Smoking is the most common risk factor for COPD (Chronic Obstructive Pulmonary Disorder) – Singapore's 10th leading cause of death – with 25% of chronic smokers developing the condition. But does COPD have any symptoms? Is the condition only caused by smoking or are there other causes?

Dr Jessica Tan, Consultant from the Department of Respiratory Medicine at Sengkang General Hospital (SKH), a member of the SingHealth group, answers these questions and more.


Posted by peggyrenyan@yahoo.com

What are the basic checks to diagnose lung illness,

Are they available in polyclinics ?

Answered by Dr Jessica Tan, Consultant from the Department of Respiratory Medicine at Sengkang General Hospital (SKH)

Dear peggyrenyan,

Thank you for your question.

There are many different types of lung diseases and the type of investigation will depend on what the doctor suspects as the underlying disease.

Broadly speaking, common tests ordered to work up lung diseases include a chest radiograph (X-ray) and spirometry (lung function test). In some cases, CT scan of the chest or blood tests will be required.

Chest radiographs are widely available in all polyclinics and spirometry services can be found in selected polyclinics. It is recommended for you to check with your nearest polyclinic with regards to the availability of these tests.


Posted by Thanapala Selvan (Republished by Forum Admin)

Hi Doctor,

I am a 37-year-old male and have been smoking for the past 13 years and recently I have cut down a lot. About 5 years ago, I started having sore and sharp pain around both chest areas, I feel like the pain is coming from the lungs. It has been getting worst recently.

Few months back I approach a doctor and they ask me to do lung scan and ECG, everything was normal. Also to take note, I have acid reflux and it also getting bad.

Could you please advise if the pain is related to COPD?

Answered by Dr Jessica Tan, Consultant from the Department of Respiratory Medicine at Sengkang General Hospital (SKH)

Dear Mr Selvan,

Thank you for your question.

Firstly, it is heartening to hear that you have taken the first and most important/ challenging step towards better lung health- cutting down on cigarette smoking. Keep up your good work and hope you can achieve total smoking cessation soon.

Common symptoms of COPD include:

  1. Prolonged cough,
  2. Phlegm production,
  3. Shortness of breath (worse with physical activity),
  4. Wheezing, and 
  5. Chest tightness

However, sharp chest pain is unusual of COPD.

Glad to know that you had a normal lung scan and ECG - if the sharp chest pain persists, you should seek medical attention for further evaluation. Acid reflux can cause chest discomfort, however sharp pain is again atypical.

I wish you best of luck in quitting smoking. There are help available in major retail pharmacies and restructured hospitals should you need assistance in smoking cessation.


Posted by Vasuke Tangavelu (Republished by Forum Admin)

Hi, I don’t smoke but my asthma is getting worst. My chest feels heavy tired and there is air when I breathe normal. I can’t walk fast or uphill. My ecg is normal.

What is wrong and what I need to do?

Thank you

Answered by Dr Jessica Tan, Consultant from the Department of Respiratory Medicine at Sengkang General Hospital (SKH)

Dear Vasuke,

Thank you for reaching out to me.

To clarify, asthma and COPD are 2 separate lung conditions with differing treatment options.

I am concerned that you are feeling unwell. However, it is difficult for me to comment on what the exact cause of your symptoms is based on the history provided in your question. I would recommend that you seek your primary physician’s advice regarding the need for further evaluation and optimisation of therapy.


Posted by Khaing

Dear Dr Tan, is the smoke from incense sticks inside temples/homes considered to be safe for people in the buildings? And is second hand smoke also risk factor for COPD?

Answered by Dr Jessica Tan, Consultant from the Department of Respiratory Medicine at Sengkang General Hospital (SKH)

Dear Khaing,

Thank you for your question. I would like to answer both your questions together as they are closely related.

It is true that incense burning can produce particulate matters, gas products and other organic compounds. Many of these can cause harmful effects on our lungs when inhaled in large quantities.

Generally, the smoke from incense sticks only causes respiratory problems when there is excessive exposure to the pollutants in a poorly ventilated space, over prolonged periods of time. However, there is no clear definition on what level of exposure is considered excessive.

Similarly, cigarette smoke also produces pollutants similar to incense burning, and prolonged exposure to heavy second hand smoke in a poorly ventilated space can potentially cause respiratory tract dysfunction (including COPD).

It is advisable that people reduce the exposure time with heavy smokers and when worshipping in temples with heavy incense smoke, and not forgetting, maintain good ventilation in their homes when they burn incense or smoke.


See previous page for information on Dr Jessica Tan.

Ref: M19