Global Airway Clearance Devices System Size is anticipated to be valued at US$ 589.3 Million in 2022, forecast to grow at a CAGR of 6.2% to be valued at US$ 1,137.8 Million from 2022 to 2032. Airway clearance devices systems are used to remove excess mucus from lungs. The excess production of mucus is a common feature in the COPD (chronic obstructive pulmonary disease) and it leads to accumulation of mucus in the air way. It results in the coughing, wheezing, chronic bronchitis, emphysema and shortness of breath.

There are few types of airway clearance devices system, namely: positive expiratory pressure devices, intrapulmonary percussive ventilation, oral high-frequency oscillation, high-frequency chest wall oscillation, flutter devices, and incentive spirometry. Positive expiratory pressure devices is an alternative to conventional physiotherapy, and it consists of the one-way valve to which expiratory resistance is applied.

Intrapulmonary percussive ventilation devices combine internal thoracic percussion and aerosol inhalations. Oral high-frequency oscillation is worked on the principle of high frequency and low volume of oscillations, and it is developed from the technique of jet ventilation with high frequency.

High-frequency chest wall oscillation devices is a mechanical device which works on the principle of positive pressure air pulse on the lungs by means of air pulse generator and inflatable chest. Flutter devices is a combination of high-frequency oscillations with positives expiratory pressure therapy. Incentive spirometry is used to measure inspiratory effort by using air volume and air flow.

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Airway Clearance Devices System Market: Drivers and Restraints

Conventional methods like chest physiotherapy used for bronchial drainage in different types of respiratory dysfunction. However traditional chest physiotherapy is time-consuming and labour intensive both for non-hospitalized and hospitalized patients. On the counterpart, airway clearance devices systems increasing the compliance with patients and is the less time-consuming process.

Reduced cost and independent application are other reason for changing the preference of patient population from conventional chest physiotherapy to airway clearances devices system market. All these factors influencing the burgeoning growth of the airway clearances devices system.

Others factors like decreased respiratory complications and demand for devices over conventional methods drives the growth of the airway clearance devices system market. Limited availability of evidence based data for effectiveness of devices act as a restraint on the growth of the airway clearance devices system market

Airway Clearance Devices System Market: Market Overview

Global Airway Clearance Devices System market has witnessed a robust growth due to increasing demand due to improving respiratory drainage and reduced infections. Airway Clearance Devices System market has a presence of many regional players which have a huge market share in emerging countries operating at regional or country level.

The future of Airway Clearance Devices System market anticipated with double CAGR during forecasting period.

Airway Clearance Devices System Market: Region-Wise Overview

Global Airway Clearance Devices System market segmented into following regions North America, Latin America, Western Europe, Eastern Europe, Asia-Pacific, Japan and the Middle East and Africa. North America is dominant in the Global Airway Clearance Devices System market mainly due to increased acceptances by patient population.

In North America, particularly the USA is dominating due to the high penetration. Economic conditions in the APAC region are set to drive the Airway Clearance Devices System market to new heights. European and APAC are fastest growing region due to rising awareness of Airway Clearance Devices System Market.

Growth in the Middle East and African region is considerably less when compared to the other regions. However, North America would maintain its position in the Airway Clearance Devices System market, though, we are anticipating emerging economies such India, China, Brazil, to have the highest growth rate in Airway Clearance Devices System market.

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Airway Clearance Devices System Market: Key Participants

The key participants in the Airway Clearance Devices System market mainly include Monaghan Medical Corporation, Koninklijke Philips N.V., Vortran Medical Technology and others. Companies are mainly focused on R&D to strengthen core competencies of the company’s product portfolio.

The research report presents a comprehensive assessment of the market and contains thoughtful insights, facts, historical data, and statistically supported and industry-validated market data. It also includes projections using a suitable set of assumptions and methodologies. The research report provides analysis and information according to market segments such as geographies, application, and industry.

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Obesity constitutes an important threat to national and global public health in terms of its prevalence and rising incidence, quality of life, life expectancy, and economic burden [1,2]. In severe obesity, bariatric surgery is the most effective therapeutic option to achieve long-term weight loss and improve the associated comorbidities [3]. This has made Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding the most popular and commonly performed bariatric surgeries [4]. However, a small proportion of patients have also been reported to not reach their optimum goal for weight loss two years after the procedure and very few can fail or regain the weight. While anatomical factors can play a part, behavioural and psychosocial optimizations are regarded as equally important. This includes eating patterns, depression, nutritional factors, and exercise [5,6].

Virtual reality (VR) development and applications have gained wide recognition in medical services by providing solutions to improve patients’ outcomes. This is through patients’ education, improving mental health, and post-operative care, including pain management, physical therapy, and rehabilitation [7,8]. VR is a computer-generated simulation of a real or imagined environment. It can be immersive or non-immersive according to its ability to involve the users [9]. The former has been the focus of many medical applications due to its ability to give the user control of the reproduced environment. Immersive virtual reality (IVR) is usually delivered in a variety of ways and the most popular being head-mounted displays or simply a headset [8].

We aim to provide insight on some of these immersive applications and how they can be included to enhance the patient pathway to optimize outcomes both in the pre- and post-operative period for patients undergoing bariatric surgery.


A systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) research criteria was conducted from January 2015 to December 2021. PubMed was searched using the following keywords: virtual reality, patient education, anxiety and pain, physical rehabilitation, behavioural support, obesity, eating disorders, body image, and substance cessation.

Thirty-four studies were identified and included in the final manuscript (Figure 1) supporting VR technology across applications that can be applied to bariatric patients’ surgical pathways. The applications were subcategorized into eight different areas of interest, which can help to shape the concept of the virtual ecosystem of bariatric patients (Figure 2).


VR applications have been described in the eight domains mentioned below, which can be applied in relation to patients undergoing bariatric surgery.

Virtual Reality Patient Education (VR PE)

VR education has been introduced to make the information more meaningful and patient-centred by enabling its users to be fully immersed in an interactive simulated and self-controllable visual and auditory experience [10]. In a study by Pandrangi et al. [11], VR was found to be a useful informative tool in educating patients about their aneurysmal disease through interactive reconstructed three-dimensional (3D) images of their aortic anatomy. The majority of the patients in this study agreed that VR 3D anatomy helped to improve their understanding and therefore felt more engaged in their healthcare decisions [11].

VR PE has also played a role in improving the stress levels of patients undergoing radiotherapy (RT) by improving clarity and levels of education about their treatment. A randomized study on 60 patients with chest malignancy showed that patients who received VR PE showed significant improvement in comprehension and reduction in stress and anxiety levels when compared to standard education [12]. Another study on 43 patients utilized VR PE by creating 3D images of patients in RT sessions and what to expect during the treatment. After the VR PE, 95% of patients agreed that they had a clear understanding of how they would feel when lying on the treatment table. Also, patients’ understanding of the location and the size of their cancer had significantly improved from around 50% to 95% with an increase in the orientation of side effects of the treatment by 30% post-VR PE [13].

In bariatric surgery, there is no currently reported data on the applications of VR education. However, the potential impact of VR PE can be numerous across the weight management pathway. Preoperatively, bariatric patients could potentially utilize VR to be virtually educated about different surgical options versus conservative treatment through enhanced 3D interactive images. This could be seen to help in better understanding of their options including surgery and thereby enhancing informed consent and overall education.

Post-operatively, VR-enhanced education could provide an option for daily or weekly updates on lifestyle changes, which could help in improving compliance. Importantly, this can be done from the comfort of the patient’s home with the added advantage of reducing costs and time for travelling to attend appointments.

Anxiety Related to Surgery

A significant amount of anxiety related to surgery is due to the fear and uncertainty of the outcomes. Its psychological and physical effects are associated with longer recovery, an increase in the need for analgesia, anaesthetic requirement, and unfavourable behavioural and emotional outcomes [14]. Conventional methods of mitigation of preoperative anxiety are pharmacological and non-pharmacological strategies [15].

Recently, with promising results in the management of anxiety and other psychiatric disorders, VR has been successfully applied to reduce anxiety related to surgery in different surgical settings [16]. Chan et al. [17] tested the effect of VR relaxing meditation and breathing exercises on 108 women undergoing hysteroscopy. This showed that anxiety scores were significantly reduced after the 10 minutes of VR content, which helped in reducing pain and stress related to surgery. Also, around 85% of patients reported the VR experience as good or excellent [17].

In minimally invasive abdominal surgery, Haisley et al. [18] used VR meditation as a perioperative tool with favourable results in reducing pain, anxiety, and nausea and around 75% of patients stated that they would use the VR again [18]. Similarly, VR meditation showed favourable results in reducing pain and anxiety in burns and complex pain [19,20].

The rationale for using VR to improve anxiety preoperatively is by immersing patients in a fully simulated relaxing environment with the objective of placing them in a more empowered state to deal with the triggers of their anxiety [21]. This could be applied to the bariatric population before surgery. It is to be seen from future studies whether these expected results can be validated in bariatric patients. There is therefore the potential for obtaining better evidence for patient satisfaction and reducing stress related to bariatric surgery.

Pain Management

Successful pain management is a key element of the post-operative course as it shortens recovery and reduces risks of cardiovascular and pulmonary complications. In bariatric surgery, pain management is essential to enhance recovery and prompt early mobilization, which helps to decrease venous thromboembolism, prevent other events, and reduce hospitalization [22]. Therefore, a multimodal approach through regional and systematic analgesia is considered the most effective method as it minimizes opiate use, which can induce obstructive sleep apnoea, which is more liable due to the co-morbidities of obesity [23].

Applications of VR in pain management in other surgical patients have been reported to have numerous benefits. This includes a reduction in pain scores after cardiac, knee, abdominal, and spinal surgery with overall patients reporting the use of VR as a pleasant experience and stating that they would use it again on further occasions [18,24,25]. VR pain management follows a similar concept to VR and anxiety meditation by immersing patients in a simulated relaxing environment, which can help to divert the patient's feelings from their pain. This could be playing a major role in bariatric patients' management of pain and anxiety related to surgery with proper application integration in their peri-operative pathway.

Optimizing Pulmonary Function for Surgery

Respiratory function in morbidly obese patients follows a restrictive pattern with up to 77% suffering from obstructive sleep apnoea [26]. This increases the risk of impaired post-operative oxygenation and other respiratory complications in the form of atelectasis. Optimization of pulmonary function for surgery includes smoking cessation, breathing exercises, including inspiratory muscle training, incentive spirometry, and optimization of chronic disease, for example, asthma and chronic obstructive pulmonary disease (CPOD) [27].

With the increase of applications of VR in different rehabilitation programmes, VR has been aiding in pulmonary exercises in both healthy individuals and COPD patients [28,29]. VR pulmonary rehabilitation is designed to enable home-based exercises in the form of a 3D avatar instructor in an immersive relaxing environment to guide patients through breathing exercises based on traditional rehabilitation programmes [30]. In COPD patients, VR-based respiratory rehabilitation has shown to have similar outcomes when compared to a conventional programme with the additional benefit of performing the exercises from home. Moreover, VR showed enrichment of experience by also decreasing the levels of anxiety during exercise and therefore optimizing cardiorespiratory function [31].

Physical Fitness Applications

Pre- and post-operative physical activity (PA) is regarded as an important element in enhancing recovery after surgery as it improves physical state, responses to stress from surgery, and improvement of cardiovascular function, thereby reducing complications [32].

In the bariatric population, a structured exercise regime is considered a feasible and effective adjunct therapy that benefits cardiometabolic parameters when compared to those with bariatric surgery alone [33]. Exercise before surgery has shown to be beneficial in reducing body weight, improving blood pressure, general fitness, quality of life satisfaction, and decreasing fasting plasma insulin and blood lipid. Exercise after bariatric surgery has been shown to preserve dynamic muscle strength and contribute to maintaining weight loss after calorie restriction [34].

Although PA promotion is recognized as an important component of weight loss programmes, there are no current evidence-based or standardized bariatric surgery-specific PA guidelines [35]. Reported exercise regimes ranged from walking, aquatic, resistance, and supervised exercises. Also, adherence to exercise before and after surgery plays a big role in physical rehabilitation. As in the bariatric population, many can face barriers in the form of low confidence levels in their abilities and not feeling comfortable going to the gym due to real and perceived discrimination. Therefore, many come up with the belief of not having time to participate in sports [36].

VR rehabilitation has gained much recognition from dedicated platforms like treadmills, diving, cycling simulators, and medically oriented VR rehabilitation. These studies have demonstrated increased participation of users utilizing VR exercise programmes [37]. VR rehabilitation and exercise have shown to be effective in healthy individuals and different medical rehabilitations. It was reported to be equivalent and sometimes more superior to standard physiotherapy in cerebral palsy, spinal injury, and stroke [38]. In healthy individuals, VR exercise was demonstrated to increase adherence and enjoyment with positive physiological effects during exercise [39]. It was also reported that obese children performed better on treadmills while using VR than traditional walking, as VR allowed more distraction and less discomfort [40].

VR exercises during rehabilitation can therefore potentially play a major role in pre- and post-operative PA improvement in bariatric patients. Given the feasibility and the safety of these home-based devices, it can decrease the load on healthcare services, as most of the standard pre-operative programmes are resource intensive.

