Respiratory illness is a common problem in the United States. Many times, people are genetically more likely to get respiratory conditions, but your work place or environmental exposures could also play a big role. One thing is for sure, smoking is the most common cause of respiratory disease. UnityPoint Health pulmonologist, Jane Doe, DO, tells us the top eight respiratory system illnesses, including which two are the most dangerous.

Asthma

Asthma is defined as a common, chronic respiratory condition that causes difficulty breathing due to inflammation of the airways. Asthma symptoms include dry cough, wheezing, chest tightness and shortness of breath. Dr. Doe says there is a major connection between environmental allergies and asthma. Allergic reactions, infections and pollution can all trigger an asthma attack.

“Those with persistent asthma often notice a better quality of life with the help of anti-inflammatory medication,” Dr. Doe says. “Everyone who has asthma needs to have a rescue inhaler to open airways quickly.”

Usually, asthma starts in childhood years and progresses into adulthood. However, some people in their 60s, 70s and 80s can get adult onset asthma. Dr. Doe says asthma is a reversible obstructive lung disease. He’s seen asthma patients who are able to improve their breathing flow rates better than those who have the respiratory disease known as COPD.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease is an umbrella term that encompasses several respiratory illnesses that cause breathlessness, or the inability to exhale normally. People usually experience symptoms, including shortness of breath, and normally cough up sputum (mucus from the lungs), especially in the morning. COPD can be tricky for some people to identify, because symptoms are often mistaken for the gradual aging process and body deterioration. In fact, COPD can develop over the course of several years without any signs of shortness of breath. For that reason, Dr. Doe says COPD often goes undetected for far too long. He says the disease usually begins while people are in their 30s or 40s and then peaks during their 50s, 60s and 70s.

“This disease is generally associated with cigarette smoking. It’s rare to see people with COPD who haven’t been exposed to some sort of smoking. People can experience varying severity levels of COPD. At its most severe, it can cause people difficulty doing every day activities,” Dr. Doe says.

Treatment includes smoking cessation, bronchodilator therapy (medication that opens the airways) and pulmonary rehabilitation, which is a supervised exercise program for people with COPD. Unlike asthma, COPD is not reversible. According to the American Lung Association, COPD is the third leading cause of death in the U.S. Dr. Doe identifies COPD as one of the most serious and dangerous respiratory illnesses, and COPD is the number one problem seen in most pulmonology offices.

“It’s a very serious disease. Once you get COPD, you’ve got it. It’s a disease that continues to worsen, even with smoking cessation,” Dr. Doe says.

Chronic Bronchitis

Chronic bronchitis is a form of COPD emphasized by a chronic cough. Usually people cough up sputum (mucus from the lungs), especially in the morning. Dr. Doe says this happens because mucus glands in the airways increase output, and patients have to cough that extra secretion out. Since chronic bronchitis is a form of COPD, it’s treated the same way. People can also develop acute bronchitis, which is not a long-term disease but rather an infectious problem. It develops from a viral or bacterial infection and can be treated with antibiotics. Symptoms associated with acute bronchitis will subside once the infection has resolved.

Emphysema

Emphysema is a serious respiratory disease, which is another form of COPD. The most common cause is smoking. Those who suffer from emphysema have trouble exhaling air from their lungs. Cigarette smoke damages the air sacs in the lungs to a point where they can no longer repair themselves. Dr. Doe says this respiratory system illness most commonly leads to respiratory failure and the need for extra oxygen to meet breathing needs. Emphysema evolves slowly over the years, and there is no cure; however, those who quit smoking are more likely to see the disease’s progression slow.

Lung Cancer

With the ability to develop in any part of the lungs, this cancer is difficult to detect. Most often, the cancer develops in the main part of the lungs near the air sacs. DNA mutations in the lungs cause irregular cells to multiply and create an uncontrolled growth of abnormal cells, or a tumor. These tumors interfere with the regular functions of the lungs.

