A Comprehensive Analysis of Emphysema: From Causes to Prevention
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This essay provides a comprehensive overview of emphysema, a chronic lung disease characterized by the enlargement of alveoli and loss of elasticity in lung tissues. It discusses the causes of emphysema, with a strong emphasis on cigarette smoking as the primary factor, and its prevalence in the United States and globally. The essay outlines various risk factors, including age, exposure to pollutants, and genetics. It details the symptoms of emphysema, such as chronic cough, shortness of breath, and potential complications like pulmonary hypertension and pneumothorax. Diagnostic methods, including lung function tests and spirometry, are explained, along with treatment options such as bronchodilators, antibiotics, corticosteroids, and lifestyle interventions. The importance of prevention, primarily through smoking cessation, is also highlighted. The essay references several studies and medical sources to support its claims, providing a well-rounded understanding of emphysema.

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Emphysema
Introduction
Emphysema is described as a chronic lung disease in which the natural airspaces of the
lungs, that is, the alveoli, becomes larger yet reduce in numbers. Tissues surrounding the alveoli
lose their elasticity. Thus, the airspaces no longer expand as well as shrink as normal. This leads
to the reduction of the amount of oxygen which is transferred to the bloodstream by the lungs.
Consequently, air gets trapped into the spaces instead of being exhaled, thus, making it
very hard for one to breathe. Emphysema has been classified as Chronic Obstructive Pulmonary
Disease (COPD). The disease normally results from the exposure to chemicals and toxins like
cigarettes and air pollutants (Mayo Clinic Health Letter, 2018), irritants, chemical fumes, and
dust. It should be noted that the health damage caused by emphysema is not reversible yet
treatment can help reduce or slow the development and progress of the disease.
Causes and prevalence of emphysema in the United States of America
It has been empirically proven that cigarette smoking is the major cause of emphysema.
Even though smoking has reduced in the United States of America for numerous years, it is still
one of the main causes of the disease (Lao et al. 2015) A large number of people suffering from
the disease are present smokers or have been smoking in the past. It should be noted that
smoking is responsible for about 81% and 91% of the COPD cases, including emphysema
(Sasaki et al. 2018). Emphysema considered as part of COPD is a disease which affects a huge
number of individuals globally. For instance, in 2016, the study on the Global Burden of Disease
revealed a prevalence of 252 million cases of COPD worldwide. Approximately 90% of deaths
due to COPD happen in low as well as middle-income nations (Pulmonx Corp, 6AD 2018). The
Emphysema
Introduction
Emphysema is described as a chronic lung disease in which the natural airspaces of the
lungs, that is, the alveoli, becomes larger yet reduce in numbers. Tissues surrounding the alveoli
lose their elasticity. Thus, the airspaces no longer expand as well as shrink as normal. This leads
to the reduction of the amount of oxygen which is transferred to the bloodstream by the lungs.
Consequently, air gets trapped into the spaces instead of being exhaled, thus, making it
very hard for one to breathe. Emphysema has been classified as Chronic Obstructive Pulmonary
Disease (COPD). The disease normally results from the exposure to chemicals and toxins like
cigarettes and air pollutants (Mayo Clinic Health Letter, 2018), irritants, chemical fumes, and
dust. It should be noted that the health damage caused by emphysema is not reversible yet
treatment can help reduce or slow the development and progress of the disease.
Causes and prevalence of emphysema in the United States of America
It has been empirically proven that cigarette smoking is the major cause of emphysema.
Even though smoking has reduced in the United States of America for numerous years, it is still
one of the main causes of the disease (Lao et al. 2015) A large number of people suffering from
the disease are present smokers or have been smoking in the past. It should be noted that
smoking is responsible for about 81% and 91% of the COPD cases, including emphysema
(Sasaki et al. 2018). Emphysema considered as part of COPD is a disease which affects a huge
number of individuals globally. For instance, in 2016, the study on the Global Burden of Disease
revealed a prevalence of 252 million cases of COPD worldwide. Approximately 90% of deaths
due to COPD happen in low as well as middle-income nations (Pulmonx Corp, 6AD 2018). The

EMPHYSEMA 3
prevalence of emphysema in the U.S. is about 14 million which entails 4% white male
nonsmokers and 15% white smokers (Pulmonx Corp, 6AD 2018). However, the prevalence is
somewhat less for African Americans and white females. The incidence of the disease is
increasing due to the rise in cigarette smoking as well as environmental pollution (Mendy et al.