Virtual Reality and Enhanced Cognitive Behavioural Therapy

Eating and depressive disorders significantly affect the bariatric population with a prevalence of 24% and 17%, respectively. Both can lead to less post-operative weight loss, weight regains, impaired general psychology, and quality of life [41]. Cognitive behavioural therapy (CBT) is recommended for patients undergoing weight loss surgery (WLS). It has been shown to improve self-monitoring and control eating behaviours with significant improvement in depression and anxiety and therefore better results [42].

Over the last decades, VR-enhanced cognitive therapy (VRCBT) has been embraced for being a novel way to deliver CBT. The technique creates an interactive 3D environment to simulate successful goal achievement. This helps patients to overcome memories of previous real-life experiences through emotionally guided virtual exposure [43]. VRCBT has shown favourable results in anxiety, phobias, social anxiety disorders, and depression [21]. Moreover, randomized trials have shown VRCBT to be superior to conventional CBT in managing eating disorders and binge eating [44,45]. This helped in weight reduction therapy and adding adherence to programmes [46].

There is a paucity of evidence of the use of VR in the overweight and morbidly obese population. Phelan et al. [47] tested the use of a VR environment on 15 overweight adults for four weeks with the main hypothesis to evaluate the effect of the simulated scenes on behavioural skills related to eating habits. Although they showed no difference in weight loss among participants, VR intervention was more preferred by patients over traditional weight loss programmes [47]. Manzoni et al. [45] tested the efficacy of an enhanced VRCBT module aimed to unlock the negative memory of the body and modify its behavioural and emotional behaviour. A total of 163 female morbidly obese inpatients were randomly assigned to three CBT-based treatments: a standard behavioural inpatient programme (SBP), SBP plus standard CBT, and SBP plus VR-enhanced CBT. The study showed that patients in the VR group had a greater probability of maintaining or improving weight loss at one-year follow-up than SBP patients and, to a lesser extent, CBT patients. On the contrary, participants who received only a behavioural programme regained on average most of the weight they had lost [45].

VRCBT can therefore be a valuable tool in managing behavioural disorders related to obesity in patients undergoing WLS. This can help in maintaining weight loss and improving well-being and quality of life.

Virtual Reality and Body Image (VRBI)

Body image disorders (BIDs) are linked to various psychological and physical sequelae of impaired functions, for instance, depression, anxiety, eating disorders, and poor quality of life [48]. Among the bariatric population, body image dissatisfaction is associated with binge eating, depression, and lower self-esteem, with one in five bariatric patients identifying appearance as their main motive for surgery [49]. Improvement in body image perception after successful surgery has been linked to a decrease in compulsive eating syndromes, reduction in body mass index (BMI), and improvement in self-esteem and intimate relationships [50].

A contrary aspect of body image after surgery includes the issue of excess skin with massive weight reduction. This has been linked to poor body satisfaction, dermatitis and skin fold irritations, and impairment in daily activities and exercise. In turn, this leads 85% of bariatric patients to seek body-contouring surgery (BCS) to elevate this problem [51].

The application of VR has been used to improve BID. This is by creating a 3D simulation of their bodies in the form of avatars through an immersive environment that reproduces situations related to their body image concerns. Through multisensory simulations, it produces an empowered feeling of ownership of one’s body, which consequently promotes a healthier body image and behaviour [52]. A recent systematic review of six studies utilizing avatars and VR in weight loss programmes showed that avatar-based interventions were effective in both short- and mid-term weight loss. Also, the technology helped to improve exercise adherence in the long term [53]. VR was also used to assess the BID of 78 women with different BMIs by exposing the participants to different versions of avatars: slimmer, same weight, and overweight. The study showed that women with higher BMI reported more BID on their replicated avatar and showed satisfaction with their slimmer version. This finding indicated that VR may serve as a novel tool for measuring BID [54].

Potentially, VR avatars can also play a role in body image perception in bariatric patients. It can be integrated to improve BIDs by recreating slimmer avatars, which could promote adherence to weight loss and exercise programmes.

Smoking and Alcohol

While the increase in BMI is a risk factor for adverse outcomes related to surgical procedures, smoking's hazardous effects range from increased risks of pulmonary complications, wound infection, venous thromboembolism, and slower recovery. Similarly, alcohol consumption before surgery can lead to increased unfavourable outcomes [55]. Smoking and other substance abuse are recommended to be stopped four to six weeks pre-operatively [56]. VR has been tested as a potential solution to stop smoking and alcohol usage by inducing an advanced cue exposure therapy (CET), which was superior to static images or videos used in conventical settings [57]. Also, VR exposure therapy (VRET) has been reported to be more effective if combined with conventional cognitive behaviour therapy in relation to stopping smoking [58].

Although its applications are still under development and validation, VRET in smoking and alcohol cessation could play an important role in optimizing patients undergoing bariatric surgery as a part of a virtual reality surgical care package (VRSCP).


Patients who are candidates for WLS usually undergo variable preparatory phase and post-operative optimization to improve both short- and long-term results. Standard care models usually involve education and follow-up through multidisciplinary teams with reflection on the patient's progress through educational sessions and follow-up plans.

While VR applications are being investigated in many surgical and medical specialities, their application to patients undergoing WLS is limited and not yet explored. The favourable applications of VR in patient education, anxiety and pain management, preoperative optimization, and behavioural and physiological treatment can be packaged as a surgical care bundle making bariatric patients' journey more satisfactory with the potential for improved outcomes.

Despite its promising applications, VR is still an emerging technology and has its own initial drawbacks to gaining traction in the healthcare system. There are several reasons for this. Firstly, the obvious cost of the systems and the absence of adequate clinical validation could play a major role in limiting widespread adoption. Further delays in adoption would likely be seen within the education of both healthcare providers and their patients, particularly on the application and utilization of the systems. The technology is still seen to be clumsy to wear and will need educational support to use [59].

With the increased investments and advancement in VR technology, education of healthcare professionals and further studies demonstrating evidence of improved outcomes, VR will play a major role in surgical patients and more specifically bariatric patients. This could be even refined as a personalized surgical care package. This will contribute to a fully virtual ecosystem in health care.

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Baptist Memorial Hospital-North Mississippi’s pulmonary rehabilitation program was recently certified by the American Association of Cardiovascular and Pulmonary Rehabilitation, recognizing the hospital’s commitment to enhancing standards of patient care.

To earn accreditation, Baptist North Mississippi’s rehabilitation program participated in an application process that requires extensive documentation of the program’s practices.

“The certification from the American Association of Cardiovascular and Pulmonary Rehabilitation is a testament to the high-quality care of our pulmonary rehab program,” said Bill Henning, administrator and CEO of Baptist North Mississippi. “Our health care providers and colleagues at Baptist North Mississippi work diligently to provide advanced care for patients.”

AACVPR Program Certification is the only peer-reviewed accreditation process that assesses a program’s adherence to standards and guidelines developed and published by AACVPR and other related professional societies.

The certification is valid for three years. Pulmonary rehabilitation programs help people with pulmonary problems (e.g., chronic obstructive pulmonary disease, respiratory symptoms) recover faster and live healthier.

Programs include exercise, education, counseling and support for patients and their families.

For more information, call 662-636-1000 or visit

Courtesy of BMH-NM

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Every year, World Lung Day is celebrated on September 25 to advocate lung health and spread awareness. Lung disease is any problem that arises in the lungs and prevents it from working properly. Lung disease is divided into three main types - airway diseases, lung tissue diseases and lung circulation diseases.

The lungs, just like any other part of your body, age with time and that's why they need extra attention and care. People don't understand the importance of healthy lungs until they experience a breathing problem. After the Covid-19 pandemic took over the world, millions across the globe showed signs of weak lungs and reported breathing issues.

In 2022, it's crucial that we look after the health of our lungs and take precaution against harmful diseases that can make our breathing difficult. After all, the lungs are a crucial part of the respiratory system as they carry oxygen from the air and pump it through the body's airways and air sacs. The oxygen is then absorbed into the bloodstream and carried to the heart via the blood vessels.

Understanding the three main types of lung disease:

Airway Diseases

These harmful diseases impact the tubes that carry oxygen, making it difficult for people to breathe.

Lung Tissue Diseases
These diseases affect the structure of the lung tissue, which then makes it difficult for the lungs to function properly and diffuse oxygen from the airways into the bloodstream.

Lung Circulation Diseases

This type of disease impacts the blood vessels in the lungs. These diseases affect the way blood flows from the heart to the rest of the body.

Most Common Lung Diseases:

Most common lung diseases emerge from one or more of these three main types. Here are the most common lung diseases:


Millions of people across the country suffer from asthma and have difficult breathing. Though there's no cure for this disease, the person can lead a healthy and normal life with the help of right treatment and managing the asthma.

The disease can be managed by working with a healthcare provider to develop a plan to keep your asthma under control by understanding your trigger and learning of simple ways to limit your exposure, understanding your medication, learning self-management skills and more.

Chronic Obstructive Pulmonary Disease (COPD)
This disease includes Chronic Bronchitis and Emphysema and is a long-term lung disease that makes it hard to breathe but is often preventable and treatable.


Most commonly referred to as bronchitis, acute bronchitis is a lower respiratory infection that impacts the air tubes of the lungs and usually comes on suddenly and can last for a week to 10 days.

Tips To Prevent Lung Diseases:

Stop smoking as it increases your risk of lung cancer. According to several reports, smokers are 12 to 13 times more likely to die from COPD than nonsmokers.

Exercise. Getting a regular workout will really help your health. It will not only make you fitter but also improve your overall health. When you workout, your heart beats faster and your lungs work harder.

Get some fresh air. It's no secret that we are exposed to pollutants on a daily basis. So give your lungs the much needed break and reduce the exposure to harmful air by making your home smoke-free zone, dusting your furniture, improving the indoor air ventilation by opening a window, avoid synthetic air fresheners, candles, and wear a good mask when you go outside.

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Neil Lydon jokes with program co-ordinators Lisa Curtis and Robyn Palk. (Megan Macalpine/CBC - image credit)

Neil Lydon jokes with program co-ordinators Lisa Curtis and Robyn Palk. (Megan Macalpine/CBC - image credit)

As Neil Lydon adjusts the seat on a recumbent stepper machine, he chuckles, looking back on his first days in the Saint John-based pulmonary rehabilitation program.

"I was never brought up with sports, and I see a machine and I think, 'Oooh … effort,'" he says.

After living with chronic obstructive pulmonary disease, or COPD, for more than a decade, a respirologist referred Lydon to the promising pilot initiative. There is no cure for COPD, but the program aims to build a patient's stamina and, ultimately, keep them out of the hospital.

"Blood oxygen is low, so you use up whatever energy you've got pretty quickly," he said.

"My doctor said, 'Maybe we'll try you on some meds,' and in the end I wound up on two different medications, and he thought it would be a good idea to get some physicality into the program.

"It sort of got me out of my inertia."

Megan Macalpine/CBC

Megan Macalpine/CBC

Lydon said the gym wasn't an environment he was familiar with, but then he found he could use the machines that best suited his fitness level at that time.

"I tried the treadmill, but I got very winded, very quickly on that … I did push my limits on the step machine," he says. "I increased that from three or four hundred steps up to 1,700-and-something by the time I'd finished. It took about half an hour."

The rehab program is a research project and is infused with students from the New Brunswick Community College and the University of New Brunswick. Students from a number of disciplines, such as respiratory therapy, nursing and pharmacy technology, work almost one-on-one with the seniors who take part.

To be eligible, participants have to be at least 60 years old and living with moderate to severe COPD with nothing to disqualify them, like a recent heart attack, uncontrolled blood pressure or being at risk for falls.

One in five seniors

Tammie Fournier, a respiratory therapist and chair of Allied Health programs for NBCC, says one in five New Brunswick seniors have COPD.

"People living with COPD experience shortness of breath and they have a chronic cough. The combination of those two symptoms would lead to inactivity which inevitably worsens with their condition," Fournier said.

"So the worsening shortness of breath and cough and decrease in activity really become this vicious cycle that robs people with COPD of their quality of life over time."

This program is meant to break that cycle, and Fournier says it's shown some exciting results.

Submitted by Robyn Palk

Submitted by Robyn Palk

"One person decided not to sell their home after completing the clinic reduced their shortness of breath while climbing their stairs," she said. "Two other participants both gained enough strength to travel to Toronto and receive life-saving lung transplantation."

In a computer lab-turned-gym at NBCC's Allied Health Education Centre on the UNB campus, the seniors in the program build their endurance using gym equipment, free weights and drumming exercises.

Besides helping participants increase their stamina, the program also teaches them how to properly take their medications to get the most out of them and what to do if symptoms suddenly get worse.

Robyn Palk, the co-ordinator of the program, says a participant told her that information helped her avoid calling an ambulance after accidentally inhaling fumes while she was cleaning her oven. The woman thought back to classes on breath techniques and was able to take control of her breathing, Palk said.

"The hospitals are full," Palk said. "You don't want to be short of breath and having to wait in an emergency room for an extended period of time. If there are steps you can take at home to keep yourself out of hospital, that's really important right now."

Big savings

New Brunswick spends $23 million annually on COPD, Fournier said, which equates to about 3,100 hospital admissions at $7,400 per admission.

