Chronic Obstructive Pulmonary Disease (COPD) Risk Factors

Medically Reviewed By Nick Villalobos, MD

Chronic obstructive pulmonary disease (COPD) is caused by damage and inflammation in the airways. Certain factors may increase the risk of developing the condition. COPD risk factors include smoking, air pollution, and genetic differences. COPD happens when the airways experience chronic inflammation. It is caused by breathing in harmful substances at a high level or over the long term. This results in damage to the lungs and airways. This damage may eventually become chronic or severe, leading to COPD.

COPD risk factors may increase a person’s likelihood of developing the condition. Some may not be preventable. However, you can take steps to reduce the effects of other COPD risk factors.

This article discusses the risk factors of COPD, including modifiable and non-modifiable COPD risk factors. It also explains how to reduce your risk and help prevent COPD if possible.

Modifiable risk factors for COPD

An infographic depicting modifiable and non-modifiable COPD risk factors.
Infographic by Maya Chastain

Some COPD risk factors can be modifiable. This means you can take steps to reduce or help prevent their effects.

Below are some modifiable COPD risk factors.

Smoking and secondhand smoke

Smoking tobacco is thought to be the main cause of COPD. According to the U.K. National Health Service (NHS), 9 in 10 cases of COPD may be due to smoking. Plus, a large 2019 study Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source by the Centers for Disease Control and Prevention (CDC) also suggested that as much as 15.2% of people who smoked went on to develop COPD.

This means that not everyone who smokes develops COPD. However, smoking and exposure to smoke may increase your risk significantly. Being exposed to secondhand smoke, particularly early on in life, may also raise the risks.

Other smoke exposure

Exposure to other kinds of smoke may also increase the risk of COPD. Examples include:

  • wood smoke
  • coal smoke
  • industrial smoke and chemical vapors

Air pollution and chemical fumes

Long-term exposure to air pollution, both inside and outside, may heighten the risk of COPD. However, researchers aren’t exactly sure how COPD relates to pollution.

Other substances in the air can also cause irritation that increases the risk of COPD, such as Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • heavy metal dust and fumes, such as from lead or cadmium
  • welding fumes
  • disinfectants and cleaning chemicals
  • pesticides, insecticides, and herbicides
  • arsenic
  • chemicals known as isocyanates, which are in polyurethane
  • polycyclic aromatic hydrocarbons
  • dust, such as from:
    • grain and flour
    • silica
    • coal

People are often exposed to these substances at work or in industrial areas.

History of childhood respiratory infections

Having a history of severe or frequent respiratory infections, such as pneumonia, during childhood may raise the risk of COPD.

It is not possible to change your medical history if you have already had infections in the past. However, you can take steps to avoid or reduce the risk of further infections, especially in any children you care for.

Steps include receiving vaccinations as recommended and washing your hands regularly.

Non-modifiable risk factors for COPD

Some COPD risk factors are non-modifiable. This means that they cannot be prevented, and it may not be possible to reduce their risks.

Below are non-modifiable risk factors for COPD.

Genetics

Some people may inherit a genetic difference that increases the risk of COPD. This genetic difference is known as alpha-1-antitrypsin deficiency (AATD), and it can run in families. Alpha-1-antitrypsin is a protein that helps protect the lung tissues from becoming damaged.

As a result, if you have a deficiency in alpha-1-antitrypsin, the lungs may be more prone to damage from other causes. This means that while AATD alone doesn’t cause COPD, it can heighten the chances of developing COPD alongside other causes.

Asthma

The American Lung Association (ALA) suggests that having a history of asthma may raise the risk of developing COPD. This is because asthma can cause damage to the lungs and airways over time.

Learn more about asthma treatment and how to optimize your care.

Structural differences in the lungs

Differences in the development and structure of the lungs may increase a person’s risk of COPD. Some of these structural differences may be present from development in the womb or at birth.

A 2020 study Trusted Source JAMA Peer reviewed journal Go to source suggests that dysanapsis may link to COPD in older adults. Dysanapsis is a structural lung condition in which the size of the airways is proportionally too small for the size of the lungs.