2018) Reducing mortality from other causes like infectious and cardiovascular diseases is also
another contributing factor for the increase in the incidence of the disease. The severity of the
disease is importantly greater in people working mines which is independent of the status of
smoking.
Risk factors of emphysema
The risk factors of emphysema include; smoking, that is, the disease is developed mostly in
people smoke cigarettes, yet pipe and cigar smokers are also susceptible. Age is also a risk factor
as people with tobacco-linked emphysema starts to experience the disease at the ages between 40
and 60. Other risk factors include exposure to outdoor and indoor pollution, occupational
exposure to dusts or fumes, exposure to secondary or secondhand smoke, and genetics (Shaikh,
Sood, Sarkar & Thakur, 2017).
Complications and symptoms
It is important to note that an individual can have emphysema for several years without
noticing the symptoms or signs. Two of the basic symptoms of emphysema are chronic cough
and shortness of breath (Mondoñedo & Suki, 2017). However, these symptoms usually appear in
the early stages of the disease. Other symptoms of the disease include lips or fingernails turning
grey or blue with exertion, fatigue, or chest tightness. As the alveoli get more stretched, air gets
trapped in bullae which form in the lungs, producing a ‘barrel chest’ that is, the shape of the
prevalence of emphysema in the U.S. is about 14 million which entails 4% white male
nonsmokers and 15% white smokers (Pulmonx Corp, 6AD 2018). However, the prevalence is
somewhat less for African Americans and white females. The incidence of the disease is
increasing due to the rise in cigarette smoking as well as environmental pollution (Mendy et al.
2018) Reducing mortality from other causes like infectious and cardiovascular diseases is also
another contributing factor for the increase in the incidence of the disease. The severity of the
disease is importantly greater in people working mines which is independent of the status of
smoking.
Risk factors of emphysema
The risk factors of emphysema include; smoking, that is, the disease is developed mostly in
people smoke cigarettes, yet pipe and cigar smokers are also susceptible. Age is also a risk factor
as people with tobacco-linked emphysema starts to experience the disease at the ages between 40
and 60. Other risk factors include exposure to outdoor and indoor pollution, occupational
exposure to dusts or fumes, exposure to secondary or secondhand smoke, and genetics (Shaikh,
Sood, Sarkar & Thakur, 2017).
Complications and symptoms
It is important to note that an individual can have emphysema for several years without
noticing the symptoms or signs. Two of the basic symptoms of emphysema are chronic cough
and shortness of breath (Mondoñedo & Suki, 2017). However, these symptoms usually appear in
the early stages of the disease. Other symptoms of the disease include lips or fingernails turning
grey or blue with exertion, fatigue, or chest tightness. As the alveoli get more stretched, air gets
trapped in bullae which form in the lungs, producing a ‘barrel chest’ that is, the shape of the
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EMPHYSEMA 4
over-expanded chest. The chronic damage of the lung prevents the normal circulation of the
blood by the heart. Damage of the lung can cause elevation of pressure in the part of the heart
which moves blood via the lung. This is known as pulmonary hypertension which is believed to
occur in people suffering from emphysema developing abdominal bloating, swelling of the leg,
or prominent pulsation in the veins of the neck. Bullae may rupture or explode into the pleural
space outside the lung. As the individual experiences air accumulation outside the lung, he or she
can suffer from pneumothorax (Valipour et al. 2018). As a result, the body can react by
attempting to compensate for the low level of oxygen by increasing the number of red blood
cells. However, the increase in the number of red blood cells may be so severe to the body
causing blood clots.
Diagnosis
A physician who suspects an individual as having emphysema will probably want to
know about his or her history and will conduct a lung function test (Kane, Bajpai & Biswas,
2018). The physician will conduct tests such as spirometry which examines the amount of air an
individual can exhale in a second (FEV1) and FVC which examines the total amount of air an
individual’s lung can expel. Pulmonary function test entails spirometry yet also measures the size
of the lung, gas diffusion test, and oxygenation. Oximetry which measures the amount of oxygen
in the blood by a device clipped on the ear, toe, or figure (Linan Dong et al. 2014)
Treatment and prevention
One of the best preventions of the disease is stop smoking. Treatment of the disease
entails bronchodilators (Gasparini, Zuccatosta, Bonifazi & Bolliger, 2012)., use of antibiotics in
the event of infection, corticosteroids, lung surgery or lung transplant, an exercise which helps in
over-expanded chest. The chronic damage of the lung prevents the normal circulation of the
blood by the heart. Damage of the lung can cause elevation of pressure in the part of the heart
which moves blood via the lung. This is known as pulmonary hypertension which is believed to
occur in people suffering from emphysema developing abdominal bloating, swelling of the leg,
or prominent pulsation in the veins of the neck. Bullae may rupture or explode into the pleural
space outside the lung. As the individual experiences air accumulation outside the lung, he or she
can suffer from pneumothorax (Valipour et al. 2018). As a result, the body can react by
attempting to compensate for the low level of oxygen by increasing the number of red blood
cells. However, the increase in the number of red blood cells may be so severe to the body
causing blood clots.