"The program is decreasing the risk of lung attack in 80 men and women, or about 0.14 per cent of our New Brunswick COPD population," she said. "So by extension, if each one of those participants reduces their admission to hospital by only one, this could save almost $600,000 of health-care spending on those 80 people alone."

Funding for the program comes from the Healthy Seniors pilot project, a $75-million provincial and federal initiative to research ways to better support the aging population.

However, the funding ends in 2023, Fournier said, and they're now looking for a source of sustainable funding to ensure it can continue.

Megan Macalpine

Megan Macalpine

"I've been a respiratory therapist,and Robyn has as well, for over 20 years now," said program co-ordinator Lisa Curtis. "This is the most rewarding work we've ever done because we get to spend so much more time with people than you do in acute care."

Curtis says over the course of the program, they get to watch participants go from barely making it into the building to coming in with a smile, and getting on a treadmill and walking for 30 minutes.

What happens to the research?

Curtis and Palk say they've been in contact with other institutions across Canada hoping to set up their own programs, and they've developed a how-to manual or toolkit for getting a program started.

They've also been selected to present at an international conference on COPD.

Neil Lydon hopes more people hear about the program that's helped him.

"I think people who are out there who have COPD, they might not realize … there is a program that will assist them in dealing with it, getting some relief," Lydon said.

"It's important to get the word out."

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Baptist North Mississippi’s pulmonary program certified by leading cardiovascular and pulmonary organization

Published 8:00 am Friday, September 23, 2022

Baptist Memorial Hospital-North Mississippi’s pulmonary rehabilitation program was recently certified by the American Association of Cardiovascular and Pulmonary Rehabilitation, in recognition of the hospital’s commitment to enhancing standards of patient care.

To earn accreditation, Baptist North Mississippi’s rehabilitation program participated in an application process that requires extensive documentation of the program’s practices.

“The certification from American Association of Cardiovascular and Pulmonary Rehabilitation is a testament to the high-quality care of our pulmonary rehab program,” said Bill Henning, administrator and CEO of Baptist North Mississippi. “Our health care providers and colleagues at Baptist North Mississippi work diligently to provide advanced care for patients.”

AACVPR Program Certification is the only peer-reviewed accreditation process that assesses a program’s adherence to standards and guidelines developed and published by AACVPR and other related professional societies. The certification is valid for three years.

Pulmonary rehabilitation programs are designed to help people with pulmonary problems (e.g., chronic obstructive pulmonary disease, respiratory symptoms) recover faster and live healthier. Programs include exercise, education, counseling and support for patients and their families.

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Introduction: Muscle mass may be a better predictor of mortality than BMI in chronic obstructive pulmonary disease (COPD). Serum creatinine depends on muscle mass and renal function; low values may predict higher mortality.

Objective: To determine whether there is an association between low serum creatinine and mortality in severe COPD.

Methods: This is a retrospective study of serum creatinine values at admission and within the last year before admission. Outcomes measured were mortality at 30 days and one year after admission in patients with acute type 2 respiratory failure secondary to COPD, who were admitted over a one-year period to a respiratory ward (N = 130). The statistics were calculated using the chi-squared test.

Results: There appears to be a significant relationship between the one-year pre-admission creatinine values and mortality at one year (p = 0.0003).

Conclusions: The relationship with mortality appears to be stronger with pre-admission creatinine values rather than the admission values and appears to predict the patients at the highest risk of mortality one year after admission.


In chronic obstructive pulmonary disease (COPD), a low body mass index (BMI) is an adverse prognostic factor and is associated with an increase in mortality [1-4]. A composite score consisting of BMI, airflow obstruction, dyspnoea, and exercise tolerance (BODE index) is often used for prognostication in patients with stable COPD and is considered to be superior to the forced expiratory volume in one second (FEV1) alone for this purpose [5]. For prognostication during an acute exacerbation of COPD, a composite score of comorbidities including airflow obstruction, dyspnoea, exercise tolerance, and details of the severity of previous exacerbations (CODEX) was found to be superior to both the BODE index on its own or when the BODE index was used in conjunction with additional information about previous exacerbations (BODEX) [6].

Mid-arm muscle area was shown in a study to be a better prognostic indicator than BMI in patients with COPD [7]. The relationship between BMI and fat-free muscle mass index (FFMI) is not very good and FFMI is shown to give additional prognostic information in patients with COPD [4].

Serum creatinine values depend in part on muscle mass and are commonly measured as part of the routine assessment in patients admitted to the hospital with different conditions, including an exacerbation of COPD. These values are also measured quite frequently in primary care, as part of chronic disease monitoring. A previous study in unselected patients admitted to intensive care has shown both high and low serum creatinine values to be associated with increased mortality risk [8].

The DECAF (dyspnoea, eosinopenia, consolidation, acidemia, and atrial fibrillation) study on factors that predict hospital mortality in patients with COPD exacerbation included baseline serum biochemistry at the time of admission but did not include historical pre-admission creatinine values [9]. As creatinine values can also rise acutely, due to many other conditions such as the presence of renal impairment or infection, the values measured at the time of admission may be less reliably correlated to the muscle mass in an individual and this may explain why in the DECAF study a low creatinine value was not identified as a risk factor for mortality. If this is the case, it may be that the creatinine values measured during periods of stability, such as samples taken routinely in primary care, may have a better correlation with the muscle mass in an individual patient.

We postulate that low serum creatinine values either at the time of admission or before admission may be associated with an increased risk of mortality in patients with severe COPD. If this is found to be the case, it would offer the advantage of the ready availability of a prognostic indicator, as this test is frequently performed both in the primary care and secondary care setting. If so, it may help to identify patients at risk of adverse outcomes promptly.

Patients who receive non-invasive ventilation (NIV) for acute type 2 respiratory failure (commonly secondary to COPD) are at high risk of dying with an inpatient mortality rate of 34% in the British Thoracic Society national audit on NIV, 2013. We wanted to see if there would be a significant difference in mortality in this group of patients based on their admission or pre-admission creatinine levels.

Materials & Methods

The study was approved by the Health Research Authority, Health and Care Research Wales (IRAS project ID: 254977), and by the Hospital Research and Development department. We undertook a retrospective observational cohort study in patients with severe COPD, who were admitted with acute type 2 respiratory failure and treated with NIV. All patients who had received NIV for the treatment of acute type 2 respiratory failure secondary to COPD in a respiratory ward in Royal Blackburn Teaching Hospital (Lancashire, United Kingdom) in 2013 were included in the study. The diagnosis of COPD was confirmed by a review of the discharge summaries, clinic letters, or patient notes, and any patients where NIV was used for indications other than COPD (such as obesity hypoventilation or neuromuscular disease resulting in type 2 respiratory failure) were excluded. The study was performed in 2019 and the reason for selecting the cohort from 2013 was to ensure complete data capture to evaluate one-year mortality after discharge.

A total of 130 patients met the criteria for inclusion in the study. The normal reference ranges set by the hospital laboratory for creatinine were 46-92 μmol/L for women and 58-110 μmol/L for men. For the study, a patient was considered to have low serum creatinine values if they had creatinine values of 45 or lower for females and 57 or lower for males.

Mortality rates were compared at 30 days and one year after discharge between patients who had low creatinine values within the year prior to discharge and patients who had normal or high creatinine values. The first sample taken at the time of admission for serum biochemistry was taken as the admission creatinine value and any value of creatinine that was abnormally low between the preceding year and time of admission was taken as evidence of low pre-admission creatinine value for the purpose of our calculations.


We performed a chi-squared test to see if there were statistically significant differences in mortality rates observed in patients with low admission or baseline creatinine values, compared to patients with normal values, at 30 days and one year after discharge.

Patients included in the study were 35% male (N = 46) with an average age of 68.9 years (median = 69 years). The median pH of blood gases at the time of initiation of NIV was 7.29 (range = 7.19-7.34). The results are summarized in Table 1.

  Died within 30 days Alive at 30 days P-value Died within 1 year Alive at 1 year P-value
Low admission creatinine (N = 31) 7 24 0.107 17 14 0.068
Normal or high admission creatinine (N = 99) 11 88   36 63  
Low creatinine within 1 year prior to admission (N = 48) 6 42 0.734 30 18 0.0003
Normal or high creatinine in the year before admission (N = 82) 12 70   25 57  

Based on the admission serum biochemistry, 31 patients (23.85%) out of the total of 130 patients in the study had low serum creatinine values. The mortality rate in this group was 22.58% (N = 7) at 30 days and 54.84% (N = 17) at one year (Figure 1). The differences did not reach statistical significance (p-values of 0.107 and 0.068 for 30 days and one year, respectively) when compared to patients with normal or high creatinine values based on admission values where the 30-day mortality was 11.11% (N = 11) or 36.36% at one year (N = 36).

When patients were grouped based on the presence of low creatinine values on blood tests done within one year before admission, the mortality rate in patients at 30 days in those with low creatinine (N = 6) was 12.5%, compared to 14.63% in others (p = 0.734). The mortality rate at one year, however, was significantly higher (p = 0.0003) in patients with low pre-admission creatinine where 62.5% of patients (N = 30) had died compared to 30.49% mortality (N =25) in patients with normal or high creatinine values (Figure 2).


Low BMI has been known to be an adverse prognostic indicator in patients with COPD, but muscle mass may be superior to BMI in this respect [7] or to show additional information than BMI [4]. Measurement of fat-free muscle mass or mid-arm muscle area is complex. In studies, this has been calculated by using equations incorporating various other factors such as mid-arm circumference, BMI, skinfold thickness, and estimation of fat mass [7]. This complexity makes the use of endpoints such as these problematic in day-to-day utilization in the care of patients with COPD. In addition to this, although there is a suggested method of categorizing cut-offs for low fat-free muscle index [10], there is no official guidance on this subject.

Serum creatinine values are routinely checked during hospital admissions and frequently measured in primary care. Although the values of serum creatinine can be influenced by a variety of factors such as intrinsic renal disease, use of nephrotoxic medications, and presence of systemic illness, values also depend on underlying muscle mass [11]. As some of these factors are more likely to be present during the period of hospitalization, it would be expected that measurement of serum creatinine values during stable conditions, perhaps in primary care, would be more closely related to the actual muscle mass than those which are measured during periods of hospitalization, as the latter ones may be falsely elevated by factors such as acute kidney injury or use of nephrotoxic drugs. This may explain why in the DECAF study low serum creatinine was not noted to be a significant factor that influenced mortality, as only the values on admission were considered.

In our study, we find that although there were no significant differences in mortality between patients with low creatinine values and others at 30 days post-admission, there appeared to be a trend toward significance at one year when patients were identified based on the admission values, and a highly significant difference when the patients were identified based on pre-admission creatinine values. This suggests that the differences in mortality may be apparent on a medium to long-term basis rather than in the immediate post-admission period. Previous studies have shown that an increase in BMI through nutritional support improved survival [3] and quality of life in patients with COPD [12]. If further studies (ideally done prospectively) confirm the value of low serum creatinine as a useful prognostic marker in identifying patients at increased risk of death, it may be possible to improve outcomes by offering nutritional support to these patients, especially as the increase in mortality is not in the immediate post-discharge period.


The identification of a greater number of patients with low serum creatinine based on pre-admission values rather than the admission ones appears to suggest that some of these patients did develop an increase in their creatinine values, which might reflect acute deterioration in their overall health. This may explain the lack of significant differences in mortality based on admission values is in part due to the death of these patients in the low creatinine comparative group.

It would be recommended to confirm the findings of our study by performing a prospective study where other important factors such as the patient’s BMI, nutritional status, and severity of airflow obstruction can also be considered to assess the differences in mortality.

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The pleura is a vital part of the respiratory tract. Its role is to cushion the lung and reduce any friction that may develop between the lung, rib cage, and chest cavity.

Each pleura (there are two) consists of a two-layered membrane that covers each lung. The layers are separated by a small amount of viscous (thick) lubricant known as pleural fluid.

OpenStax College / Wikimedia Creative Commons

There are a number of medical conditions that can affect the pleura, including pleural effusions, a collapsed lung, and cancer. When excess fluid accumulates between the pleural membranes, various procedures may be used to either drain the fluid or eliminate the space between them.

This article outlines what the pleurae are, what they do, and what conditions can affect them and impact respiratory health.

The plural form of pleura is pleurae.

Anatomy of the Pleura

There are two pleurae, one for each lung, and each pleura is a single membrane that folds back on itself to form two layers. The space between the membranes (called the pleural cavity) is filled with a thin, lubricating liquid (called pleural fluid).

The pleura is comprised of two distinct layers:

  • The visceral pleura is the thin, slippery membrane that covers the surface of the lungs and dips into the areas separating the different lobes of the lungs (called the hilum).
  • The parietal pleura is the outer membrane that lines the inner chest wall and diaphragm (the muscle separating the chest and abdominal cavities).

The visceral and parietal pleura join at the hilum, which also serves as the point of entry for the bronchus, blood vessels, and nerves.

The pleural cavity is also known as the intrapleural space. It contains pleural fluid secreted by the mesothelial cells. The fluid allows the layers to glide over each other as the lungs inflate and deflate during respiration (breathing).

