My name is Keith Prowse. I'm a consultant chest physician,
and I'm chairman of the British Lung Foundation.
COPD means chronic obstructive pulmonary disease,
which is a rather extended way of saying it's a chronic condition
that affects the lung tubes, the air tubes and the lung tissue itself.
It's probably better known to people in the past
as chronic bronchitis and emphysema.
The main symptoms of COPD are cough, particularly in the early morning,
or what's sometimes called a smoker's cough.
Coughing up mucus is the next thing that follows,
and the condition is defined clinically by coughing up mucus every day
for three months of the year, usually in the winter.
Breathlessness on exertion comes later,
and usually, obviously, initially on exercise, walking up hills,
but it can progress,
and eventually people can become very seriously disabled by it.
If I thought I'd got symptoms of this condition,
I'd go along to my GP, tell him about them,
and, hopefully, he'd arrange a chest x-ray,
which excludes other conditions.
He'd probably do a simple blowing test and measure what my lung function is
compared to average.
Then he would probably prescribe either an inhaler
to open up the air passages when I get spasms or coughing,
an inhaler to cut down inflammation,
which you get when you get infections and other things,
and possibly also an emergency supply of antibiotics,
so that if I get an infection, a chest infection,
I can treat it immediately.
I'm not waiting to get a prescription.
The main cause is cigarette smoking,
but it can be caused by exposure to fumes and dust at work.
It can be caused by exposure to air pollution,
and it can be caused by some chemical exposures.
So there's an awful lot known about the cause.
What we don't know, at the moment, precisely
is why some people get it
and why other people don't.
The British Lung Foundation has been very active.
We know many people have this condition,
but many of them don't consult their doctors and many don't even know.
When we've done surveys,
and I mean going out into a shopping centre,
and measuring people's function,
we find that up to a third of people have abnormal function.
Most of those are smokers, the commonest cause of COPD,
and most of them don't know about it.
So there's a huge, hidden collection of people,
what we call the hidden millions, about two million,
who are not getting appropriate advice and treatment.
If we can take action early, then we can prevent a lot of that disability.
The two key actions are to stop people smoking
or stop their exposure to smoke
and, secondly, to get treatment,
both to help the tubes to keep open, to help to clear mucus,
and, particularly, to deal with or prevent infections.