“Far and away the most common risk factor for lung cancer is cigarette smoke. Other risk factors include radon exposure, workplace exposure, including asbestos and diesel fumes, secondhand smoke, air pollution and radiation exposure from frequent CT scans of the chest,” Dr. Doe says.

Symptoms can take years to appear, but include things like chronic coughing, changes in voice, harsh breathing sounds and coughing up blood. According to the American Cancer Society, lung cancer is by far the leading cause of cancer death among both men and women in the U.S.

Cystic Fibrosis/Bronchiectasis

Cystic fibrosis is a genetic respiratory disease caused by a defective gene that creates thick and sticky mucus that clogs up tubes and passageways. This mucus causes repeat, and dangerous, lung infections, as well as obstructions in the pancreas that prevent important enzymes from breaking down nutrients for the body. According to the Cystic Fibrosis Foundation, this disease affects 30,000 people in the U.S., 75 percent of which were diagnosed by age of two. Symptoms of cystic fibrosis include salty-tasting skin, chronic coughing, frequent lung infections and a poor growth rate in children. Dr. Doe says people who have cystic fibrosis will also develop bronchiectasis.

“Bronchiectasis is a condition in which patients develop abnormally dilated bronchial tubes. This allows mucus to pool, causing frequent respiratory tract infections, wheezing and shortness of breath. There are other ways bronchiectasis develops besides cystic fibrosis, including other infections,” Dr. Doe says.

Dr. Doe says bronchiectasis usually develops later in life and is more common in women than men.

Pneumonia

Pneumonia is a common lung disease caused by an infection in the air sacs in the lungs. The infections can be bacterial, viral or fungal. Most people can recover in one to three weeks, but for certain people, pneumonia can be extremely serious and even life-threatening.

“The very young and the very old are more at-risk for pneumonia and complications associated with pneumonia. Patients can be at increasingly susceptible to pneumonia, based on their smoking history or just their overall immune status. If they are frail or sickly, they can develop pneumonia more readily than young, healthy, well-nourished people,” Dr. Doe says.

Symptoms, which include cough, fever, shaking chills and shortness of breath, can range from mild to severe. Dr. Doe says it’s really important for adults over 65 or those with other chronic disease to get the pneumococcal pneumonia vaccine. Additional suggested ways to prevent this respiratory condition include washing hands frequently and getting the flu shot.

Pleural Effusion

Pleural effusion is a collection of fluid between the lung and the chest wall in what’s called the pleural space. The fluid can collect for a variety of reasons, including pneumonia, cancer or congestive heart failure. Usually patients notice symptoms of increasing chest discomfort and shortness of breath. Dr. Doe says those with this diagnosis usually undergo a procedure to remove the fluid, which allows the lung to re-expand, allowing the patient to breathe better. Then, the fluid is tested to determine what’s causing it and a treatment plan is formed.

Preventative Measures for Respiratory Disease

“My number one piece of advice to avoid respiratory system illnesses is to stop smoking and preferably, never start. Tobacco use is very difficult to overcome. It’s along the same lines of crack and heroin,” Dr. Doe says.

Cigarette smoking either causes or worsens every respiratory disease on this list. The Center for Disease Control and Prevent (CDC) says tobacco use is the leading cause of preventable illness and death and produces 480,000 deaths a year (including deaths from secondhand smoke).

Dr. Doe also recommends people practice avoidance in order to prevent respiratory disease. That includes avoiding sick people and places with a lot of dust or harsh chemicals.

“Hog confinement barns or hog dust exposure can cause COPD just like cigarette smoking can. I can’t tell the difference based on lung function tests between someone who has smoked for 30 years or someone who has worked in hog barns for 20 years,” Dr. Doe says.

Dr. Doe says to focus on the basics, too. Try to maintain a healthy weight, get adequate sleep, decrease stress, add plenty of activity and eat a balanced diet.

“Finally, be kind to yourself and be kind to others. Having that type of outlook will help you avoid illness,” Dr. Doe says.