What the Pleura Do

The structure of the pleura is essential to respiration, providing the lungs with the lubrication and cushioning needed to inhale and exhale. The intrapleural space contains roughly 4 cubic centimeters (ccs) to 5 ccs of pleural fluid, which reduces friction whenever the lungs expand or contract.

The pleura fluid itself has a slightly sticky quality that helps draw the lungs outward during inhalation rather than slipping round in the chest cavity. It creates surface tension that helps maintain the position of the lungs against the chest wall.

The pleurae also serve as a division between other organs in the body, preventing them from interfering with lung function and vice versa.

Because the pleura is self-contained, it can help prevent the spread of infection to and from the lungs.

Conditions That Affect the Pleura

A number of conditions can cause injury to the pleura or undermine its function. Harm to the membranes or overload of pleural fluid can affect how you breathe and lead to adverse respiratory symptoms.


Pleurisy is inflammation of the pleural membranes. It is most commonly caused by a viral infection, but may also be the result of a bacterial infection or an autoimmune disease (such as rheumatoid arthritis or lupus).

Pleuritic inflammation causes the membrane surfaces to become rough and sticky. Rather than sliding over each other, they membranes stick together, triggering sharp, stabbing pain with every breath, sneeze, or cough. The pain can get worse when inhaling cold air or taking a deep breath. It can also worsen during movement or shifts in position. Other symptoms of pleurisy include fever, chills, and loss of appetite.

Pleural Effusion

A pleural effusion occurs when excess fluid accumulates in the pleural space. When this happens, breathing can be impaired, sometimes significantly.

Congestive heart failure is the most common cause of a pleural effusion, but there is a multitude of other causes, including lung trauma or lung cancer (in which effusion is experienced in roughly half of all cases).

A pleural effusion can be very small (detectable only by a chest x-ray or CT scan) or be large and contain several pints of fluid. Common symptoms include chest pain, dry cough, shortness of breath, difficulty taking deep breaths, and persistent hiccups.

Malignant Pleural Effusion

A malignant pleural effusion refers to an effusion that contains cancer cells. It's most commonly associated with lung cancer or breast cancer that has metastasized (spread) to the lungs.


Pleural mesothelioma is a cancer of the pleura that most often is caused by occupational exposure to asbestos. Symptoms include pain in the shoulder, chest or lower back, shortness of breath, trouble swallowing, and swelling of the face and arms.


Pneumothorax, also known as a collapsed lung, can develop when air collects in the pleural cavity. It may be caused by any number of things, including chest trauma, chest surgery, and chronic obstructive pulmonary disease (COPD). In addition to shortness of breath, there may be crepitus, an abnormal crackling sound from just under the skin of the neck and chest.

Spontaneous pneumothorax is a term used to describe when a lung collapses for no apparent reason. Tall, thin adolescent males are at the greatest risk for spontaneous pneumothorax, although females can also be affected. Risk factors include smoking, connective tissue disorders, and activities such as scuba diving and flying in which atmospheric pressure changes rapidly.

Pneumothorax can often heal on its own but may sometimes require thoracentesis to extract any accumulated air from the pleural cavity.


Hemothorax is a condition in which the pleural cavity fills with blood, typically as a result of traumatic injury or chest surgery. Rarely, a hemothorax can happen spontaneously due to a vascular rupture.

The main symptom of hemothorax is pain or a feeling of heaviness in the chest. Others include a rapid heartbeat, trouble breathing, cold sweats, pale skin, and a fever, all indications that prompt medical attention is needed.

Frequently Asked Questions

  • Does COVID cause pleural thickening?

    Research has demonstrated that coronaviruses, like COVID-19 and Middle Eastern respiratory syndrome coronavirus (MERS-CoV) can cause pleural thickening. In some cases, this has been associated with poorer outcomes.

  • Is pleural effusion life-threatening?

    Pleural effusion, or fluid build-up in the pleural space, is a serious but treatable condition. It can be caused by a number of diseases, including cancer. If left untreated, fluid can continue to build up and impact breathing.

  • Is pleural thickening serious?

    Not necessarily, but it depends on the underlying cause. Because multiple conditions can cause thickening of the pleurae, it's important to be evaluated by a healthcare provider and get proper treatment.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Charalampidis C, Youroukou A, Lazaridis G, et al. Pleura space anatomyJ Thorac Dis. 2015;7(Suppl 1):S27–S32. doi:10.3978/j.issn.2072-1439.2015.01.48

  2. Kass SM, Williams PM, Reamy BV. Pleurisy. Am Fam Physician. 2007;75(9):1357-64.

  3. Bintcliffe OJ, Lee GY, Rahman NM, Maskell NA. The management of benign non-infective pleural effusions. Eur Respir Rev. 2016;25(141):303-16. doi:10.1183/16000617.0026-2016

  4. Karkhanis VS, Joshi JM. Pleural effusion: diagnosis, treatment, and managementOpen Access Emerg Med. 2012;4:31–52. doi:10.2147/OAEM.S29942

  5. Dixit R, Agarwal KC, Gokhroo A, et al. Diagnosis and management options in malignant pleural effusionsLung India. 2017;34(2):160-6. doi:10.4103/0970-2113.201305

  6. Rossini M, Rizzo P, Bononi I, et al. New perspectives on diagnosis and therapy of malignant pleural mesotheliomaFront Oncol. 2018;8:91. doi:10.3389/fonc.2018.00091

  7. Aghajanzadeh M, Dehnadi A, Ebrahimi H, et al. Classification and management of subcutaneous emphysema: a 10-year experienceIndian J Surg. 2015;77(Suppl 2):673–677. doi:10.1007/s12262-013-0975-4

  8. Mitani A, Hakamata Y, Hosoi M, et al. The incidence and risk factors of asymptomatic primary spontaneous pneumothorax detected during health check-upsBMC Pulm Med. 2017;17:177. doi:10.1186/s12890-017-0538-8

  9. Pumarejo Gomez L, Tran VH. Hemothorax. In: StatPearls [Internet].

  10. National Library of Medicine: Medline Plus. Hemothorax.

  11. Carotti M, Salaffi F, Sarzi-Puttini P, et al. Chest CT features of coronavirus disease 2019 (COVID-19) pneumonia: Key points for radiologists. Radiol Med. 2020;125(7):636-646. doi:10.1007%2Fs11547-020-01237-4

  12. American Society of Clinical Oncology. Fluid around the lungs or malignant pleural effusion.

  13. Yale Medicine. Fluid Around the Lungs (Pleural Effusion).

  14. Alfudhili KM, Lynch DA, Laurent F, Ferretti GR, Dunet V, Beigelman-Aubry C. Focal pleural thickening mimicking pleural plaques on chest computed tomography: Tips and tricksBJR. 2016;89(1057):20150792. doi:10.1259%2Fbjr.20150792

Additional Reading

By Lynne Eldridge, MD

 Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."

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Newswise — Westwood, NJ - (September 19, 2022) – Hackensack Meridian Pascack Valley Medical Center has received recertification of its Cardiac and Pulmonary Rehabilitation programs from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). The recertification recognizes Pascack Valley Medical Center for commitment to improving patient outcomes and quality of life by enhancing standards of care.

The Cardiac and Pulmonary Rehabilitation Center at PVMC was established in 2014 and has been AACVPR-certified since 2015, as a leader in the field of cardiovascular rehabilitation. AACVPR’s certification is the only peer-review accreditation process designed to review individual programs for adherence to standards and guidelines developed and published by AACVPR and other professional societies.

Cardiovascular and pulmonary rehabilitation programs are designed to help people recover quicker and improve their quality of life following a cardiovascular diagnosis or procedure (e.g., heart attack, coronary artery bypass graft surgery). Programs includes exercise, education, counseling, and support for patients and their families. 

Pascack Valley Medical Center’s Cardiac and Pulmonary Rehabilitation Center participates in a certification process every three years that requires extensive documentation and review of the program’s practices and outcomes. To learn more about Pascack Valley Medical Center’s Cardiac and Pulmonary Rehabilitation services click here.


Founded in 1985, the American Association of Cardiovascular and Pulmonary Rehabilitation is a multidisciplinary organization dedicated to the mission of reducing morbidity, mortality and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research and disease management. Central to the core mission is improvement in quality of life for patients and their families.

About Hackensack Meridian Pascack Valley Medical Center

Hackensack Meridian Pascack Valley Medical Center is a 128-bed, full-service, acute-care community hospital, located in Westwood, NJ providing a caliber of care consistent with Hackensack Meridian Health’s world-class standard.  The state-of-the-art facility features a brand-new Emergency Department, state-of-the-art maternity center, a women’s imaging center, cardiac and pulmonary rehabilitation, center for joint replacement, wound care center, and an intensive/critical care unit. The hospital is the only hospital in Bergen County with all private rooms at no additional cost to the patient. Find the kind of care you’ve been looking for at Pascack Valley Medical Center. For more, please visit 


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UPDATED guidelines for the management of chronic obstructive pulmonary disease (COPD) include both non-pharmacological and pharmacological strategies to reflect the importance of a holistic approach to clinical care for people living with the disease.

Developed by the Lung Foundation Australia and the Thoracic Society of Australia and New Zealand, and published as a summary in the MJA, the guidelines include 26 recommendations addressing:

  • case finding and confirming diagnosis – confirmation by spirometry, blood eosinophil levels, behaviour and risk factors (smoking, treatment adherence, self-management skills, physical activity, comorbid conditions);
  • optimising function – non-pharmacological therapies, pharmacological therapies, managing comorbid conditions, palliative care, lung volume reduction surgery, pulmonary rehabilitation, non-invasive ventilation;
  • preventing deterioration – smoking cessation, immunisation, oxygen therapy, prophylactic antibiotics, biologic therapies, palliative care, home bilevel ventilation;
  • developing a plan of care; and
  • managing exacerbations – pharmacological management, non-invasive ventilation, and multidisciplinary care.

“About one in 13 Australians over the age of 40 years is estimated to have chronic obstructive pulmonary disease (COPD),” wrote the authors, led by Associate Professor Eli Dabscheck, a respiratory and sleep physician from Melbourne’s Alfred Hospital.

“In 2018, COPD was the leading cause of potentially preventable hospitalisations, the third leading specific cause of total disease burden, and the fifth leading cause of death in Australia. The impact of COPD is even greater among Indigenous Australians compared with non-Indigenous Australians.”

Non-pharmacological therapies for COPD include walking and structured exercise, as well as pulmonary rehabilitation to improve breathlessness, exercise performance, physical activity level and health status. Pharmacological therapies, including short- and long-acting inhaled bronchodilators, inhaled corticosteroids (ICS), and long-acting β-agonists, are evaluated in the guidelines.

The full guidelines are available at

Supervised injecting centres: 21 years of evidence

TWENTY-one years after the establishment of the Uniting Sydney Medically Supervised Injecting Centre (MSIC), research shows that, rather than becoming a “honeypot”, the MSIC has led to improved and sustained public amenity, leading to a call for the establishment of more supervised injecting facilities. Associate Professor Carolyn Day, from the University of Sydney, and colleagues wrote in the MJA that they had “addressed key questions regarding [supervised injecting facility (SIF)] operations and contend that there is sufficient evidence to support SIF rollout and expansion”. “Good policy, with clear legislation and careful management of clients within a harm reduction framework, can and does alleviate problems that may be perceived as inherent to the operation of such services. Given the solid evidence, current governments, in Australia and elsewhere, should expand SIF services without unnecessary protracted trial periods. The key challenge in SIF expansion is supporting legislation. Questions regarding the scientific and operational merit of SIFs have been answered. After 21 years of success, it is time for robust support for further services to be implemented both within Australia and internationally.”

Neurological manifestations of COVID-19 in adults and children

An international group of researchers, including from Australia, have detailed the differences in neurological manifestations of COVID-19 in adults and children in an article published in Brain. Researchers analysed data from the International Severe Acute Respiratory and emerging Infection Consortium cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021 – 161 239 patients (158 267 adults, 2972 children) admitted to hospital with COVID-19 and assessed for neurological manifestations and complications were included. “In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%), and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%), and central nervous system (CNS) infection (0.2%). Each occurred more frequently in [intensive care unit (ICU)] than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU vs. non-ICU (7.1% vs. 2.3%, P < .001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease, and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure, and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age.”

Counting steps important but faster cadence matters too

Research published in JAMA Internal Medicine, including authors from the University of Sydney, has found that accumulating more steps per day (up to about 10 000) may be associated with a lower risk of all-cause, cancer, and cardiovascular disease (CVD) mortality and with lower incidence of cancer and CVD, and that higher step intensity may provide additional benefits. The authors analysed data from 78 500 participants in the UK Biobank for 2013–2015, including adults aged 40–79 years. Participants were invited by email to partake in an accelerometer study. Registry-based morbidity and mortality were ascertained through October 2021. “The study population … was followed for a median of 7 years during which 1325 participants died of cancer and 664 of CVD (total deaths 2179). There were 10 245 incident CVD events and 2813 cancer incident events during the observation period. More daily steps were associated with a lower risk of all-cause ([mean rate of change (MRC)], −0.08; 95% CI, −0.11 to −0.06), CVD (MRC, −0.10; 95% CI, −0.15 to −0.06), and cancer mortality (MRC, 95% CI, −0.11; −0.15 to −0.06) for up to approximately 10 000 steps. Similarly, accruing more daily steps was associated with lower incident disease. Peak-30 cadence was consistently associated with lower risks across all outcomes, beyond the benefit of total daily steps,” the authors reported. “Steps performed at a higher cadence may be associated with additional risk reduction, particularly for incident disease.”

