Chronic pulmonary disease in rural women exposed to biomass fumes

Kayseri Chest Diseases Hospital, Kayseri, Turkey.
Clinical and investigative medicine. Médecine clinique et experimentale (Impact Factor: 1.23). 10/2003; 26(5):243-8.
Source: PubMed


Biomass (organic) fuels cause indoor air pollution when used inside dwellings. We evaluated the frequencies of chronic obstructive pulmonary disease (COPD) and chronic bronchitis (CB) among rural women using biomass fuels for heating and cooking and compared them to women living in urban areas where such fuels are not used.
From electoral lists we randomly selected 242 women living in rural areas near Kayseri, Turkey and 102 women living in apartments in the city having central heating and cooking with fuels other than biomass ones. Using a translated version of the American Thoracic Society questionnaire, with additional questions from the British Medical Research Council questionnaire, trained interviewers conducted personal interviews. They also collected information on fuels used for cooking and heating. All study subjects underwent a physical examination and measurement of pulmonary function.
We found that rural women were younger than urban women (mean age [and standard deviation], 40.5 [14.1] yr v. 43.6 [11.9] yr). More urban than rural women were current (14.7% v. 4.5%, p < 0.001) or past (11.8% v. 1.2%, p < 0.001) smokers. CB was more prevalent among rural women than urban women (20.7% v. 10.8%, p < 0.03). Similarly, COPD was more prevalent in rural women (12.4% v. 3.9%, p < 0.05). Although the pulmonary function tests were within normal limits, FEV, values in rural women were found to be relatively low compared with those of urban women (p < 0.05).
Rural women exposed to biomass fumes are more likely to suffer from CB and COPD than urban women even though the prevalence of smoking is higher among the latter group.

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    • "Non-smoker COPD patients included in our study consisted of coal miners in 20% and housewives in 62%. Exposure to biomass has been determined to be at quite high rates among housewives in our country 26. The mortality of COPD has been reported to be associated with smoking in 85% in males and 70% in females 27. "
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a disease of increasing significance in terms of economic and social burden due to its increasing prevalence and high costs. Direct costs of COPD are mostly associated with hospitalization expenditures. In this study, our objective was to investigate the costs of hospitalization and factors affecting these costs in patients hospitalized due to acute exacerbation of COPD (AECOPD). A total of 284 patients hospitalized AECOPD were included in the study. Data were examined retrospectively using the electronic hospital charts. Mean duration of hospitalization was 11.38 ± 6.94 days among study patients. Rates of admission to the intensive care unit, initiation of non-invasive mechanical ventilation (NIMV) and invasive mechanical ventilation (MIV) were 37.3% (n=106), 44.4% (n=126) and 18.3% (n=52) respectively. The rate of mortality was 14.8% (n=42). Mean cost of a single patient hospitalized for an AECOPD was calculated as $1765 ± 2139. Mean cost of admission was $889 ± 533 in standard ward, and $2508 ± 2857 in intensive care unit (ICU). The duration of hospitalization, a FEV1% predicted value below 30%, having smoked 40 package-years or more, the number of co-morbidities, NIMV, IMV, ICU, exitus and the number of hospitalizations in the past year were among the factors that increased costs significantly. Hospital acquired pneumonia, chronic renal failure and anemia also increased the costs of COPD significantly. The costs of treatment increase with the severity of COPD or with progression to a higher stage. Efforts and expenditures aimed at preventing COPD exacerbations might decrease the costs in COPD.
    International journal of medical sciences 06/2012; 9(4):285-90. DOI:10.7150/ijms.4039 · 2.00 Impact Factor
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    • "p = 0.0001]. Kiraz et al. [31] found that rural women exposed to biomass fumes are more likely to suffer from chronic bronchitis (CB) and COPD than urban women even though the prevalence of smoking is higher among the latter group. In a cross-sectional study in Mid-Anatolia [32], pulmonary function measurements of 112 cow-dung users and 153 modern energy source users, all non-smokers, were assessed and compared. "
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    ABSTRACT: The aim of this study was to determine the effects of indoor air pollution exposure on respiratory symptoms and illnesses in non-smoking women in Niš, Serbia. The study was carried out in 1,082 never-smoking females, aged 20-40 years, who were not occupationally exposed to indoor air pollution. The prevalence of respiratory symptoms and illnesses was assessed using the American Thoracic Society questionnaires. Multivariate methods were used in the analysis. A strong association was found between respiratory symptoms and indoor air pollution. The associations between home dampness and sinusitis and bronchitis were also found to be statistically significant. Indoor air pollution exposure is an important risk factor for respiratory symptoms and illnesses in non-smoking women in Niš, Serbia.
    12/2011; 6(6):351-5. DOI:10.1186/2049-6958-6-6-351
    • "This biomass smoke has been proposed to produce pathologic changes of COPD similar to those observed in cigarette smokers by Rivera et al (2008).[11] Also, several researchers have reported prevalence of COPD/chronic bronchitis in people exposed to biomass smoke especially from wood and cow dung.[12–16] "
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    ABSTRACT: Limited data is available on the clinical expression of chronic obstructive pulmonary disease (COPD) from India. The impact of gender on expression of COPD has received even less attention. Apart from tobacco smoke, indoor air pollution, especially from biomass fuel may play an important role in development of COPD in women. Seven hundred and two patients of COPD were studied regarding the etiological and risk factors leading to COPD, gender-related differences in clinical presentation, radiological expression of COPD and the co-morbidities in COPD. Tobacco smoke in the form of beedi smoking was the predominant smoke exposure in males, whereas smoke from biofuel burning was the predominant exposure in females. As compared to males, females were younger, reported more dyspnea, more severe bronchial obstruction, more exacerbations, and exhibited higher prevalence of systemic features. Also, females smoked less and had lesser incidence of productive cough, lower body mass index, lesser co-morbidities and less number of hospital admissions as compared to males. Males were more likely than females to have an emphysema-predominant phenotype, while airway-predominant disease was more common among females. The current study shows that gender-related differences do exist in COPD patients. Understanding these differences in etiological agent and clinical picture will help early diagnosis of COPD in females.
    Lung India 10/2011; 28(4):258-62. DOI:10.4103/0970-2113.85686
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