to diagnose most lower respiratory diseases include

some combination of the following:

 Blood tests such as arterial blood gases (ABG) and a complete blood

count (CBC)
  Lung function tests such as peak expiratory flow rate
(PEFR) and spirometry
 Imaging such as chest X-rays, which are often used to support a
diagnosis and may show inflammation in airways
 Pulse oximetry
 Exercise capacity

The severity of the illness and treatment vary based on the particular type
of chronic respiratory disease. If you're a current smoker, the most
important thing you can do to aid your treatment is to quit
smoking.2 Avoiding secondhand smoke and other air pollutants may also
help, as can wearing a mask or ventilator at your workplace if you're
regularly around triggering substances.

Your healthcare provider will help you create a pulmonary rehabilitation

program focused on your specific disease management needs and that
works to help you boost your quality of life.

Certain symptoms, such as coughing, wheezing, or high blood pressure,

may be treated with medications. In patients with low blood oxygen levels
as a result of their chronic lower respiratory disease, supplemental oxygen
may be given.

Exercise has also been shown to be helpful in many different lung

conditions, as it helps improve lung function. One study of 114 COPD
patients found that physical activity in the form of walking positively affected
lung function decline.