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Causes and Risk Factors Most Common Cause: Cigarette smoking (primary) Other Risk Factors: Biomass fuel exposure Air pollution Occupational dust/fumes Recurrent lung infections Aging Genetic Cause: Alpha-1 Antitrypsin deficiency (early-onset emphysema, especially in non-smokers) Pathophysiology (Simplified) Smoking or irritants inflammation elastase and proteases Loss of elastic recoil and destruction of alveolar walls Enlarged airspaces gas exchange surface Air trapping hyperinflation Types of Emphysema (based on lobes affected) 1

The decision from the OTA is generally final unless you want to make a further appeal through the California state court system

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