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This post was contributed by a community member. The views expressed here are the author's own.

Elmhurst Hospital’s pulmonary rehabilitation program has achieved certification from the Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). The certification is recognition of Elmhurst Hospital’s commitment to improving the quality of life of patients by enhancing standards of care.

Cardiovascular and pulmonary rehabilitation programs are designed to help people with cardiovascular problems (e.g., heart attacks, coronary artery bypass graft surgery) and pulmonary problems (e.g., chronic obstructive pulmonary disease [COPD], respiratory symptoms) recover faster and live healthier. Both programs include exercise, education, counseling and support for patients and their families.

To earn accreditation, the Elmhurst Hospital pulmonary rehabilitation program participated in an application process that requires extensive documentation of the program’s practices. AACVPR Program Certification is the only peer-review accreditation process designed to review individual programs for adherence to standards and guidelines developed and published by AACVPR and other related professional societies.

Find out what's happening in Elmhurstwith free, real-time updates from Patch.

For more information, about pulmonary rehabilitation services at Elmhurst Hospital and Edward-Elmhurst Health, visit

The views expressed in this post are the author's own. Want to post on Patch?

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According to DelveInsight, the Chronic Obstructive Pulmonary Disease Market in 7MM is expected to witness a major change in the study period 2019-2032

“The increase in Chronic Obstructive Pulmonary Disease Market size is a direct consequence of an increase in R& D activity, increasing prevalent population, expected commercial success of upcoming therapies in the 7MM


The Chronic Obstructive Pulmonary Disease Market is expected to gain market growth in the forecast period of 2022 to 2032. The growing cases of tumors will directly impact the growth of the Chronic Obstructive Pulmonary Disease Market


The Chronic Obstructive Pulmonary Disease market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM Chronic Obstructive Pulmonary Disease market size from 2019 to 2032. The Report also covers current Chronic Obstructive Pulmonary Disease treatment practice, market drivers, market barriers, SWOT analysis, reimbursement, market access, and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.


Key takeaways from the Chronic Obstructive Pulmonary Disease Market Research Report

  • The expected launch of the Chronic Obstructive Pulmonary Disease emerging therapies and the research and development activities of pharmaceutical companies will also fuel the Chronic Obstructive Pulmonary Disease market growth during the forecast period.
  • The estimates suggest a Chronic Obstructive Pulmonary Disease higher diagnosed prevalence in the United States with 17,455,605 diagnosed cases in 2020, which might increase in 2030.
  • The total Chronic Obstructive Pulmonary Disease diagnosed prevalent population in seven major markets was found to be 31,730,590 in 2020 and is anticipated to increase in 2030.
  • Chronic Obstructive Pulmonary Disease Market Companies included Afimmune, AstraZeneca, Amgen, Circassia Pharmaceuticals Inc., Biomarck Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, Chiesi Farmaceutici, Chiesi Farmaceutici S.p.A., Genentech, GlaxoSmithKline, and several others
  • Chronic Obstructive Pulmonary Disease Market Therapies included Anoro Ellipta, Incruse Ellipta/Encruse Ellipta, and several others


Interested to know more about the ongoing developments in the Chronic Obstructive Pulmonary Disease Market Outlook? Visit here-


Chronic Obstructive Pulmonary Disease Overview

Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. The most common respiratory symptoms include dyspnea, cough, and/or sputum production; these symptoms may be under-reported by patients. The main risk factor for COPD is tobacco smoking, but other environmental exposures such as biomass fuel exposure and air pollution may contribute.

Besides exposures, host factors predispose individuals to develop COPD. These include genetic abnormalities, abnormal lung development, and accelerated aging. COPD may be punctuated by periods of acute worsening of respiratory symptoms, called exacerbations. In most patients, COPD is associated with significant concomitant chronic diseases, which increase its morbidity and mortality. COPD is a long-lasting lung disease where the small airways in the lungs are damaged, making it harder for air to get in and out.


Chronic Obstructive Pulmonary Disease Epidemiology Insights

The Chronic Obstructive Pulmonary Disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by Total Diagnosed Prevalent Cases of Chronic Obstructive Pulmonary Disease (COPD), Gender-specific Diagnosed Prevalent Cases of Chronic Obstructive Pulmonary Disease (COPD), Age-specific Diagnosed Prevalent Cases of Chronic Obstructive Pulmonary Disease (COPD), Diagnosed Prevalent Cases of COPD Based on Severity of Airflow Limitation, and Diagnosed Prevalent Cases of COPD Based on Symptoms and Exacerbation History scenario in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom) and Japan from 2019 to 2032.


Chronic Obstructive Pulmonary Disease Epidemiology Segmentation in the 7MM 

  • Total Chronic Obstructive Pulmonary Disease Diagnosed Prevalent Cases
  • Chronic Obstructive Pulmonary Disease Gender-specific Diagnosed Prevalent Cases
  • Chronic Obstructive Pulmonary Disease Age-specific Diagnosed Prevalent Cases
  • Chronic Obstructive Pulmonary Disease Diagnosed Prevalent Cases Based on Severity of Airflow Limitation


Chronic Obstructive Pulmonary Disease Treatment Market

Chronic Obstructive Pulmonary Disease treatment include drugs, for example, nicotine replacement therapy, beta-2 agonists and anticholinergic agents (bronchodilators), combined drugs using steroids and long-acting bronchodilators, mucolytic agents, oxygen therapy, and surgical procedures such as bullectomy, lung volume reduction surgery, and lung transplantation. The goals of COPD treatment are to reduce hospitalizations, reduce and prevent exacerbations, decrease dyspnea, improve quality of life, slow disease progression, and reduce mortality. The mainstays of treatment are smoking cessation, when applicable, and pharmacotherapy with inhaled bronchodilators and corticosteroids. Additional therapies include oral phosphodiesterase-4 inhibitors, vaccinations, pulmonary rehabilitation, and long-term oxygen therapy in hypoxic patients. Bronchodilators are used to treat chronic obstructive pulmonary disease (COPD). The medicines come in many forms, with some forms requiring special instructions. There are several short-acting bronchodilators for COPD.


Discover more relevant information on the Chronic Obstructive Pulmonary Disease Market Research Report here-


Chronic Obstructive Pulmonary Disease Marketed Drugs

Anoro Ellipta: GlaxoSmithKline/Theravance/Innoviva

Anoro Ellipta is a combination of umeclidinium, an anticholinergic, and vilanterol, a long-acting beta2-adrenergic agonist (LABA), indicated for the maintenance treatment of patients with chronic obstructive pulmonary disease (COPD) (FDA, 2013). Anoro Ellipta is a once-daily product approved in the US that combines two long-acting bronchodilators in a single inhaler for the maintenance treatment of COPD.

Incruse Ellipta/Encruse Ellipta: GlaxoSmithKline

Incruse Ellipta is an anticholinergic approved for the long-term once-daily maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and/or emphysema. GSK’s once-daily anticholinergic, a type of bronchodilator also known as a long-acting muscarinic antagonist (LAMA), is contained in the Ellipta inhaler. The FDA-approved strength is 62.5 mcg.


Chronic Obstructive Pulmonary Disease Emerging Drugs

Itepekimab (SAR440340/REGN3500/Anti-IL-33 mAb): Sanofi/Regeneron Pharmaceuticals

REGN3500 is a fully human monoclonal antibody that inhibits interleukin-33 (IL-33), a protein that is believed to play a key role in type 1 and type 2 inflammation. The drug is administered subcutaneously. Preclinical research showed REGN3500 blocked several markers of both types of inflammation. Regeneron and Sanofi are currently studying REGN3500 in respiratory and dermatological diseases where inflammation plays an underlying role.

Dupixent (Dupilumab): Regeneron Pharmaceuticals/Sanofi

Dupixent (dupilumab) is a monoclonal antibody targeting α chain of the interleukin (IL)-4 receptor. It inhibits the biological effects of the cytokines IL-4 and IL-13, which are key drivers in the TH2 response (Sastre, 2018). Dupilumab is approved in the US to treat patients aged ≥12 with moderate-to-severe atopic dermatitis (AD) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies.


Chronic Obstructive Pulmonary Disease Market Outlook

Many people with Chronic Obstructive Pulmonary Disease have mild forms of the disease for which little therapy is needed other than smoking cessation. Even for more advanced stages of the disease, effective therapy is available that can control symptoms, slow progression, reduce the risk of complications and exacerbations, and improve the ability to lead an active life. The goal in treating Chronic Obstructive Pulmonary Disease is to help the person breathe easier and get back to regular activities; many treatments and lifestyle approaches can help. The patient may also try some natural and alternative treatment options. Chronic Obstructive Pulmonary Disease treatment focuses on relieving symptoms, such as coughing, breathing problems, and avoiding respiratory infections. The treatments are often based on the stages of Chronic Obstructive Pulmonary Disease.


Chronic Obstructive Pulmonary Disease Market Size

The Chronic Obstructive Pulmonary Disease Market Size has been categorized into three groups based on the type of therapies that are used and that might get launched, i.e., Monotherapies, Double combination therapies, and Triple combination therapies. The monotherapies are further categorized into Long-Acting Bronchodilators (LABDs), Inhaled Corticosteroids (ICS), Phosphodiesterase Type 4 Inhibitors, and other monotherapies. In LABA, drugs like Striverdi Respimat, Arcapta/Onbrez, Serevent, and Brovana are there, and in LAMA class, molecules such as Spiriva (Spiriva HandiHaler and Spiriva Respimat), Tudorza Pressair, Incruse Ellipta, Yupelri, Seebri Neohaler, Lonhala Magnair, etc. are included.


Read more about the Chronic Obstructive Pulmonary Disease Market Companies and Therapies in the report-


Scope of the Chronic Obstructive Pulmonary Disease Market Forecast Report

  • Coverage- 7MM
  • Study Period-2019-2032
  • Chronic Obstructive Pulmonary Disease Market Forecast Period- 2022-2032
  • Chronic Obstructive Pulmonary Disease Market Companies included Afimmune, AstraZeneca, Amgen, Circassia Pharmaceuticals Inc., Biomarck Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, Chiesi Farmaceutici, Chiesi Farmaceutici S.p.A., Genentech, GlaxoSmithKline, and several others
  • Chronic Obstructive Pulmonary Disease Market Therapies included Anoro Ellipta, Incruse Ellipta/Encruse Ellipta, and several others
  • Chronic Obstructive Pulmonary Disease Market Drivers and Barriers
  • KOL Views
  • Chronic Obstructive Pulmonary Disease Market Access and Reimbursement


Table of Content

1. Key Insights

2. Report Introduction

3. Chronic Obstructive Pulmonary Disease (COPD) Market Overview at a Glance

4. Executive Summary of Chronic Obstructive Pulmonary Disease (COPD)

5. Key Events

6. Disease Background and Overview

7. Epidemiology and Patient Population

8. Patient Journey

9. Organizations contributing toward Chronic Obstructive Pulmonary Disease (COPD)

10. Chronic Obstructive Pulmonary Disease Marketed Therapies

11. Chronic Obstructive Pulmonary Disease Emerging Drugs

12. Potential of Emerging and Current therapies

13. Chronic Obstructive Pulmonary Disease (COPD): Seven Major Market Analysis

14. KOL Views

15. Chronic Obstructive Pulmonary Disease Market Drivers

16. Chronic Obstructive Pulmonary Disease Market Barriers

17. SWOT Analysis

18. Unmet Needs

19. Reimbursement and Chronic Obstructive Pulmonary Disease Market Access

20. Appendix

21. DelveInsight Capabilities

22. Disclaimer

23. About DelveInsight


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About Us

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Patients with COPD derived significant benefits from inpatient pulmonary rehabilitation regardless of inhaled triple therapy use, according to findings reported in the journal Respiratory Medicine by Italian investigators.

That finding notwithstanding, the research team also reports that benefits in exercise tolerance were larger and improvement in dyspnea was higher in those receiving triple therapy.

As context for their research the authors cite uncertainty on the topic and write, “To the best of our knowledge, this is the first large real-life study on the effectiveness of pulmonary rehabilitation in individuals with COPD using triple therapy as compared to those using no triple therapy.”

Led by Prof Nicolino Ambrosino, from the department of respiratory rehabilitation at the Institute of Lumezzane at the Maugeri IRCCS Scientific Clinical Institutes in Brescia, Italy, the multicenter retrospective analysis included data from 1139 individuals admitted to in-hospital pulmonary rehabilitation programs from July 2018 to December 2021. Participants all reported a diagnosis of COPD.

Investigators collected baseline patient characteristics, including demographics, anthropometrics, comorbidities, history of acute COPD exacerbation in the past 12 months, blood eosinophil count, length of rehabilitation hospital stay, presence of chronic respiratory failure, airflow distribution and Global Initiative for Chronic Obstructive Lung Disease stages. Use of inhaler therapy was recorded after reassessment.

