CHARLESTON, W.Va. -- Nearly 9 percent of West Virginia adults have been diagnosed with chronic obstructive pulmonary disease. John Walsh of the COPD Foundation said that's the fourth-highest rate in the United States, and it translates to more than 130,000 people. Walsh told West Virginia Public Broadcasting that health disparities in the state contribute to the numbers, including high percentages of adult and teenage smokers. However, he said COPD also is caused by inhalation of secondhand smoke, occupational dust and chemicals, and air pollution. COPD is the second most common disability nationwide, and Walsh said some people don't know they should get tested. He said shortness of breath and coughing are not normal parts of aging. He suggests people take an online survey to determine if they're at risk.