Dear Dr. Donohue: I work with a woman who claims she has emphysema. She smokes regularly and finds herself out of breath when coming up the stairs. She is 60. She says the onset of this condition occurred when she was 9. A local gas station near her childhood home moved and, in the process, pulled up the gas tanks that provide gas to the pumps. The fumes from the move caused her emphysema. She doesn’t know anyone else with the problem, and there are no class-action lawsuits I can find that cite gas fumes from moving gas tanks as causing emphysema.
Will you clarify and talk about emphysema? — E.E.
A: Emphysema is destruction of the millions of air sacs that fill the lungs. It’s through these sacs that oxygen reaches the blood. One of the chief signs of emphysema is shortness of breath when active, as in climbing stairs. Emphysema is one-half of chronic obstructive pulmonary disease, COPD. The other half is chronic bronchitis, an inflammation and narrowing of the breathing tubes, filled with pus. The inflamed tubes obstruct airflow into the lungs. The chief sign of chronic bronchitis is a never ending cough.
Smoking is the greatest cause of COPD, emphysema and chronic bronchitis, but not the only cause. In past days, workers in mines inhaling the dust were subject to emphysema, as were people who worked in cotton mills. Those who made a living in grain-processing plants also were subject to COPD. Now stringent regulations protect these workers.
An inherited condition, called alpha-1 antitrypsin deficiency, also leads to emphysema. Alpha-1 antitrypsin tells cells that scrub the interior of air sacs to stop the scrubbing when the air sacs are cleaned. Without its signal, scrubbing goes on, and the air sacs are destroyed.
I have never heard of emphysema arising in a situation like your fellow worker describes. She must be happy explaining her situation the way she does. Let her be happy. It’s her way of coping with the illness. She also must be smart enough to know that smoking is harming her greatly, regardless of her emphysema cause.
