الفهرس 
Chapter 1 : Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
Aim of the Work
Our aim in this study is to study the role of different risk factors in the development of COPD in our locality, to study the role of exposure time to the risk factor in the pathogenesis of COPD, to study the relationship between each risk factor and the severity of COPD and to study how much these risk factors interact to develop COPD among smokers and non-smokers.
Conclusions and Recommendation
It had been concluded that modifiable risk factors were more represented than non-modifiable ones. However, cases that had combined both types of risk factors were more to suffer of advanced grades of the disease severity. COPD seemed to be a result of a group of risk factors, interacting together in order to produce as well as modify it. The role of exposure time to most of the risk factors was a cardinal predictor for disease progression among most cases.
At the end of our study, we recommend the following:
1) Reduction of the total personal exposure to smoking, occupational dust, fumes and gases in addition to indoor and outdoor pollutants should be an important goal to prevent the onset and progression of COPD.
2) The main emphasis should be on primary prevention, which is best achieved by elimination or reduction to the various risk factors, together with health education about the risk of such exposures.
3) However, due to the effect of the duration of exposure to the different risk factors in the progression of COPD, secondary prevention, achieved through surveillance and early case detection, is also of large importance to improve the present situation and to reduce the burden of the lung disease.
4) Preventive strategies should reduce exposure to noxious agents in the workplace by enforce strict, legally mandated control of airborne exposure in the workplace and the use of respiratory protective equipments. This may also involve new technologies to reduce exposures and better workplace monitoring to ensure levels remain within recommended standards.
5) Patients with known occupational exposure should have routine lung function measurement to detect any decline in lung function.
6) Legislation of a set level of air quality and maintaining it.
7) If fuels are to be used for cooking and heating, patients should be encouraged to perform this within places with adequate ventilation. And it is better to introduce clean burning household fuels if possible.
8) Special concern should be directed towards those who smoke, occupationally exposed, living within polluted, overcrowded and confined places as the duration of exposure to such conditions has been linked to the progression of the disease. So, early intervention would be accompanied with better outcome.
9) We must remind ourselves that any preventive measure taken in relation to COPD must be inevitably linked to the fight against tobacco. Smoking has been correlated to the severity of COPD. All smokers, including those who may be at risk for COPD as well as those who already have the disease, should be offered the most intensive smoking cessation intervention feasible.
10) Due to the combined effect of a group of risk factors together in the progression both the development and progression of COPD, those exposed to many risk factors such as those occupationally exposed, should be educated on how cigarette smoking aggravates occupational lung disease.
11) Patients with a positive family history of chronic chest diseases should be strictly advised to avoid smoking.
12) Patients with bronchial asthma should be informed about the risk of developing COPD, and encouraged to use inhalers as early as possible, recommended by respiratory guidelines, in order to try stopping further progression to irreversible obstructive airway disease.
13) The extremely important association between COPD and low socioeconomic status represents, if we could say it, a hope for intervention to stop disease development and progression as it forms a modifiable risk factor. This would need governmental awareness about the danger of the disease. Improving the living conditions of the citizens whether in planning of buildings, education or income would marvelously prevent an evitable danger.
14) Encourage consumption of dietary antioxidants and finding of cheaper sources of them if possible.
15) Messages of avoidance of risk factors should be transmitted to both sexes.
16) Low body mass index, whether a result of or a cause for COPD, need to be fatherly evaluated using other types of studies.
17) Aged people should be regularly screened for early detection and intervention for COPD.
18) Due to the cross-sectional design of the present study, exposure to the different risk factors has been established retrospectively. However, for substantial proof for such factors, longitudinal studies would be better for that, however, they need several years in order to detect their effects over a long follow-up period that they seem to match with large team work studies.