The primary outcome measure was 6-minute walking test distance and secondary outcomes of interest were scores on the Medical Research Council scale for dyspnea and the COPD assessment test.

Among all study participants, 61% were receiving inhaled triple therapy.


Ambrosino et al observed improvement in 6-minute walking test in both groups, with those on triple therapy increasing distance from 283.1 m to 337.3 m and those not on triple therapy improving from 336.2 m to 378.7 m (P<.01 for both outcomes). The effect size, however, was higher (54.3 m vs 42.5 m; P=.004) and the proportion of individuals who reached the minimal clinically important difference (MCID) of 6-minute walking test greater (64.2% vs 54.3%; P=.001) among participants receiving triple therapy, according to investigators. For key secondary outcomes, the research team also reported improvement in both study groups.

Additional analyses found that the key significant independent predictors of reaching the MCID of 6-minute walking test were hospital provenance (odds ratio [OR], 2.17; 95% CI, 1.61-2.94), triple therapy use (OR, 1.33; 95% CI, 1.03-1.70) and high eosinophil count (OR, 1.67; 95% CI, 1.14-2.43).

“Whether these results are associated with the inhaled therapy used or with the characteristics leading to the use should be further evaluated with randomized controlled trials,” the researchers wrote. “Our data reflect the specific population of individuals with indications of pulmonary rehabilitation [and are] not comparable and extensible to other populations of individuals with COPD.”

Reference: Vitacca M, Paneroni M, Spanevello A, et al. Effectiveness of pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease according to inhaled therapy: The Maugeri study. Res Med J. 2022;doi:10.1016/j.rmed.2022.106967

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From a pathophysiological point of view, bronchiectasis disease is sustained by a vicious circle in which an alteration in mucociliary clearance is followed by chronic respiratory infections, chronic inflammation, and irreversible bronchial anatomical damage, which over time can lead to a progression and aggravation of the disease itself.

 What are the causes of bronchiectasis?

Bronchiectasis can have several causes, either congenital or acquired, such as primary or secondary immune deficits, previous pneumonias, alterations in ciliary motility, fungal infections (such as from Aspergillus) or from non-tuberculous mycobacteria, autoimmune and chronic inflammatory processes.

However, in 40-50% of cases the cause of the disease remains unknown despite extensive diagnostic investigations.

What are the symptoms of bronchiectasis?

The main symptoms/signs of bronchiectasis are coughing, daily expectoration, and recurrent respiratory infections (including pneumonia).

In addition to these symptoms, episodes of haemophthisis/haemoptysis (blood in the sputum), dyspnoea (shortness of breath), persistent fever, and daily significant asthenia may also be present.


The gold standard for the diagnosis of bronchiectasis is a high-resolution chest CT scan and the pulmonologist is the referral specialist.

At the time of the diagnosis of bronchiectasis and depending on the severity of the clinical picture, a series of laboratory tests should be performed, including quantitative assessment of total IgG, IgA, IgM and IgE immunoglobulins, IgG and IgE specific for A. fumigatus, protein electrophoresis, complete respiratory function tests, a sputum culture test for bacteria, fungi and mycobacteria, a visit with a respiratory physiotherapist and a pulmonologist.

Then, every six months or annually, and always depending on the severity of the clinical picture, it is recommended to perform a sputum culture examination, and a re-evaluation with a respiratory physiotherapist and a pulmonologist.

In some patients it is also important to rule out certain genetic disorders (such as cystic fibrosis or primitive ciliary dyskinesia) as well as the coexistence of possible connective tissue diseases (such as rheumatoid arthritis).


There are to date no European or American approved drugs to treat this disease.

The management of bronchiectasis is totally individualised on the basis of the clinical and biological characteristics expressed by each patient.

The most important treatment is respiratory physiotherapy, which uses a specific exercise programme to remove the mucus that tends to stagnate in bronchiectasis.

Other important tools at our disposal are antibiotics, immunomodulatory therapies, bronchodilator drugs (if bronchial obstruction is present) as well as treatments to manage the two most frequent complications of the disease: flare-ups and the presence of blood in the sputum.

The optimal management of bronchiectasis passes through a multidisciplinary approach in which the pulmonologist, flanked by the respiratory physiotherapist, can count on the collaboration of other professionals including the clinical microbiologist, the radiologist, the clinical immunologist/rheumatologist, the geneticist, the gastroenterologist and the otorhinolaryngologist.

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Extrinsic, Intrinsic, Occupational, Stable Bronchial Asthma: Causes, Symptoms, Treatment

A Guide To Chronic Obstructive Pulmonary Disease COPD



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As part of the Health and Safety Executive (HSE)’s role as an enabling regulator it has recently refreshed its silica guidance for brick and tile manufacturing, stonework and foundries ahead of manufacturing sector focused inspections in autumn/winter.

The HSE warns that prolonged exposure to airborne particles of respirable crystalline silica (RCS) can lead to life-changing respiratory conditions such as silicosis and chronic obstructive pulmonary disease.

Silica is a natural substance found in most stone, rocks, sand, quartz and clay. Silica particles are produced during many manufacturing tasks involving these materials. Silicosis, chronic obstructive pulmonary disease (COPD) and lung cancer can all be caused by breathing in tiny particles of silica. Over time, exposure to silica particles can harm a worker’s ability to breathe and cause irreversible, often fatal, lung disease.

Starting in October 2022, HSE Inspectors will begin a targeted inspection initiative focusing on manufacturing business where materials that contain silica are used, to ensure they have control measures in place to protect workers’ respiratory health. This will include brick and tile manufacturers, foundries, stone working sites and manufacturers of kitchen worktops.

Employers have a legal duty to put in place suitable arrangements to manage health and safety and ensure they comply with the Control of Substances Hazardous to Health Regulations 2002 (COSHH). Inspectors will be looking for evidence that businesses have put in place effective measures, such as Local Exhaust Ventilation (LEV), water suppression and where appropriate, use of protective equipment such as Respiratory Protective (RPE), to reduce workers exposure to the RCS. If any health and safety breaches are discovered, HSE will take enforcement action to make sure workers’ health is protected.

HSE’s Head of Manufacturing David Butter said: “It’s hugely important for manufacturing businesses where workers use materials that contain silica to act now to ensure they comply with the law and protect their workers from the risks of devastating lung disease. Businesses should take note that that good ventilation in the workplace and protective equipment are just some of the measures they need in place to protect the respiratory health of workers.

“Ahead of our autumn/winter inspection campaign, we want employers and workers to make sure they are aware of the risks associated with the activities they do. For example brick and tile manufacture, foundry workers and stoneworkers where they cut and shape bricks, tiles and stone that can create RCS dust that could be breathed in. To assist them we have refreshed our guidance. In addition, we have committed to providing duty holders with regular updates, information and advice through our ebulletin.”

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It’s said that singing heals the soul, but what if it actively helps people with respiratory disease? In a world first, Monash University researchers are currently recruiting people with two common, and incurable, chronic lung diseases into a two-year trial to see whether online group singing improves their condition.

Chronic obstructive pulmonary disease (COPD) is an incurable condition characterised by airflow limitation, persisting respiratory symptoms, and progressive respiratory failure. In Australia, COPD represents 43% of all chronic respiratory disease burden, affecting 30% of people aged over 75 years, with disproportionate impacts on those living in regional areas or with lower socioeconomic status. With over 72,000 admissions each year attributable to COPD, it is the third leading cause of avoidable hospitalisation and generates significant healthcare costs. Internationally, COPD is the second most common respiratory disease after asthma in the United Kingdom and the third leading cause of death worldwide.

Interstitial lung disease (ILD) is an umbrella term which captures a large group of diseases resulting in fibrosis of the lungs which often generate distressing, progressive symptoms, and account for a further 8% of chronic respiratory disease burden in Australia.

According to Associate Professor Natasha Smallwood, the Head of the Chronic Respiratory Disease laboratory at Monash University’s Central Clinical School who is leading the trial, pulmonary rehabilitation which includes exercise, breath training, psychosocial counselling, and patient education, has been shown to improve symptoms and function, and reduce hospitalisations. “Despite these benefits, of the nearly 1.5 million older Australians living with symptomatic COPD, fewer than 10% have ever accessed a program,” she said.

“Singing can be delivered as a guided, weekly, group-based activity, emphasising focus and control of breathing for patients with COPD and ILD.”

Online singing gained traction during COVID lockdowns when the risk of aerosol spread of the virus led to banning of choirs. “Online delivery of singing represents an attractive opportunity to improve healthcare access for participants with limited mobility, poor health, or who live in a rural location with limited access to health services,” the authors added.

The SingINg For breathing in COPD aNd ILD pAtients (SINFONIA) trial is a phase II/III trial of guided, online group singing that will be conducted over 24 months. Data will be collected on quality of life, anxiety and depression, breathlessness, mastery of breathing, exercise tolerance, loneliness, healthcare utilisation, and carer quality of life (optional).

/Public Release. This material from the originating organization/author(s) may be of a point-in-time nature, edited for clarity, style and length. The views and opinions expressed are those of the author(s).

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Conditions such as heart disease, stroke, and respiratory infections account for the majority of deaths each year around the world. With that said, there are many steps you can take to prevent these deadly diseases.

When people think of the deadliest diseases in the world, their minds probably jump to the fast-acting, incurable ones that grab headlines from time to time. However, many of these types of diseases don’t rank in the top 10 causes of worldwide deaths.

An estimated 55.4 million people passed away worldwide in 2019, and 74% of these deaths were because of noncommunicable diseases, or chronic conditions that progress slowly.

Perhaps even more surprising is that several of the deadliest diseases are partially preventable. Non-preventable factors include where a person lives, access to preventive care, and quality of healthcare, all of which factor into risk.

But there are several steps that everyone can take to lower their risk.

Read on to see 10 of the deadliest diseases worldwide.

The deadliest disease in the world is coronary artery disease (CAD).

Also called ischemic heart disease, CAD occurs when the blood vessels that supply blood to the heart become narrowed. Untreated CAD can lead to chest pain, heart failure, and arrhythmias.

Impact of CAD across the world

Although it’s still the leading cause of death, mortality rates have declined in many European countries and in the United States.

This may be because of better public health education, access to healthcare, and other forms of prevention. However, in many developing nations, mortality rates for CAD are on the rise.

An increasing life span, socioeconomic changes, and lifestyle risk factors play a role in this rise.

Risk factors and prevention

Risk factors for CAD include:

Talk with a doctor or healthcare professional if you have one or more of these risk factors.

You can prevent CAD with medications and by taking steps to improve heart health. Some of the ways you can decrease your risk include:

  • exercising regularly
  • reaching or maintaining a moderate weight
  • eating a balanced diet that’s low in sodium and high in fruits and vegetables
  • avoiding smoking, if applicable
  • drinking only in moderation

A stroke occurs when an artery in your brain is blocked or leaks. This causes the oxygen-deprived brain cells to begin dying within minutes.

During a stroke, you feel sudden numbness and confusion or have trouble walking and seeing. If left untreated, a stroke can cause long-term disability.

In fact, strokes are the leading cause of long-term disabilities. People who receive treatment within 3 hours of having a stroke are less likely to have disabilities.

The Centers for Disease Control and Prevention (CDC) reports that one survey found that 93% of people knew sudden numbness on one side was a symptom of stroke. However, only 38% knew all the symptoms that would prompt them to look for emergency care.

Risk factors and prevention

Risk factors for stroke include:

  • high blood pressure
  • family history of stroke
  • smoking, especially when combined with oral contraceptives
  • being African American
  • being female

Some risk factors of strokes can be lowered with preventive care, medications, and lifestyle changes. In general, good health habits can lower your risk.

Stroke prevention methods may include controlling high blood pressure with medications. You should also maintain a healthy lifestyle, complete with regular exercise and a balanced diet that’s low in sodium.

If you smoke, consider quitting and drink only in moderation, as these activities increase your risk of stroke.

A lower respiratory infection is an infection in your airways and lungs. It can be due to:

Though viruses usually cause lower respiratory infections, they can also be caused by bacteria.

Coughing is the main symptom of a lower respiratory infection. It may produce blood sputum. You may also have a fever, sweating, or chills or experience breathlessness, wheezing, and a tight feeling in your chest.

Risk factors and prevention

Risk factors for lower respiratory infection include:

  • the flu
  • poor air quality or frequent exposure to lung irritants
  • smoking
  • a weak immune system
  • crowded child care settings, which mainly affect infants
  • asthma
  • HIV

One of the best preventive measures you can take against lower respiratory infections is to get the flu shot every year. People at high risk of pneumonia can also get a vaccine.

Be sure to wash your hands regularly with soap and water to avoid transmitted bacteria, especially before touching your face or eating.

If you have a respiratory infection, stay at home and rest until you feel better, as rest improves healing.

Chronic obstructive pulmonary disease (COPD) is a long-term, progressive lung disease that makes breathing difficult. Chronic bronchitis and emphysema are types of COPD.

In 2018, about 16.4 million people in the United States reported a diagnosis of any type of COPD.

Risk factors and prevention

Risk factors for COPD include:

  • smoking or secondhand smoke
  • lung irritants such as chemical fumes
  • family history, with the alpha-1 antitrypsin deficiency gene being linked to COPD
  • history of respiratory infections as a child

There’s no cure for COPD, but its progression can be slowed with medication.

