People who develop chronic lung disease are more likely to be shorter in height than the general population, University of Nottingham researchers say.

 They looked at more than one million people aged over 35 for their study.

 They say those with Chronic Obstructive Pulmonary Disease (COPD) were 1.12cm shorter on average.

 In the Journal of Epidemiology and Community Health, they write this lack of height may be a "marker" that people have come from a poorer background.

 They say that historical studies had shown a strong relationship between adult height and the risk of developing COPD but they wanted to test whether the effect remained today now that living conditions have improved.

 They obtained data on 1,025,662 people from a general practice database called the Health Improvement Network.

 The association between height and lung disease was strongest in people aged 35 to 49 years and decreased progressively with age.

 The smallest height difference was in the over 90s where the average difference was only 0.51cm.

 They say this could be because many of the older generation who suffered from the disease actually died from it in recent years.

 Scarring

 People with COPD have permanent scarring to the lung tissue caused mostly be smoking.

 It is estimated that 3.7 million people in the UK have the disease, but only 900,000 are currently diagnosed.

 The researchers think that people who came from poorer backgrounds were more likely to have had mothers who smoked, had poor nutrition during their early years affecting general growth and lung development, and were more likely to live in smoking households and smoke themselves.

 Richard Hubbard, professor of respiratory epidemiology at the University of Nottingham, who co-authored the study said: "There's a double whammy associated with deprivation.

 "Poorer nutrition in the 'womb' and when growing up as a child can affect general growth and lung development.

 "This is combined with an increased likelihood to live with families and peers who smoke - influencing the chance of taking up and sticking with the habit.

 "We know that smoking is the principal cause of COPD and all of these factors combined could increase the risk even more."

 Professor Mike Morgan, chairman of the British Thoracic Society, said: "We need to make it easier for people from disadvantaged backgrounds to make positive life choices and improvements to their health - whether it be eating well or stopping smoking.

 "GPs and primary care professionals could also look out for height alongside smoking status and other chronic lung disease symptoms, to ensure that the disease is caught early."

 A Department of Health spokesman said several factors which may affect growth, such as poor nutrition, are also risks for COPD.

 "As part of the forthcoming national strategy on COPD we will be investigating how we can best identify these risk factors and take action to either prevent people developing respiratory conditions or halt the progression of the disease once diagnosed."

 Professor Stephen Spiro, of the British Lung Foundation, which funded the study, said: "This study adds to our understanding of why some people are more at risk of developing COPD and how many of these factors are linked with deprivation.

 "This research highlights the importance of the forthcoming national strategy for COPD and the need for patients to be offered regular lung function tests and lung health advice so they can be diagnosed as early as possible."

 A less traumatic way of delivering surfactant, a lung lubricant that premature babies need to help them breathe, could reduce the incidence of respiratory problems they’ll have later, Medical College of Georgia physicians say. The problem is that while surfactant keeps the tiny air sacs inside the lungs from sticking together when they inflate and deflate while breathing, the delivery method causes trauma to the respiratory system and can lead to chronic lung disease, says Dr. Jatinder Bhatia, an MCG neonatologist.

 “Traditionally, babies are given the surfactant through an endotracheal tube and left on the ventilator until they can be weaned off,” he says. “But that can cause trauma to the lungs in several ways – damage caused by the amount of pressure and volume used to breathe for the baby; trauma caused by the endotracheal tube; and trauma from the high concentration of oxygen.”

 In a new study, Dr. Bhatia, chief of the Department of Pediatrics’ Section of Neonatology in the School of Medicine, and doctors at the University of Southern California and the University of Oklahoma are studying 60 premature babies. Thirty will receive surfactant the traditional way and another 30 will receive the substance through an endotracheal tube that is quickly removed. Those babies will then be placed on a less invasive Continuous Positive Airway Pressure device that gently pushes oxygen in through the nose.

 “The idea behind this is that removing the tube as soon as you deliver the surfactant and putting them on a non-invasive nasal CPAP reduces the trauma,” Dr. Bhatia says. “The lungs of premature babies are very fragile and the ventilator can cause scarring, which results in the chronic lung disease and difficulty breathing later.”

 Of the 12.5 percent of babies born prematurely in the United States each year, over 50 percent of them will develop the disease, depending on how small they are when they are born, he says.

 “If a baby is born at 3 to 6 months, we could be talking about three months of recovery time spent on a ventilator and oxygen before they reach the normal gestational age (36 weeks) and can typically breathe without support,” he says. “That’s a long time to be on a ventilator.”

 Doctors will reexamine the babies after one week and again at 36 weeks gestational age because chronic lung disease, which can last from one to five years, is often characterized by the need for additional oxygen after reaching 36 weeks.

 As they get older, children with chronic lung disease have more asthma-like attacks, get more infections and generally have more respiratory problems because they already have damaged lungs, Dr. Bhatia says.

 “There are lifetime effects as well, such as limitations of exercise,” he says. “We believe that even with the progress we’ve made with it, that we have reached a limit of the surfactant itself. The next strategies will have to be how to limit the time of being on a ventilator or positive pressure device.”

 The function of the respiratory system is to deliver air to the lungs. Oxygen in the air diffuses out of the lungs and into the blood, while carbon dioxide diffuses in the opposite direction, out of the blood and into the lungs. Respiration includes the following processes:

 Pulmonary ventilation is the process of breathing—inspiration (inhaling air) and expiration (exhaling air).

 External respiration is the process of gas exchange between the lungs and the blood. Oxygen diffuses into the blood, while CO2 diffuses from the blood into the lungs.

 Gas transport, carried out by the cardiovascular system, is the process of distributing the oxygen throughout the body and collecting CO2 and returning it to the lungs.

 Internal respiration is the process of gas exchange between the blood, the interstitial fluids (fluids surrounding the cells), and the cells. Inside the cell, cellular respiration generates energy (ATP), using O2 and glucose and producing waste CO2.

 The respiratory and circulatory systems work together to deliver oxygen to cells and remove carbon dioxide in a two-phase process called respiration. The first phase of respiration begins with breathing in, or inhalation. Inhalation brings air from outside the body into the lungs. Oxygen in the air moves from the lungs through blood vessels to the heart, which pumps the oxygen-rich blood to all parts of the body. Oxygen then moves from the bloodstream into cells, which completes the first phase of respiration. In the cells, oxygen is used in a separate energy-producing process called cellular respiration, which produces carbon dioxide as a byproduct. The second phase of respiration begins with the movement of carbon dioxide from the cells to the bloodstream. The bloodstream carries carbon dioxide to the heart, which pumps the carbon dioxide-laden blood to the lungs. In the lungs, breathing out, or exhalation, removes carbon dioxide from the body, thus completing the respiration cycle.

 The respiratory and circulatory systems work together to deliver oxygen to cells and remove carbon dioxide in a two-phase process called respiration. The first phase of respiration begins with breathing in, or inhalation. Inhalation brings air from outside the body into the lungs. Oxygen in the air moves from the lungs through blood vessels to the heart, which pumps the oxygen-rich blood to all parts of the body. Oxygen then moves from the bloodstream into cells, which completes the first phase of respiration. In the cells, oxygen is used in a separate energy-producing process called cellular respiration, which produces carbon dioxide as a byproduct. The second phase of respiration begins with the movement of carbon dioxide from the cells to the bloodstream. The bloodstream carries carbon dioxide to the heart, which pumps the carbon dioxide-laden blood to the lungs. In the lungs, breathing out, or exhalation, removes carbon dioxide from the body, thus completing the respiration cycle.