Diagnosis
A physician who suspects an individual as having emphysema will probably want to
know about his or her history and will conduct a lung function test (Kane, Bajpai & Biswas,
2018). The physician will conduct tests such as spirometry which examines the amount of air an
individual can exhale in a second (FEV1) and FVC which examines the total amount of air an
individual’s lung can expel. Pulmonary function test entails spirometry yet also measures the size
of the lung, gas diffusion test, and oxygenation. Oximetry which measures the amount of oxygen
in the blood by a device clipped on the ear, toe, or figure (Linan Dong et al. 2014)
Treatment and prevention
One of the best preventions of the disease is stop smoking. Treatment of the disease
entails bronchodilators (Gasparini, Zuccatosta, Bonifazi & Bolliger, 2012)., use of antibiotics in
the event of infection, corticosteroids, lung surgery or lung transplant, an exercise which helps in
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EMPHYSEMA 5
strengthening of the muscles, oxygen therapy to increase the amount of oxygen the body receives
on every breath. Vaccinations against pneumonia and influenza, and use of purified human
alpha-1-antitrypsin.
strengthening of the muscles, oxygen therapy to increase the amount of oxygen the body receives
on every breath. Vaccinations against pneumonia and influenza, and use of purified human
alpha-1-antitrypsin.

EMPHYSEMA 6
References
Mayo Clinic Health (2018). A family friend was recently diagnosed with emphysema, but he
never smoked. Are there other causes of emphysema? Mayo Clinic Health, 36(10), 8.
Gasparini, S., Zuccatosta, L., Bonifazi, M., & Bolliger, C. T. (2012). Bronchoscopic Treatment
of Emphysema: State of the Art. Respiration, 84(3), 250–263. Retrieved from
https://doi.org/10.1159/000341171
Kane, S., Bajpai, S., & Biswas, T. K. (2018). A clinical study of COPD in the elderly with
special reference to HRCT chest and PFT. International Archives of Integrated
Medicine, 5(9), 99–104.
Lao, T., Glass, K., Weiliang Qiu, Polverino, F., Gupta, K., Morrow, J., … Xiaobo Zhou. (2015).
Haploinsufficiency of Hedgehog-interacting protein causes increased emphysema
induced by cigarette smoke through network rewiring. Genome Medicine, 7(1), 1–13.
Retrieved from https://doi.org/10.1186/s13073-015-0137-3
Linan D., Jun Li, Wushuai J., Lu Z., Mingshu W., Hongli S. & Shuqian L. (2014). Emphysema
early diagnosis using X-ray diffraction enhanced imaging at synchrotron light
source. BioMedical Engineering OnLine, 13(1), 1–17. https://doi.org/10.1186/1475-
925X-13-82
Mendy, A., Salo, P. M., Cohn, R. D., Wilkerson, J., Zeldin, D. C., & Thorne, P. S. (2018). House
Dust Endotoxin Association with Chronic Bronchitis and Emphysema. Environmental
Health Perspectives, 126(3), 1–6. Retrieved from https://doi.org/10.1289/EHP2452
References
Mayo Clinic Health (2018). A family friend was recently diagnosed with emphysema, but he
never smoked. Are there other causes of emphysema? Mayo Clinic Health, 36(10), 8.
Gasparini, S., Zuccatosta, L., Bonifazi, M., & Bolliger, C. T. (2012). Bronchoscopic Treatment
of Emphysema: State of the Art. Respiration, 84(3), 250–263. Retrieved from
https://doi.org/10.1159/000341171
Kane, S., Bajpai, S., & Biswas, T. K. (2018). A clinical study of COPD in the elderly with
special reference to HRCT chest and PFT. International Archives of Integrated
Medicine, 5(9), 99–104.
Lao, T., Glass, K., Weiliang Qiu, Polverino, F., Gupta, K., Morrow, J., … Xiaobo Zhou. (2015).