The best ways to prevent COPD are to stop smoking, if applicable, and avoid secondhand smoke and other lung irritants. If you experience any COPD symptoms, getting treatment as soon as possible improves your outlook.

Respiratory cancers include cancers of the trachea, larynx, bronchus, and lungs.

The main causes are smoking, secondhand smoke, and environmental toxins. However, household pollutions, such as fuels and mold, also contribute.

Impact of respiratory cancers around the world

A 2015 study reports that there are around 18 million new cases of lung cancer annually. In developing countries, researchers project an 81% to 100% increase in respiratory cancers because of pollution and smoking.

Many Asian countries, especially India, still use coal for cooking. Solid fuel emissions account for 17% of lung cancer deaths in males and 22% in females.

Risk factors and prevention

Trachea, bronchus, and lung cancers can affect anyone, but they’re most likely to affect those who have a history of smoking or tobacco use.

Other risk factors for these cancers include family history and exposure to environmental factors such as diesel fumes.

Aside from avoiding fumes and tobacco products, it isn’t known if there’s anything else that can be done to prevent lung cancers. However, routine lung scans and early detection can result in more effective treatment and an improved outlook.

Diabetes is a group of diseases that affect the production or use of insulin.

In type 1 diabetes, the pancreas is unable to produce insulin. This type of diabetes is believed to be caused by an autoimmune reaction.

In type 2 diabetes, the pancreas doesn’t produce enough insulin, or insulin can’t be used effectively. Type 2 diabetes can be caused by a number of factors, including poor diet and physical inactivity.

Impact of diabetes around the world

Over time, uncontrolled diabetes can cause damage to the nerves and blood vessels. This can lead to complications such as impaired wound healing, kidney failure, and blindness.

People in low- and middle-income countries are more likely to die of complications from diabetes because of limited access to medications and technologies needed to manage blood sugar levels.

Risk factors and prevention

Risk factors for diabetes include:

  • having overweight or obesity
  • high blood pressure
  • older age
  • not exercising regularly
  • an unhealthy diet

While diabetes isn’t always preventable, you can control the severity of symptoms by exercising regularly and following a well-rounded, nutritious diet. Adding more fiber to your diet can also help with controlling blood sugar levels.

Alzheimer’s disease is a progressive disease that destroys memory, interferes with decision making, and interrupts normal cognitive functions. These include thinking, reasoning, and other everyday behaviors.

Alzheimer’s disease is the most common type of dementia and accounts for about 60 to 70% of cases.

The disease starts off by causing mild memory problems, difficulty recalling information, and slips in recollection. Over time, however, the disease progresses, and you may not have memory of large periods of time.

Risk factors and prevention

Risk factors for Alzheimer’s disease include:

There’s not currently a way to prevent Alzheimer’s disease, and researchers aren’t sure why some people develop it and others don’t. As they work to understand this, they’re also working to find preventive techniques.

One thing that may be helpful in lowering your risk of the disease is following a healthy diet. In fact, some research suggests that eating plenty of fruits, vegetables, whole grains, heart-healthy fats, and legumes could support brain function and prevent cognitive decline.

Diarrhea is when you pass three or more loose stools in a day. If your diarrhea lasts more than a few days, your body loses too much water and salt. This causes dehydration, which can be fatal in severe cases.

Diarrhea is usually caused by an intestinal virus or bacteria transmitted through contaminated water or food. It’s particularly widespread in areas with poor sanitary conditions.

Impact of diarrheal diseases around the world

Diarrheal disease is the second leading cause of death in children younger than 5 years old. About 525,000 children die from diarrheal diseases each year.

Risk factors and prevention

Risk factors for diarrheal diseases include:

  • living in an area with poor sanitary conditions
  • not having access to clean water
  • age, with children being the most likely to experience severe symptoms of diarrheal diseases
  • malnourishment
  • a weakened immune system

The best method of prevention is practicing good hygiene. Handwashing, improved sanitization and water quality, and access to early medical treatment can also help prevent diarrheal diseases.

TB is a lung condition caused by bacteria called Mycobacterium tuberculosis. It’s a treatable airborne bacterium, although some strains are resistant to conventional treatments.

TB is one of the top causes of death in people who have HIV. Furthermore, people who have HIV are 18 times more likely to develop active TB.

Impact of TB around the world

The cases of TB have fallen 2% each year between 2015 and 2020.

One of the targets of the United Nations Sustainable Development Goals is to end the TB epidemic by 2030.

Risk factors and prevention

Risk factors for TB include:

  • diabetes
  • HIV infection
  • a lower body weight
  • proximity to others with TB
  • regular use of certain medications such as corticosteroids or drugs that suppress the immune system

The best prevention against TB is to get the bacillus Calmette-Guerin vaccine, which is commonly given to infants and children in areas where TB is common.

If you think you’ve been exposed to TB bacteria, a doctor can prescribe preventive medications (chemoprophylaxis) to lower the likelihood of developing an active infection.

Cirrhosis is the result of chronic or long-term scarring and damage to the liver. The damage may be the result of a kidney disease, or it can be caused by conditions such as hepatitis, alcoholic liver disease, or nonalcoholic fatty liver disease.

A healthy liver filters harmful substances from your blood and sends healthy blood into your body. As substances damage the liver, scar tissue forms. As more scar tissue forms, the liver has to work harder to function properly and may eventually stop working.

Risk factors and prevention

Risk factors for cirrhosis include:

  • chronic alcohol use
  • fat accumulation around the liver (nonalcoholic fatty liver disease)
  • chronic viral hepatitis

Moderating alcohol intake can help prevent liver damage and cirrhosis.

Likewise, you can prevent nonalcoholic fatty liver disease by enjoying a nutritious diet rich in fruits and vegetables and low in sugar and fat.

Lastly, you can lower the likelihood of contracting viral hepatitis by using barrier methods each time you engage in sexual activity and by avoiding sharing anything that could have traces of blood such as needles, razors, or toothbrushes.

How many rare diseases are there?

A rare disease is usually defined as a disease or condition that affects fewer than 200,000 people in the United States.

According to most scientists and clinicians, there are around 7,000 different rare diseases. However, this estimate can vary from 5,000 to 8,000 rare diseases, depending on the source.

It’s believed that around 1 in 10 people in the United States, or around 30 million people in total, has a rare disease.

Some rare diseases are hereditary and can be passed from parent to child. Some may be visible from birth, while others might show up later in life.

Which disease has no cure?

There’s no known cure for many conditions, including several on the list of the deadliest diseases.

This also includes conditions such as cancer, Alzheimer’s disease, multiple sclerosis, and muscular dystrophy.

In many cases, certain lifestyle factors, such as smoking cessation and modifying your diet or exercise routine, may lower the risk of developing some of these conditions.

In other cases, a combination of lifestyle changes, medications, and other treatment methods might help manage or reduce symptoms of a condition, though it may not necessarily cure it.

What’s the deadliest disease?

Ischemic heart disease is the leading cause of death around the globe. Other conditions, such as stroke, COPD, lower respiratory infections, and respiratory cancers, also account for a significant portion of deaths each year.

While deaths from certain diseases have increased, those from more serious conditions have also decreased.

Several factors, such as an increasing life span, naturally increase the prevalence of age-related diseases such as CAD, stroke, and heart disease.

However, many of the diseases on this list are preventable and treatable, and as medicine continues to advance and prevention education grows, we may see improved outcomes for many of these diseases.

A good approach to lowering your risk of any of these conditions is to follow a balanced diet, live a healthy lifestyle, and stay active.

Moderating your alcohol intake and quitting smoking, if applicable, can also help.

For bacterial or viral infections, proper handwashing can help prevent or lower your risk.

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Mucus in the lungs is common in certain health conditions and needs treatment. For example, if you have bronchiectasis or chronic obstructive pulmonary disease (COPD), clearing mucus from your lungs is an important part of managing your lung disease.

Having too much mucus in your lungs or phlegm build-up can block narrowed air passages and make it hard for you to breathe. Increased mucus in the lungs can also lead to infections, such as pneumonia.

There are ways to treat mucus in the lungs, including controlled coughing, medications, and chest physiotherapy.

This article will go over some causes of mucus in the lungs as well as ways that your provider might want you to clear mucus from your lungs as part of your treatment.

Verywell / Emily Roberts

Home Remedies and Lifestyle Changes for Mucus in Lungs

You can use at-home exercises to help prevent and decrease mucus buildup in your lungs. If you have lung disease these techniques should be used regularly to loosen and remove the excess mucus from your lungs.

Controlled Coughing for Mucus in Lungs

Controlled coughing engages the chest and stomach muscles to clear mucus in the lungs. Unlike a hacking cough that uses the chest muscles more than the diaphragm, controlled coughing focuses on stabilizing the core muscles to engage the diaphragm more effectively.

There are two common methods of controlled coughing: deep and huff.

How to use deep coughing to clear mucus in the lungs:

  1. Sit comfortably in a chair with your feet on the ground.
  2. Wrap your arms around your stomach, and take a deep breath in.
  3. Keeping your lips pursed, cough forcefully while pressing your arms firmly against your stomach muscles.

How to use huff coughing to clear mucus in the lungs:

  1. Take a deep, slow breath to fully expand your lungs.
  2. Tense your stomach muscles
  3. Exhale three times very quickly and make a "ha" sound with each breath.
  4. Repeat this step, keeping your core firm, until you feel the mucus in your lungs breaking up.
  5. Cough deeply to clear your lungs.

Deep Breathing for Mucus in Lungs

When you do deep breathing exercises, you slowly breathe in (inhale) and breathe out (exhale) to help your lungs expand. These breathing exercises are examples of pulmonary hygiene—treatments that use physical manipulation techniques to help you cough up sticky mucus and clear your lungs.

Your respiratory therapist can teach you deep breathing techniques that you can do at home on a regular schedule to help keep your lungs clear.

Over-the-Counter (OTC) Treatment for Lung Mucus

Several OTC medications can help clear excess mucus from your lungs, for example, Robitussin and Mucinex.

These medications are expectorants. They have an ingredient called guaifenesin in them that thins and loosens mucus in the lungs to make it easier to cough up. They can also block the production of the main protein in mucus (mucins).

Most expectorants can be bought at a pharmacy or grocery store, but some combination drugs that have expectorants and other ingredients in them require a healthcare provider's prescription.

Prescription Medications for Lung Mucus

Mucolytics, including N-acetylcysteine and carbocysteine, are only available by prescription.

These medications work differently than expectorants. Mucolytics break the chemical bonds in mucus to help make it easier to cough up.

Chest Physiotherapy for Mucus in Lungs

Chest physiotherapy (CPT) techniques can be done manually or with a mechanical device. A CPT routine can take anywhere from 20 minutes to an hour.

You can do some CPT techniques by yourself, but others require help from a partner, such as a therapist or a family member at home.

  • Manual CPT combines chest percussion and vibration to loosen the mucus in the lungs and make you cough. To do chest percussion, a therapist or loved one will clap on your chest or back to help loosen the thick mucus in your lungs so you can cough it up. Vibration is done by placing their flat hands on your chest wall and making a shaking motion.
  • Airway clearance devices are hand-held machines that use high-frequency vibration, low-frequency sound waves, and other technology to break up mucus in the lungs. They are easy to use by yourself. Some of the devices are worn like a vest, while others require you to breathe into them (like a flute).

While you are having chest physiotherapy, make sure you breathe in and out slowly and fully until the mucus in your lungs is loose enough to cough up. Your therapist will show you how to get into a position that uses gravity to help the mucus in your lungs drain.

Alternative Medicine for Lung Mucus

There are some natural remedies that may help reduce the mucus in your lungs. Keep in mind that even though they are "natural," complementary and alternative medicine (CAM) therapies can have side effects.

CAM therapies that may help clear mucus in the lungs include:

  • Warm fluids: Drinking warm (not hot) liquids can help loosen thickened mucus. Try tea, warm broth, or hot water with lemon.
  • Steam: You can use a device such as a cool-mist humidifier or steam vaporizer to breathe in warm air. You can also take a hot shower or breathe in vapors from a pot of simmering water. These methods introduce moist air into your air passages, which helps loosen the mucus in your lungs. However, do not inhale oils because they can cause an inflammatory or allergic lung reaction.
  • HoneyHoney may reduce inflammation and coughing. However, it is not clear whether honey specifically helps in coughing up mucus.
  • Chinese medicine: Chinese herbs and treatments have traditionally been used to reduce mucus in the lungs. While there are anecdotal reports that they are helpful, the scientific data is not clear about the benefits.
  • A few herbs—including mao huang (Herba ephedrae), tao ren (Semen persicae), and Huang qin (Radix scutellariae)—may ease the symptoms of respiratory disease.
  • Qigong, a practice of breathing exercises and movements, may also help.

Ask Your Provider About CAM for Lung Mucus

CAM therapies are not safe for everyone. If you take certain medications or have certain health conditions, you may not be able to use them.

If you want to try an herb, supplement, or natural remedy to help clear mucus in your lungs, talk to your provider. They will make sure that it would be safe for you to try these treatments.


Mucus in the lungs can be part of having certain health conditions and something that you'll need to learn how to manage.

