Reduced lung function due to biomass smoke exposure in young adults in rural Nepal
ABSTRACT This study aimed to assess the effects of biomass smoke exposure on lung function in a Nepalese population addressing some of these methodological issues from previous studies.We carried out a cross-sectional study of adults in a population exposed to biomass smoke and a non-exposed population in Nepal. Questionnaire and lung function data were acquired along with direct measures of indoor and outdoor air quality.Ventilatory function (FEV1, FVC, FEF25-75) was significantly reduced in the population using biomass across all age groups compared to the non-biomass using population, even in the youngest (16-25) age group [mean FEV1 (95% CI) 2.65 (2.57-2.73) vs. 2.83 (2.74-2.91), p=0.004]. Airflow obstruction was twice as common among biomass users compared to liquefied petroleum gas users (8.1% vs. 3.6%, p<0.001) with similar patterns for males (7.4% vs. 3.3%, p=0.022) and females (10.8% vs. 3.8%, p<0.001) based on lower limit of normal. Smoking was a major risk factor for airflow obstruction but biomass exposure added to the risk.Exposure to biomass smoke is associated with deficits in lung function, an effect which can be detected as early as late teenage years. Biomass smoke and cigarette smoke have additive adverse effects on airflow obstruction in this setting.
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ABSTRACT: More than two fifths of the world's population cook with solid fuels and are exposed to household air pollution (HAP). As of now, no studies have assessed whether switching to alternative fuels like biogas could impact cardiovascular health among cooks previously exposed to solid fuel use.Methods We conducted a propensity score matched cross-sectional study to explore if the sustained use of biogas fuel for at least ten years impacts blood pressure among adult female cooks of rural Nepal. We recruited one primary cook ≥30 years of age from each biogas (219 cooks) and firewood (300 cooks) using household and measured their systolic (SBP) and diastolic blood pressure (DBP). Household characteristics, kitchen ventilation and 24-h kitchen carbon monoxide were assessed. We matched cooks by age, body mass index and socio-economic status score using propensity scores and investigated the effect of biogas use through multivariate regression models in two age groups, 30–50 years and >50 years to account for any post-menopausal changes.ResultsWe found substantially reduced 24-h kitchen carbon monoxide levels among biogas-using households. After matching and adjustment for smoking, kitchen characteristics, ventilation status and additional fuel use, the use of biogas was associated with 9.8 mmHg lower SBP [95% confidence interval (CI), −20.4 to 0.8] and 6.5 mmHg lower DBP (95% CI, −12.2 to −0.8) compared to firewood users among women >50 years of age. In this age group, biogas use was also associated with 68% reduced odds [Odds ratio 0.32 (95% CI, 0.14–0.71)] of developing hypertension. These effects, however, were not identified in younger women aged 30–50 years.Conclusions Sustained use of biogas for cooking may protect against cardiovascular disease by lowering the risk of high blood pressure, especially DBP, among older female cooks. These findings need to be confirmed in longitudinal or experimental studies.Environmental Research 11/2014; 136. DOI:10.1016/j.envres.2014.10.031 · 3.95 Impact Factor
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ABSTRACT: This study assessed the association between use of solid fuel in kitchen and ARI among under five children in Nepal. The latest data from the Nepal Demographic and Health Survey 2011 were used. A total of 4,802 under 5 de-jure children were included in this analysis. Cough accompanied by short/rapid breath and chest problem within 2 weeks before survey was considered as the symptoms of ARI. Logistic regression analysis was performed to calculate the odds of being suffered from ARI among the children from households using solid fuel in comparison to the children from households using cleaner fuel. About 84.6 % of the families used solid fuel as a primary fuel. Approximately 4.5 % children had symptoms of ARI within 2 weeks before the survey. About 3.4 and 4.9 % of children from the families using cleaner fuel and solid fuel respectively had symptoms of ARI within 2 weeks preceding survey. After adjusting for age, sex, birth order, urban/rural residence, ecological zone, development region, economic status, number of family members, mother’s smoking status and mother’s education, odds of suffering from ARI was 1.79 times higher among the children from the households using solid fuel in comparison to the children from households using cleaner fuel (95 % CI 1.02, 3.14). This study found the use of solid fuel in the kitchen has as a risk factor for ARI among under five children in Nepal. Longitudinal studies with direct measurement of indoor air pollution and clinical ARI cases can be future research priority.Journal of Community Health 11/2014; 40(3). DOI:10.1007/s10900-014-9965-0 · 1.28 Impact Factor
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ABSTRACT: New technologies continue to be introduced into the workplace and the environment. These novel technologies also bring in new hazards leading to evolving patterns of established occupational and environmental diseases, as well as novel conditions never before encountered. Many of these emerging conditions have appeared in media outlets or in the literature as case reports. These sentinel cases often serve as a warning sign for subsequent outbreaks. This review will discuss environmental and occupational lung diseases and exposures from a global perspective. These diseases and exposures include environmental exposure to asbestos and lung diseases, accelerated silicosis in sandblasting jean workers, coal worker's pneumoconiosis in surface coal miners, health effects of indoor air pollution from burning of biomass fuels and exposures to heavy metals and potential health effects from hydraulic fracturing (fracking). Other emerging conditions are also discussed, including smog in developing countries, sand storms in Asia and the Middle East and respiratory illnesses from nanoparticles and man-made fibres. Clinicians must remain vigilant for potential occupational and environmental exposures, especially when evaluating patients with unusual and unique presentation, so that occupational and environmental risk factors may be identified, and monitoring and preventive measures can be implemented early.Current opinion in pulmonary medicine 01/2015; DOI:10.1097/MCP.0000000000000136 · 2.96 Impact Factor