Could grandkids get COPD?

Dear Dr. Roach: I have grandchildren who are very allergic to cats. Could they develop COPD from being around cats? — Anon.

Answer: The vast majority of cases of chronic obstructive pulmonary disease are caused by tobacco. A much smaller but still substantial number of cases are in people with an enzyme defect, alpha-1 antitrypsin deficiency, but many people with this get symptoms only when they smoke or are exposed to lung irritants (including occupational exposures).

People with cat allergies may develop asthma, an obstructive lung disease that is distinct from COPD, and have worsened symptoms around cats. In that case, the most important treatment is to avoid cats. Cleaning a home of cat allergens is very difficult, and professional services can be beneficial.

There is an overlap syndrome of COPD with asthma, but I don’t believe that cat allergy is a likely cause.