Martha Wagner said that six years ago she was struggling for air and close to death when doctors diagnosed her with chronic obstructive pulmonary disease.

“My breathing was only 44 where most people are 95 or 100,” she said. “They said they didn’t know how I pulled out of it. The doctor said he thought I was going to die.”

The American Lung Association says that COPD is the fourth leading cause of death. Smoking is the most significant risk factor contributing to the development of COPD. Other risk factors include air pollution, secondhand smoke, history of childhood respiratory infections, and occupational exposure to industrial pollutants.

Wagner, 64, a retired motel manager, said she believes her COPD was caused by fumes in the workplace.

“Being a beauty operator, I was exposed to all those chemicals,” she said. “Then when I was a hotel manager, I was smelling all those cleaning chemicals all the time.”

Healthcare professionals say the number of people with COPD is increasing. In Wagner’s case, it has had a big impact on her lifestyle.

“You get to where you can’t hardly breathe,” she said. “You can’t go nowhere unless you take your oxygen tank with you. Usually you have to use your oxygen when you sleep.”

Wagner gets a breathing treatment every 4 to 6 hours. She uses a device called a nebulizer that lets her inhale two drugs that help her lungs work more efficiently. Since COPD is a disease where the symptoms don’t show up until years after exposure to the cause, Wagner advised younger people to protect themselves.

“I would tell them to get some kind of breathing mask, especially around paint or chemicals,” she said.

COPD includes chronic bronchitis, asthma and emphysema. The American Lung Association says an estimated 11.4 million Americans have been diagnosed with COPD. However, as many as 24 million U.S. adults have some evidence of impaired lung function, indicating an under-diagnosis of the disease. COPD also has the distinction of being the only one of the top ten causes of death that is increasing.

COPD is insidious; it can exist for decades before becoming evident as diminished capacity to perform routine daily activities. There is no cure.

Sandy Henry, director of the Cardio-pulmonary Department at Tahlequah City Hospital, said COPD includes diseases like chronic bronchitis and asthma that cause constriction and inflammation of the airways.

“The No. 1 cause is smoking,” she said. “There are hundreds of chemicals in cigarettes that people aren’t aware of, including carbon monoxide.”

Henry said COPD causes the patient’s airways to become reactive and constrict.

“Sometimes there can be causes like food allergies, or even things such as perfumes,” she said. “There are also environmental causes including stress. In a health care environment, you have to be extremely careful around the patients. Even things like cologne or cleaning chemicals can be a problem.”