Smaller Lung Airways Increase Women’s Risks for COPD

Many people used to consider chronic obstructive pulmonary disease (COPD) as a condition that only affected older men. Since about 2008, though, the global prevalence of this serious breathing problem in women is quickly approaching that seen in men. Medical professionals attribute the rise of COPD among women to increased rates of tobacco smoking among women worldwide, exposure to biomass fuels, and susceptibility to airborne contaminants. New research shows that a woman’s anatomy – specifically the size of her airways – may heighten her risk for developing COPD.

Women tend to have narrower airways than do men – as much as 26 to 35 percent smaller, by some estimates. Having smaller airways can make people more vulnerable to lung disease, even for people who have smoked less than 100 cigarettes over the course of their lifetime or who have never smoked.

About the Lungs and the Effects of COPD

As their name suggests, airways are the passages through which air travels to the lungs. When someone inhale, air enters through their nose or mouth and into their trachea, also known as the windpipe. The trachea branches off into the left and right bronchial tubes that connect to the left and right lungs. The bronchial tubes branch off into smaller airways, known as bronchioles, which can be as thin as a human hair.

Each lung is separated into sections that contains thousands of air sacs, known as alveoli, which fill with air. Tiny blood vessels absorb oxygen from the air, and disperses this oxygen to cells around the body. Narrow airways can reduce the amount of air moving into the lungs, thereby decreasing the amount of oxygen delivered to body cells.

COPD also narrows airways. Chronic obstructive pulmonary disease is an umbrella term that covers two respiratory diseases: emphysema and chronic bronchitis. Emphysema causes the walls of the alveoli to become inflamed and lose elasticity, which eventually causes the bronchioles to collapse. Chronic bronchitis is long-lasting inflammation of the bronchial tubes, which causes severe coughing spells that bring up mucus, wheezing, shortness of breath, and chest pain. Chronic inflammation can also cause thickening and scarring of the bronchial tubes.

Cigarette smoking can also narrow lung airways. Chemicals in the smoke irritates the tender tissue in the bronchioles; smoking for years can cause chronic inflammation and thickening of the walls of the air sacs. The damage to alveoli cannot be reversed, and can lead to the development of COPD. The inflammation can also decrease the size of the empty space within the trachea, known as the lumen, to reduce air flow into the lungs.

COPD is a serious respiratory problem – it is also common: COPD is the third leading cause of death in the world, according to the World Health Organization.

COPD is also preventable. Long-term cigarette smoking is the main risk factor for developing COPD, and quitting smoking is the best way to avoid this disease. Avoiding second-hand smoke can help, as can avoiding exposure to industrial dusts, chemicals, and fumes from burning fuel.

New Research Suggest Women are at a Disadvantage When it Comes to COPD

In a new study published in August of 2022, researchers found that the structural differences in airways between the genders might explain why the prevalence of COPD is rising so rapidly in women. The researchers looked at data gathered from the Genetic Epidemiology of COPD (COPD Gene) study, which included 10,000 participants who were current, former, and never smokers between the ages of 45 and 80. The participants were recruited from 21 clinical centers across the United States and all underwent chest CT scans.

The researchers found that when cigarette smoking narrows airways, the effect on women is greater than on men when it comes to symptoms and survival. In other words, smoking causes more harm to women because it narrows their already-narrow airways.

Using the results of the CT scans, the researchers assessed each participant’s airway disease by measuring several metrics, including airway wall thickness and the diameter of the lumen. The researchers found that, of the 9,363 smokers in the study, men had thicker airway walls while women had a narrower lumen diameter. They also found that the women who had thicker airway walls or a narrower lumen diameter had poorer lung function, more shortness of breath, and worse overall survival. The female smokers also had a higher risk for mortality than did their male counterparts.

The research underscores the importance of considering gender when it comes to assessing patients’ risk for COPD and breathing problems associated with respiratory disease. CT scan can help detect signs of COPD, such as bronchial wall thickening, which can lead to early detection and treatment that slows the progression of COPD.