Air pollution is the leading cause of COPD: Why is this lung disease deadly

In recent weeks, Delhi has witnessed a dangerous spike in air pollution levels, with the air quality deteriorating to “severe” levels, prompting health warnings for millions of residents.
As the capital and surrounding areas grapple with hazardous levels of smog, experts are raising alarm over the long-term health consequences, particularly for individuals suffering from chronic respiratory diseases like Chronic Obstructive Pulmonary Disease (COPD).
COPD, which currently affects nearly 63 million people worldwide, is a progressive lung disease that makes breathing increasingly difficult. According to the World Health Organisation (WHO), air pollution is one of the leading environmental risk factors for COPD, alongside smoking.
In fact, air pollution contributed significantly to the 3.1 million deaths caused by COPD in 2021, underscoring its deadly impact.
Dr Manoj Goel, Director & Unit Head of Pulmonology at Fortis Memorial Research Institute, explained that air pollution is a complex mix of harmful substances, including sulfur oxides, nitrogen oxides, volatile organic compounds, and particulate matter. These pollutants, which originate primarily from industrial emissions and vehicle exhaust, can have both immediate and long-term health effects.
“Air pollution is not only harmful to the lungs, but it can also affect nearly every organ in the body,” said Dr Goel. “The fine particulate matter (PM2.5) found in polluted air is small enough to enter the lungs and bloodstream, causing widespread inflammation and damage.”
In COPD patients, exposure to air pollution accelerates the decline of lung function and exacerbates symptoms. Particulate matter, which is often less than 2.5 micrometres in diameter, can infiltrate deep into the lung’s air sacs (alveoli), triggering inflammation, oxidative stress, and chronic tissue damage.
Over time, this leads to more frequent exacerbations of COPD, worsening respiratory function, and increasing the risk of mortality.
Dr Kuldeep Kumar Grover, a Consultant Pulmonologist at CK Birla Hospital, highlighted the significant impact of both indoor and outdoor pollution on COPD patients.
“Indoor pollution, often from cooking with solid fuels, can exacerbate inflammation in lung tissue and increase symptoms,” said Dr Grover. “Outdoor pollution, particularly during high-smog seasons, further increases the risk of COPD flare-ups, loss of lung function, and even death.”
The lethal effects of air pollution are not limited to COPD. In fact, the WHO reports that outdoor fine particulate matter is responsible for over 4 million deaths globally each year, making it the fifth leading risk factor for death. Air pollution is also linked to a wide range of other diseases, including lung cancer, heart disease, and stroke.
For those living with COPD, the combination of smoking, environmental pollutants, and chronic lung damage makes managing the disease even more challenging.
With pollution levels in cities like Delhi routinely exceeding safe limits, the need for urgent action to tackle air quality is clearer than ever.