Haploinsufficiency of Hedgehog-interacting protein causes increased emphysema
induced by cigarette smoke through network rewiring. Genome Medicine, 7(1), 1–13.
Retrieved from https://doi.org/10.1186/s13073-015-0137-3
Linan D., Jun Li, Wushuai J., Lu Z., Mingshu W., Hongli S. & Shuqian L. (2014). Emphysema
early diagnosis using X-ray diffraction enhanced imaging at synchrotron light
source. BioMedical Engineering OnLine, 13(1), 1–17. https://doi.org/10.1186/1475-
925X-13-82
Mendy, A., Salo, P. M., Cohn, R. D., Wilkerson, J., Zeldin, D. C., & Thorne, P. S. (2018). House
Dust Endotoxin Association with Chronic Bronchitis and Emphysema. Environmental
Health Perspectives, 126(3), 1–6. Retrieved from https://doi.org/10.1289/EHP2452
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EMPHYSEMA 7
Mondoñedo, J. R., & Suki, B. (2017). Predicting Structure-Function Relations and Survival
following Surgical and Bronchoscopic Lung Volume Reduction Treatment of
Emphysema. PLoS Computational Biology, 13(2), 1–17. Retrieved from
https://doi.org/10.1371/journal.pcbi.1005282
Pulmonx Corp. (6AD 2018). FDA Approves Zephyr Endobronchial Valve for Treating Severe
Emphysema. Business Wire (English).
Sasaki, M., Chubachi, S., Kameyama, N., Sato, M., Haraguchi, M., Miyazaki, M., … Matsuo, K.
(2018). Effects of long-term cigarette smoke exposure on bone metabolism, structure,
and quality in a mouse model of emphysema. PLoS ONE, 13(1), 1–14. Retrieved from
https://doi.org/10.1371/journal.pone.0191611
Shaikh, M., Sood, R. G., Sarkar, M., & Thakur, V. (2017). Quantitative Computed Tomography
(CT) Assessment of Emphysema in Patients with Severe Chronic Obstructive Pulmonary
Disease (COPD) and its Correlation with Age, Sex, Pulmonary Function Tests, BMI,
Smoking, and Biomass Exposure. Polish Journal of Radiology, 82, 760–766. Retrieved
from https://doi.org/10.12659/PJR.903278
Valipour, A., Slebos, D.-J., de Oliveira, H. G., Eberhardt, R., Freitag, L., Criner, G. J., & Herth,
F. J. F. (2014). Expert Statement: Pneumothorax Associated with Endoscopic Valve
Therapy for Emphysema - Potential Mechanisms, Treatment Algorithm, and Case
Examples. Respiration, 87(6), 513–521. https://doi.org/10.1159/000360642
Mondoñedo, J. R., & Suki, B. (2017). Predicting Structure-Function Relations and Survival
following Surgical and Bronchoscopic Lung Volume Reduction Treatment of
Emphysema. PLoS Computational Biology, 13(2), 1–17. Retrieved from
https://doi.org/10.1371/journal.pcbi.1005282
Pulmonx Corp. (6AD 2018). FDA Approves Zephyr Endobronchial Valve for Treating Severe
Emphysema. Business Wire (English).
Sasaki, M., Chubachi, S., Kameyama, N., Sato, M., Haraguchi, M., Miyazaki, M., … Matsuo, K.
(2018). Effects of long-term cigarette smoke exposure on bone metabolism, structure,
and quality in a mouse model of emphysema. PLoS ONE, 13(1), 1–14. Retrieved from
https://doi.org/10.1371/journal.pone.0191611
Shaikh, M., Sood, R. G., Sarkar, M., & Thakur, V. (2017). Quantitative Computed Tomography
(CT) Assessment of Emphysema in Patients with Severe Chronic Obstructive Pulmonary
Disease (COPD) and its Correlation with Age, Sex, Pulmonary Function Tests, BMI,
Smoking, and Biomass Exposure. Polish Journal of Radiology, 82, 760–766. Retrieved
from https://doi.org/10.12659/PJR.903278
Valipour, A., Slebos, D.-J., de Oliveira, H. G., Eberhardt, R., Freitag, L., Criner, G. J., & Herth,
F. J. F. (2014). Expert Statement: Pneumothorax Associated with Endoscopic Valve
Therapy for Emphysema - Potential Mechanisms, Treatment Algorithm, and Case
Examples. Respiration, 87(6), 513–521. https://doi.org/10.1159/000360642
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