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Chronic Obstructive Pulmonary Disease
by Prudential Financial
Chronic obstructive pulmonary disease is a degenerative disorder of the lungs in which there is a reduced ability to expire air. COPD includes a combination of lung diseased such as asthma, chronic bronchitis, and emphysema.
Chronic obstructive pulmonary disease affects at least 15 million Americans. The majority of people diagnosed with COPD can be directly related to former heavy or current cigarette use. However, not all who smoke get COPD. Obstructive lung disease develops in 10-15% of all cigarette smokers and individuals who continue to smoke cigarettes are more likely to sustain a rapid progression of the disease than non-smokers.
The most accurate method of diagnosing COPD is the pulmonary function test, otherwise known as a spirometry test. It measures the amount of forced air exhaled into a tube. FEV1 is the maximum amount of air exhaled during the first second of a forced exhalation. The results help determine the severity of the COPD for the underwriter. The average non-smoking adult shows a decline in FEV1 of 20-25 ml per year whereas the average heavy smoker declines 40-45 ml per year.
For underwriting purposes, it is imperative to determine the severity of COPD by having the ability to review the results of a spirometry test. COPD is classified into four groups: mild, moderate, severe, and extreme. The chart below helps define each group of COPD by symptoms, medication, %FEV1 compared to normal, and includes the expected rating class.
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Degree |
Symptoms |
Rx |
FEV1 |
Rating |
|
Mild |
None-except for occasional throat clearing and respiratory infection |
None |
60-80% |
B |
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Moderate |
Airway obstruction on moderate exertion such as climbing two flights of stairs |
Inhaler |
50-60% |
D |
|
Severe |
Shortness of breath with activity such as dressing, walking one block |
Steroids, multiple medications |
40-50% |
G |
|
Extreme |
Disabled, shortness of breath at rest or minimal activity |
Home oxygen |
<40% |
Decline |
These rating schedules relate to individuals who have been diagnosed with COPD and have discontinued cigarettes.
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