Chronic Obstructive Pulmonary Disease (COPD) is a significant yet often overlooked health issue in Malaysia. Despite affecting a considerable portion of the population, awareness and understanding of COPD remain low. Globally, COPD is the third leading cause of death worldwide, causing 3.23 million deaths in 2019, according to the World Health Organisation (WHO)[1]. In Malaysia, COPD is estimated to affect 4.7% or 448,000 Malaysians in 2003.
The Silent Epidemic often goes unnoticed until it’s too late.
COPD, which includes conditions such as chronic bronchitis and emphysema, is responsible for a large number of deaths worldwide. “Globally, COPD affects roughly 10.6% of the population[3] and is the third leading cause of death, particularly in low- and middle-income countries like Malaysia,” Dr Syed Ajmal notes. In Malaysia, the high prevalence of smoking is a primary driver of the disease, with approximately 19% of adults over 15 years old being smokers.
One of Malaysia’s biggest challenges in combating COPD is the lack of awareness as COPD develops gradually over many years. Dr Syed Ajmal describes, “Smoking is the main risk factor for COPD, and it’s directly related to how much and how long you’ve smoked.” Symptoms related to COPD include a persistent cough, often initially mistaken for a “normal” smoker’s cough or asthma. As a result, many are only diagnosed when their symptoms worsen, usually when they are older, over 60.
Misconceptions and Concerns on COPD among Young People
Dr Syed Ajmal stresses the importance of public education on COPD. “There’s a misconception that COPD is just a disease of old age, but it can affect younger people too, especially those who smoke. Former smokers are also at risk. The earlier you smoke, the risk of developing COPD younger increases,” he says.
Malaysia Adolescent Health Survey 2022 revealed a concerning trend – the use of e-cigarettes and vapes among Malaysian teens aged 13-17 increased from 9.8% in 2017 to 14.9% in 2022, while cigarette smoking rates in this group dropped from 13.8% to 6.2%[6]. Therefore, efforts to raise awareness through media campaigns and support groups are crucial in encouraging early diagnosis and better disease management.
Dr Syed Ajmal also adds, “Many patients are not familiar with COPD, often confusing it with asthma or simply attributing their symptoms to ageing,”. This lack of awareness, coupled with the disease’s slow progression, often leads to late diagnosis when treatment options are more limited[7].
The recent implementation of the Control of Smoking Products for Public Health Act 2024 on Oct 1 that prohibits the sale of tobacco and vape products to minors and restricts their use in public spaces may be a crucial step in reducing exposure to harmful substances that contribute to diseases like Chronic Obstructive Pulmonary Disease (COPD), especially among young people.
Other causes or risk factors of COPD
While smoking is the most well-known cause of COPD, other factors can also contribute to the disease. Dr Syed Ajmal explains, “Environmental exposures, such as indoor air pollution from biomass fuels and occupational hazards like inhaling fine dust in certain industries, are significant contributors such as silica dust, gas, and fumes from the furnace and boiler installation”.
Additionally, there is a genetic component known as alpha-1 antitrypsin deficiency, which can lead to early-onset COPD even in non-smokers. This is because this genetic component protects the lung tissue from proteolytic damage. It affects approximately 1 in 2000 to 6000 individuals worldwide.
Hope Through COPD Treatment and Rehabilitation Advancement
Effective management of COPD focuses on slowing disease progression and improving the patient’s quality of life. According to Dr. Syed Ajmal, “The most critical step in managing COPD is smoking cessation. Quitting smoking is the single best thing a patient can do, as it prevents further lung damage, although the damage already done cannot be entirely reversed.”
In addition to smoking cessation, pulmonary rehabilitation plays a vital role in the treatment plan. Dr. Syed Ajmal explains, “Pulmonary rehabilitation is an evidence-based program designed to increase physical fitness, reduce symptoms, and improve the overall quality of life for COPD patients. It typically runs for six to twelve weeks and includes exercise training, education, and support to help patients manage their symptoms.”
Dr Syed Ajmal also highlights the availability of pharmacological treatments, such as inhalers, which help open the airways and reduce lung inflammation. Newer treatments are being introduced for advanced cases, including bronchoscopic lung volume reduction with endobronchial valves (EBV). “This minimally invasive procedure involves placing one-way valves in the diseased parts of the lung, allowing trapped air to escape and healthy lung tissue to function better. This can significantly improve breathing and quality of life for the right candidates,” he says.
COPD remains a serious health issue in Malaysia, but with increased awareness and access to treatment, patients can lead better lives. Dr Syed Ajmal advises, “If you’re a smoker or have a history of smoking, it’s vital to get screened for COPD. Early intervention can make a significant difference.”
In addition, as Malaysia enforces the Control of Smoking Products for Public Health Act 2024 on October 1, 2024, there is optimism for its potential to reduce smoking and vaping, particularly among youth.
Established in 1999, Sunway Medical Centre, Sunway City is Malaysia’s largest private quaternary hospital. Celebrating its 25th anniversary, it is the first in Malaysia to earn three major accreditations, including the Joint Commission International’s Gold Seal of Approval®. The hospital has also received the Frost & Sullivan’s 2024 Malaysian Hospital Best Practices Market Leadership Award, Healthcare Asia Awards, and Reader’s Digest Trusted Brand 2024, and is also listed among Newsweek’s World’s Best Hospitals 2024. There are 28 Centre of Excellence including the Heart, Lung & Vascular Centre which offers specialised care with advanced tools for lung, heart and vascular diseases.
Dr Syed Ajmal Bin Syed Ali, Consultant Physician, Respiratory Medicine and Interventional Pulmonologist at Sunway Medical Centre, Sunway City, shares insights on the prevalence, risk factors, and challenges of managing COPD in Malaysia.
Corporate Release by Edelman
