Managing COPD: precautions and treatment strategies amid extreme temperatures

Originally published in Medical Economics January 16, 2024

Summer 2023 brought record-breaking heat and high humidity levels across the United States, a dangerous concoction for the 12.5 million Americans with chronic obstructive pulmonary disease (COPD). Amid seasonal shifts, extreme humidity fluctuations can make breathing more challenging, as the increased moisture can cause airway inflammation and mucus production. For those with COPD, this can exacerbate symptoms like increased coughing, shortness of breath, tightness in the chest, and wheezing. Therefore, individuals with COPD must take appropriate precautions during changing seasons and look to their physicians or allergy and asthma specialists to intercept these symptoms before they worsen.

Navigating seasonal humidity shifts

COPD sufferers are susceptible to temperature and humidity fluctuations, and this sensitivity becomes particularly pronounced during the late summer-to-fall/winter transition in the United States. As the season progresses and transitions from the typically hot and humid summer to cool fall and winter temperatures, humidity levels also tend to shift. The air becomes drier when the weather becomes colder, which can irritate the airways and trigger COPD symptoms. Conversely, sudden spikes in temperature and humidity can make it considerably more challenging for COPD patients to breathe comfortably due to factors like heightened airway inflammation, increased mucus production and shifting oxygen levels, all of which exacerbate these symptoms further. Individuals with COPD must be vigilant about monitoring weather conditions during this transitional period and adjusting their precautions accordingly.

The cost of COPD: a burden beyond health

Living with COPD impacts patients both physically and financially. The annual economic burden of COPD amounts to nearly $50 billion, comprising $29.5 billion allocated to direct health care expenses, $12.4 billion attributed to indirect mortality costs, and $8 billion associated with indirect morbidity costs. The enormous economic impact of the disease, with its significant impact on quality of life, makes effective management and prevention strategies a priority that should be center-stage.

Early interventions for rapid diagnosis

Following a comprehensive medical history review, additional assessments are key to diagnosis and disease management. Assessments include pulmonary function tests to measure lung inhalation and exhalation capacities; CT scans of the lungs for identifying emphysema and screen for lung cancer; arterial blood gas analysis to evaluate lung efficiency in oxygen delivery to the bloodstream and carbon dioxide removal; and laboratory tests aimed at ruling out genetic disorders.

Once patients are fully diagnosed, they can work with their physician or specialist to manage symptoms and handle flare-ups. Common foundational precautionary measures for COPD management often include:

• Stay hydrated: While it may seem counterintuitive, drinking water can help COPD patients manage high humidity. Staying well-hydrated can help thin mucus, making it easier to clear from the airways.
• Avoid peak heat hours: Planning outdoor activities during the cooler parts of the day, such as early morning or late evening, when humidity levels tend to be lower are less burdensome on the lungs.
• Use air conditioning: Ensuring the patient’s living space is adequately cooled and dehumidified. Air conditioning can help maintain a comfortable indoor environment.
• Stay informed: Monitoring weather forecasts and humidity levels and adjusting plans for particularly humid days helps patients avoid triggers.
• Maintain medication regimen: Sticking to prescribed COPD medications. It’s not uncommon for health care providers to adjust a patient’s treatment plan during the summer.

Best treatment practices

Treatment for COPD continues to evolve and offer relief while advancing patient outcomes. These treatment modalities include medications like antibiotics, oral steroids, home-based therapies, and lung-specific interventions.

When treating patients and setting them on the path to improvement or symptom cessation, physicians and specialists often consider the following options:

• Oxygen therapy: This may be necessary in severe cases to ensure sufficient oxygen levels in the blood. It can be administered during sleep or physical activities.
• Inhaled corticosteroids: Treatments can help reduce airway inflammation, making breathing easier.
• Short-acting bronchodilators: Albuterol can provide quick relief during exacerbations. Long-acting bronchodilators may be used regularly to help manage symptoms.
• Lifestyle changes: Patients should be strongly urged to quit smoking if they haven’t already and avoid exposure to air pollutants and irritants. Health care professionals can prescribe nicotine patches and other relevant treatments to aid smoking cessation.
• Pulmonary rehabilitation: Patients can be enrolled in a pulmonary rehabilitation program to learn breathing techniques and exercise strategies and receive support from health care professionals. Patients may also utilize bilevel positive airway pressure (BiPAP) within their homes or under the supervision of health care providers in clinical settings.

A clear future for COPD patients

Physicians and allergy and asthma specialists must understand the challenges that extreme temperatures and humidity swings bring to COPD patients. These weather variations affect both their physical health and the financial cost of managing this condition. To help patients cope effectively, taking proactive steps, adhering to treatment plans, and offering comprehensive care and guidance are essential. This approach enables COPD patients to better manage their condition and confidently navigate the seasonal transition, ultimately improving their quality of life.

Brian Reed, MD, is an experienced physician specializing in allergy and immunotherapy at AllerVie Health. He focuses on a broad range of conditions, including but not limited to, allergic rhinitis, sinusitis, dust, pollen and pet allergies, food allergies, childhood and severe asthma, and biologics for asthma.