Researchers suggest that this may be one reason why some people who have never smoked develop COPD.

Older age

The ALA also suggests that the risk of COPD rises over age 40 years. This may be because your lung function may decrease with age.

However, this may not cause COPD on its own.

Other COPD risk factors

Other COPD risk factors can include:

  • having reduced access to healthcare
  • experiencing low socioeconomic status and socioeconomic disparities affecting health
  • living in rural areas
  • being Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source exposed to smoke as a fetus in the womb
  • having a low birth weight
  • being born preterm

Risk factors don’t always relate to causes

Risk factors of a condition are not always the same as the causes of a condition.

This means that while certain factors may increase your risk of COPD, experiencing a risk factor doesn’t guarantee you will develop it. Some people may develop COPD despite experiencing only one or two risk factors.

For example, a risk factor such as older age may not be enough to cause COPD on its own. By contrast, smoking may be the most significant factor in the development of COPD.

If you have questions or concerns about your risk of COPD, contact your doctor for advice.

COPD prevention

Not all cases of COPD will be preventable. However, if you experience modifiable COPD risk factors, you may be able to take some steps to lower your risk.

These steps can include:

  • quitting smoking if you smoke (and asking your doctor for help if you are trying to quit smoking)
  • avoiding secondhand smoke
  • checking the air pollution levels before spending large amounts of time outside
  • wearing a respirator mask Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source that is approved by the National Institute for Occupational Safety & Health when using chemicals
  • using industrial and household chemicals, such as cleaning chemicals, with the windows open and as per the label instructions
  • asking your workplace to improve ventilation and reduce industrial air pollution
  • keeping up to date with your vaccinations and making sure any children you care for get their vaccinations
  • washing your hands regularly and thoroughly with soap and water
  • wearing a mask around people with respiratory infections or avoiding prolonged time with them
  • getting regular check-ups if you have high exposure to smoke or other substances related to COPD
  • contacting a doctor for personal advice about your exposure and risk
  • following your doctor’s treatment plan and advice for your care, especially if you have conditions such as asthma

The 2019 CDC study Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source mentioned above also suggests that the risk of COPD was much lower after quitting smoking.

See more advice for how to quit smoking.

Non-modifiable COPD risk factors cannot be changed. However, there may be some approaches to help you support your health if you experience non-modifiable factors.

For example, being aware of a family history of COPD and your own risk can help you take further steps to address the risks you can modify. Additionally, medical treatments for asthma and structural lung differences may improve your lung health and reduce your risk of developing the condition.

Summary

Some factors may increase the risk of developing COPD. Research suggests that the most significant COPD risk factor is smoking cigarettes and exposure to tobacco smoke. However, other factors can also play a significant role in the development of COPD.

Some COPD risk factors are modifiable, meaning you may be able to reduce their effects. These risk factors can include smoking, exposure to air pollution and chemicals, and frequent respiratory infections.

Other risk factors may be non-modifiable, including genetic differences, underlying lung conditions, and older age.

Contact your doctor for personal advice about your risks of COPD and prevention.

Was this helpful?
1
  1. Chronic obstructive pulmonary disease (COPD). (2023). https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
  2. COPD causes and risk factors. (2023). https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/what-causes-copd
  3. Dumas, O., et al. (2019). Association of occupational exposure to disinfectants with incidence of chronic obstructive pulmonary disease among US female nurses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813668/
  4. Overview: Chronic obstructive pulmonary disease (COPD). (2023). https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/
  5. Savran, O., et al. (2018). Early life insults as determinants of chronic obstructive pulmonary disease in adult life. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834168/
  6. Smith, B. M., et al. (2020). Association of dysanapsis with chronic obstructive pulmonary disease among older adults. https://jamanetwork.com/journals/jama/article-abstract/2766866
  7. Viniol, C., et al. (2018). Exacerbations of COPD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488662/
  8. Wheaton, A. G., et al. (2019). Chronic obstructive pulmonary disease and smoking status — United States, 2017. https://www.cdc.gov/mmwr/volumes/68/wr/mm6824a1.htm

Medical Reviewer: Nick Villalobos, MD
Last Review Date: 2023 May 30
View All COPD Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.