Reduced lung function due to biomass smoke exposure in young adults in rural Nepal

University of Birmingham, UK.
European Respiratory Journal (Impact Factor: 7.64). 05/2012; 41(1). DOI: 10.1183/09031936.00220511
Source: PubMed


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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    • "Women in these households, who for cultural reasons start cooking from an early age, are exposed to very high levels of HAP. Peak concentrations of respirable particles inside kitchens at times are as high as 60,000 mg/m 3 (Devakumar et al., 2014) while 24-h kitchen concentrations average several hundred mg/m 3 (autouctag tic="blue">Kurmi et al., 2013, Singh et al., 2012). There is limited evidence on the effectiveness of currently available improved stoves in reducing HAP exposure (autouctag tic="blue">Albalak et al., 2001, Riojas–Rodríguez et al., 2001). "
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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 · 4.37 Impact Factor
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    • "c o m / l o c a t e / e n v i n t the major cities. The burning of biomass in Nepal has been shown to adversely affect lung function in young adults (Kurmi et al., 2013) and exacerbate respiratory disease in children (Bates et al., 2013). Despite its high prevalence and adverse health effects, most research takes fuel usage as a proxy for true exposure. "
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    ABSTRACT: The exposure of children to air pollution in low resource settings is believed to be high because of the common use of biomass fuels for cooking. We used microenvironment sampling to estimate the respirable fraction of air pollution (particles with median diameter less than 4 μm) to which 7–9 year old children in southern Nepal were exposed. Sampling was conducted for a total 2649 h in 55 households, 8 schools and 8 outdoor locations of rural Dhanusha. We conducted gravimetric and photometric sampling in a subsample of the children in our study in the locations in which they usually resided (bedroom/living room, kitchen, veranda, in school and outdoors), repeated three times over one year. Using time activity information, a 24-hour time weighted average was modeled for all the children in the study. Approximately two-thirds of homes used biomass fuels, with the remainder mostly using gas. The exposure of children to air pollution was very high. The 24-hour time weighted average over the whole year was 168 μg/m3. The non-kitchen related samples tended to show approximately double the concentration in winter than spring/autumn, and four times that of the monsoon season. There was no difference between the exposure of boys and girls. Air pollution in rural households was much higher than the World Health Organization and the National Ambient Air Quality Standards for Nepal recommendations for particulate exposure.
    Environment international 05/2014; 66(100):79–87. DOI:10.1016/j.envint.2014.01.011 · 5.56 Impact Factor
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    ABSTRACT: Almost 3 billion people worldwide burn solid fuels indoors. Despite the large population at risk worldwide, the effect of exposure to indoor solid fuel smoke has not been adequately studied. Indoor air pollution from solid fuel use is strongly associated with chronic obstructive pulmonary disease, acute respiratory tract infections, and lung cancer, and weakly associated with asthma, tuberculosis, and interstitial lung disease. Tobacco use further potentiates the development of respiratory disease among subjects exposed to solid fuel smoke. There is a need to perform additional interventional studies in this field.
    Clinics in chest medicine 12/2012; 33(4):649-65. DOI:10.1016/j.ccm.2012.08.003 · 2.07 Impact Factor
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