Regularly clearing mucus from your lungs is part of living with bronchiectasis and COPD. Controlled coughing, deep breathing, over-the-counter and prescription medications, chest physiotherapy, and alternative therapies help by reducing, loosening, and coughing up the mucus to prevent lung infections.

It's important that you use mucus-reducing strategies on a regular basis, not just when your symptoms act up. If you have been diagnosed with pulmonary disease, talk to your healthcare provider or respiratory therapist about the best approaches for managing mucus in your lungs.

Frequently Asked Questions

  • How do you know if your lungs are filled with mucus?

    If you have mucus in your lungs, you might have a "wet" cough or be able to hear the fluid in your chest when you breathe. You may wheeze or find it harder to breathe if there is mucus build-up in your lungs.

  • How do I naturally get rid of mucus in the lungs?

    One way to get rid of mucus or phlegm naturally is by doing controlled huff coughing to clear your lungs.

    1. Sit up straight, slightly tilt your chin toward the ceiling, and open your mouth.
    2. Slowly take a deep breath in, filling your lungs about three-quarters full.
    3. Hold your breath for three seconds.
    4. Forcefully exhale in a slow, continuous manner.
    5. Repeat steps one to four at least two or three more times. Then, perform a single strong cough. This should remove mucus concentrated in the larger airways.

  • Is chest congestion common in COVID-19?

    About one-third of people with COVID-19 have chest congestion or pressure as a symptom. COVID often causes a dry (non-productive) cough but some people have a productive cough and cough up thick mucus.

  • What causes phlegm?

    The body makes phlegm and mucus to line the tissues and protect and moisturize them, as well as trap potential irritants and germs.

  • What medicine can be used to clear phlegm from the throat?

    Mucus thinners (mucolytics) are over-the-counter (OTC) medicines that help thin mucus or phlegm in the airways, making it easier to cough up. Two types of mucus thinners are Pulmozyme (dornase alfa) and hypertonic saline.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Poole P, Sathananthan K, Fortescue R. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Airways Group, ed. Cochrane Database of Systematic Reviews. 2019 May 20;5(5):CD001287. doi:10.1002/14651858.CD001287.pub6

  2. Aaron SD. Mucolytics for COPD: negotiating a slippery slope towards proof of efficacy. Eur Respir J. 2017;50(4). doi:10.1183/13993003.01465-2017

  3. Warnock L, Gates A. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis. Cochrane Database Syst Rev. 2015;(12):CD001401. doi:10.1002/14651858.CD001401.pub3

  4. Cohen HA, Hoshen M, Gur S, Bahir A, Laks Y, Blau H. Efficacy and tolerability of a polysaccharide-resin-honey based cough syrup as compared to carbocysteine syrup for children with colds: a randomized, single-blinded, multicenter studyWorld J Pediatr. 2017;13(1):27-33. doi:10.1007/s12519-016-0048-4

  5. Tong H, Liu Y, Zhu Y, Zhang B, Hu J. The therapeutic effects of qigong in patients with chronic obstructive pulmonary disease in the stable stage: a meta-analysis. BMC Complement Altern Med. 2019;19(1):239. doi:10.1186/s12906-019-2639-9

  6. American Lung Association. Understanding Mucus in Your Lungs.

  7. Centers for Respiratory Health. Clearing lung mucus in five easy steps with huff coughing.

  8. Cystic Fibrosis Foundation. Mucus thinners.

By Deborah Leader, RN

 Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD.

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Practicing belly breathing can help you hold your breath longer (and bring down your stress, too).

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Is it bad to only be able to hold your breath for 30 seconds? What about 45 seconds or a minute?

Lots of things can affect your ability to hang on to a big gulp of air, and it's normal for different people to be able to hold their breath for different lengths of time.

Here's what's typical, plus what you can do to boost your lung capacity and hold your breath for longer.

What's the Average Time to Hold Breath?

Different people can hold their breath for different amounts of time. "Most people can hold their breath for 30 to 90 seconds without any difficulty," says registered respiratory therapist Mandy De Vries, MS-RCL/Ed, director of education at the American Association for Respiratory Care (AARC).

However, that time can vary based on a number of factors.

What's the World Record for Holding Breath?

In March 2021, a Croatian man named Budimir Šobat held his breath for 24 minutes and 37.36 seconds, according to Guinness World Records, surpassing the previous world record by 34 seconds.

Factors That Affect How Long You Can Hold Your Breath

You may not be able to hold your breath for that long if you smoke or have an underlying medical condition. For example, people with chronic obstructive pulmonary disease (COPD) or asthma usually can't hold their breath as long.

Infections like COVID-19 can factor in too. Even mild cases can cause temporary shortness of breath, while more severe ones can lead to permanent lung scarring that may reduce your lung capacity, according to Johns Hopkins Medicine.

People who regularly engage in aerobic exercise, especially activities like swimming and running, tend to have greater lung volumes that makes it easier to hold their breath for longer, De Vries explains.

Taller people tend to have greater lung capacities compared to those who are shorter.

Carrying excess abdominal fat, on the other hand, can reduce your lung volume by compressing your chest wall, according to a February 2017 paper in ​Multidisciplinary Respiratory Medicine​.

Lung volume can even (temporarily) shrink during pregnancy, as a person's expanding uterus can put extra pressure on the lungs.

Finally, don't discount age. Starting at age 35, our lung volume and pulmonary function start to slowly decrease, per the ​Multidisciplinary Respiratory Medicine​ paper. So younger adults may be able to hold their breath longer than older adults.

The Benefits of Greater Lung Capacity

The lungs are responsible for taking in oxygen and removing carbon dioxide from the blood. So when your lung capacity is healthy, you'll experience healthier physical function and feel your best overall.

You may also be less prone to breathing issues. "People with greater lung capacity tend to have lower rates of respiratory problems, such as asthma and bronchitis," says De Vries.

Being able to take in more oxygen can improve your exercise performance, too, especially when it comes to endurance activities like running or swimming. So you'll be able to push yourself longer and harder and need less time to recover, De Vries says.

How to Increase Your Lung Capacity and Hold Your Breath Longer

Anyone can boost their lung capacity. How you go about doing it depends on your current fitness level and overall health.

Whether you're looking to take your workouts to the next level or just make everyday activities like walking or stair-climbing a little easier, here's what to do.

1. Prioritize Aerobic Exercise

Aerobic activities force your heart and lungs to work harder to supply your muscles with more oxygen. When done consistently, your cardiovascular system becomes more efficient at delivering oxygen to your muscles, so you're less likely to feel out of breath, according to the American Lung Association (ALA).

Exercises that involve deep breathing, like running or swimming, are the most effective for increasing lung capacity, De Vries says. "Interval training, which alternates periods of high-intensity activity with periods of rest, has been shown to be particularly beneficial," she adds. (This 20-minute HIIT workout will give you a big aerobic bang for your buck.)

That said, you don't have to go full throttle to reap the benefits of aerobic exercise. Even walking can make a difference, as long as you maintain a pace where you're moderately breathless (you should be able to talk but not sing).


Always make sure to check with your doctor before starting a new exercise program, especially if you're new to physical activity or have a long-term lung condition.

2. Practice Breath-Holding Training

Breath-holding training involves gradually increasing the amount of time you can hold your breath. "It has been shown to be an effective method for increasing lung capacity," De Vries says.

Best of all, it's easy to do — follow these steps:

  1. Sitting up straight, open your mouth and inhale as deeply as possible.
  2. Then close your lips and hold your breath for as long as you can, keeping track of the seconds with a watch or your phone.
  3. Repeat the process, gradually working to hold your breath for a few more seconds each time. (But stop if you feel dizzy or faint.)

3. Try Pursed Lip Breathing

Pursed lip breathing, which reduces the number of breaths you take to keep your airways open longer, is a common exercise used to help people with long-term lung conditions like COPD or emphysema improve lung capacity, per the ALA. (Other healthy habits can help you breathe easier with these conditions, too.)

To try it, inhale through your nose and exhale for twice as long through your mouth while keeping your lips pursed. (If you inhale to the count of two, for instance, you'd exhale to the count of four.) Repeat several times.

4. Take Deep Belly Breaths

Like pursed lip breathing, belly breathing can be used to increase your lung capacity, the ALA says. (It's a good stress-buster, too.) Here's how:

  1. Inhale through your nose while placing your hands on your stomach, so you can feel your belly rising and falling. Keep your neck and shoulders relaxed.
  2. Exhale through your mouth for two to three times as long as you inhaled. (If you inhale to the count of two, for instance, you'd exhale to the count of four to six.)
  3. Repeat several times.

5. See a Respiratory Therapist

If your breathing problems are making it harder to carry out everyday activities, talk with your doctor about seeing a respiratory therapist.

"They can provide treatments that can help improve airflow and lung function," De Vries says. "They can also teach you how to properly use inhaled medications and manage your condition."

That in turn can help you breathe easier and increase your activity level — and improve your overall quality of life.

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Physiotherapy (PT), today offers numerous and attractive career opportunities in the allied healthcare sector in India. A physiotherapy professional may choose to become a practitioner or academician and researcher, as per his/her aptitude and interest and be an integral part of the Public Health mechanism.

What is Physiotherapy?

As per Chartered Society of Physiotherapy, UK, it is a degree-based healthcare profession. Physios use their knowledge and skills to improve a range of conditions associated with different systems of the body, such as neurological (strokemultiple sclerosisParkinson’s), neuromusculoskeletal (back pain, whiplash-associated disorder, sports injuriesarthritis), cardiovascular (chronic heart diseaserehabilitation after heart attack), respiratory (asthmachronic obstructive pulmonary disease, cystic fibrosis) etc.

Utility of Physiotherapy

Physiotherapy, also known as physical therapy, helps to treat orthopaedic, neurological, and cardiopulmonary disease conditions. This health science treats patients from all age groups like infants, children, adults, and geriatric population for their respective conditions.

This health science uses the method of massage, heat therapy, electrotherapy, hydrotherapy, patient education, and advice to treat injuries, ailments or deformities. Thus, in today’s modern healthcare scenario, physiotherapy plays an important role in treating the affected, while focusing on prevention and rehabilitation.

Education, training and exposure play a major role in crafting a successful career in physiotherapy. So, looking into the current day demand, AIPH University Bhubaneswar, the first and only public health university in eastern India has designed a set of programs in physiotherapy covering UG, PG, Integrated and PhD courses.

“Owing to the major collaboration with institutes of national repute, students get exposure to the best academic and clinical knowledge at AIPH University. Looking at the growing demand for the profession, the department of physiotherapy has the best faculty and well-equipped lab facilities. This helps to train the young emerging physios both in-campus & out-campus. Time to time camps & awareness programs are also organized as part of community outreach”, says Dean, School of Allied Health Sciences, AIPH University Bhubaneswar, Dr Arjit Mohapatra.

“Besides, AIPH University Bhubaneswar has tied up with different multi-speciality hospitals, for hands-on exposure and experience to the students,” he added.

Career in Physiotherapy

A career in physiotherapy offers a challenging and interesting job profile in the healthcare industry. As a physiotherapist, you can specialise in the fields such as geriatrics, cardiorespiratory, orthopaedics & neurology. One can also opt for further research and get a doctorate degree to pursue a career in academics and research.

There is a wide scope of physiotherapy as a career option in India as well as abroad. Job opportunities in this promising sector are galore. The number of practising physiotherapists in the country has grown by over 23 per cent between 2012 and 2021.

Accoridng to the Indian Association of Physiotherapy, India has only 0.59 practising physiotherapists per 10,000 population. But the WHO norm mandated at least 1 physiotherapist per 10,000 citizens.  Hence, it is evident that there is a great need and scope for physiotherapists in India.

Going by the population of the country (1.4bn), the requirement for physiotherapists is estimated at over 1.4 lakh.

Where To Study?

If you want to pursue a career in physiotherapy and are willing to work with a clinic or hospital or individual practice, it is time to pursue a physiotherapy course from a reputed university.

Candidates may go for admission to the Bachelor in Physiotherapy (BPT), Master in Physiotherapy (MPT) or Integrated Master in Physiotherapy (IMPT) and Diploma courses depending upon their academic qualification and career plan.

Asian Institute of Public Health (AIPH) University in Bhubaneswar, a prestigious and high pedigree university, with its city campus in the vicinity of Smart City Bhubaneswar, offers various programs on Physiotherapy.

The Master in Physiotherapy (MPT), a flagship program by AIPH University Bhubaneswar, offers specialization in Cardio-Pulmonary, Neurology, Orthopedics, Sports Medicine, Manual Therapy, Geriatric Medicine, Movement Science, Rehab Science, Pediatrics, Obstetrics & Gynecology, etc. AIPHU Bhubaneswar has adopted a combined model of classroom teaching, lab and field practice that helps groom future professionals in the sector.

AIPH University Bhubaneswar, created under Odisha State Legislature, has four schools namely Public Health, Health Management, Biological Sciences and Allied Health Sciences. The university focuses on quality classroom teaching, modern labs including a state-of-the-art BSL-3 mobile laboratory, hospital tie-ups, community connect and international collaborations, building the future public health professionals.

The university is a pioneer in the state in adopting National Education Policy, NEP 2020.

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