Chronic obstructive pulmonary disease (COPD): risk factors

Major risk factors for COPD vary between countries based on their income group classification and the nature of their economies. In high- and middle-income countries such as Scotland, tobacco smoking accounts for around 90% of COPD cases, depending on the diagnostic criteria used. The remaining cases are predominantly due to occupational exposure to dust, chemicals and fumes, which contributes to a population attributable risk of 14% globally. This proportion is thought to be higher in lifelong non-smokers.

In low-income countries, COPD risk factors are more varied. Although smoking remains the most significant risk factor, accounting for 30-40% of cases, occupational exposure to pollutants as well as indoor air pollution from solid fuel or biomass cooking stoves also contribute to COPD prevalence.

Further risk factors for COPD as reviewed by the National Institute for Health and Care Excellence (2024) and by Adeloye et al. (2022) include genetics, prenatal lung development, asthma, male sex and low body mass index (BMI), although further research is needed to understand their role in the development of the disease and potential interactions with other risk factors.