5 Early-Life Risk Factors for COPD

Mother/Doctor holding peak flow meter for asthmatic child to blow into to test lung power
Chronic obstructive pulmonary disease (COPD) can have a significantly negative effect on a patient’s quality of life. What are risk factors for COPD that patients may experience earlier in life?

The way lung function develops throughout a person’s life can affect when and how likely they are to develop chronic obstructive pulmonary disease (COPD). Per a 2011 study in the American Journal of Respiratory and Critical Care Medicine, “any limitation of lung growth within the first two decades of life (leading to reduced maximal individual FEV1 values) may predispose to COPD later on.”¹

A 2020 study in the Journal of Clinical Medicine examined diagnoses of early COPD (age 50 or younger), including early-life factors that may play a role.² If patients are concerned about developing COPD, here are 5 common early-life risk factors pulmonologists can discuss with them.

  1. Preterm delivery and low birth weight

Patients may associate COPD risk with health choices later in life, but complications at birth put them at risk as well. The researchers found that preterm delivery and low birth weight were both associated with risk of impaired lung function later in life. While patients may know that smoking is associated with worsened lung function, they may not be aware that maternal smoking while in utero is also a risk factor.

  1. Asthma and childhood infections

People with a history of respiratory infections are also at risk for impaired lung function and COPD. These infections can trigger asthma or symptoms of chronic bronchitis and increase childhood pneumonia risk. This can not only decrease lung function and make developing COPD more likely, but it can also worsen the effects of COPD later in life.

  1. Air pollution exposure

Prolonged exposure to air pollution, such as pollutants from factories and vehicles, may also put people at risk of developing COPD. The researchers claim that this risk may be stronger in women, based on analysis of an association between traffic exposure and poor lung function in women. Air pollution may also be harmful to the lung function of adolescents, and prolonged warm weather can keep these pollutant particulates in the air longer.

  1. Biomass fuel exposure

The researchers also posit that exposure to biomass fuel and smoke may be one of the most significant COPD risk factors, claiming that the biomass exposure rate is nearly 3 times higher than the rate of smoking. According to a 2012 study from BioScience Trends about biomass fuel exposure in India, developing countries account for 99% of the world’s use of biomass fuel.³ Exposure has been associated not only with risk of COPD but also asthma, pulmonary tuberculosis, and lung cancer.

  1. Occupational exposure

Occupational exposure comprises exposure to dust, chemicals, gases, pesticides, and diesel exhaust. Pulmonologists may want to consider discussing occupation with their patients to determine how it may affect their risk of developing COPD and provide ways to reduce their exposure.


  1. Filippone M, Baraldi E. On early life risk factors for COPD. Am J Respir Crit Care Med. 2011;183(3):415-416. doi:10.1164/ajrccm.183.3.415
  2. Choi JY, Rhee CK. Diagnosis and treatment of early chronic obstructive lung disease (COPD). J Clin Med. 2020;9(11):3426. doi:10.3390/jcm9113426
  3. Prasad R, Singh A, Garg R, Giridhar GB. Biomass fuel exposure and respiratory diseases in India. Biosci Trends. 2012;6(5):219-228. doi:10.5582/bst.2012.v6.5.219