Respiratory symptoms, lung function decrement and chronic obstructive pulmonary disease in pre-menopausal Indian women exposed to biomass smoke
TL;DR: Cumulative exposure to biomass smoke causes lung function decrement and facilitates COPD development even in non-smoking and relatively young pre-menopausal women.
Abstract: Background: The impact of chronic exposure to smoke from biomass burning on respiratory health has been examined.Methods: Six-hundred and eighty-one non-smoking women (median age 35 years) from eastern India who cook exclusively with biomass (wood, dung and crop residues) and 438 age-matched women from similar neighborhood who cook with liquefied petroleum gas (LPG) were examined. Pulmonary function test was done by spirometry. The concentrations of particulate matter having diameter of < 10 µm (PM10) and < 2.5 µm (PM2.5) in indoor air was measured by real-time aerosol monitor.Results: Compared with LPG users, biomass users had greater prevalence of upper (50.9 versus 28.5%) and lower respiratory symptoms (71.8 versus 30.8%) and dyspnea (58.4 versus 19.9%). They showed reduction in all parameters measured by spirometer especially in mid-expiratory volume. PM10 and PM2.5 concentration in biomass using kitchen were 2–3-times more than LPG-using kitchen, and the decline in spirometry values was posit...
Citations
More filters
TL;DR: PRISm is highly prevalent, is associated with increased mortality, and represents a transitional state for significant subgroups of subjects, and additional studies to characterize longitudinal progression in PRISm are warranted.
Abstract: Rationale: Increasing awareness of the prevalence and significance of Preserved Ratio Impaired Spirometry (PRISm), alternatively known as restrictive or Global Initiative for Chronic Obstructive Lu...
112 citations
TL;DR: A critical synthesis of literature suggests a lack of exposure and monitoring studies to inform personal exposure in the household and rural areas of Asian environments, and the synthesis of regulatory guidelines and future perspectives for PM2.5 in Asian countries is concluded.
Abstract: Natural and human activities generate a significant amount of PM2.5 (particles ≤2.5 μm in aerodynamic diameter) into the surrounding atmospheric environments. Because of their small size, they can remain suspended for a relatively longer time in the air than coarse particles and thus can travel long distances in the atmosphere. PM2.5 is one of the key indicators of pollution and known to cause numerous types of respiratory and lung-related diseases. Due to poor implementation of regulations and a time lag in introducing the vehicle technology, levels of PM2.5 in most Asian cities are much worse than those in European environments. Dedicated reviews on understanding the characteristics of PM2.5 in Asian urban environments are currently missing but much needed. In order to fill the existing gaps in the literature, the aim of this review article is to describe dominating sources and their classification, followed by current status and health impact of PM2.5, in Asian countries. Further objectives include a critical synthesis of the topics such as secondary and tertiary aerosol formation, chemical composition, monitoring and modelling methods, source apportionment, emissions and exposure impacts. The review concludes with the synthesis of regulatory guidelines and future perspectives for PM2.5 in Asian countries. A critical synthesis of literature suggests a lack of exposure and monitoring studies to inform personal exposure in the household and rural areas of Asian environments.
101 citations
Cites background from "Respiratory symptoms, lung function..."
...…Cross-sectional study Reported that chronic obstructive pulmonary disease (COPD) was diagnosed in 4.6 % of solid fuel users and 0.9 % of LPG users Mukherjee et al. (2014) Japan Cohort and case control studies A significantly increased risk of pre-term birth per 10 μg m−3 increase in PM2....
[...]
TL;DR: PRISm is associated with increased mortality and this population encompasses at least three distinct subsets: one that develops COPD during follow-up, a second with high cardiovascular burden and early mortality, and a third with persistent PRISm and normal age-related lung function decline.
Abstract: Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition but its course and disease progression remain to be elucidated. We aimed to examine its prevalence, trajectories and prognosis in the general population.In the Rotterdam Study (population-based prospective cohort) we examined prevalence, trajectories and prognosis of subjects with normal spirometry (controls; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7, FEV1 ≥80%), PRISm (FEV1/FVC ≥0.7, FEV1 <80%) and chronic obstructive pulmonary disease (COPD) (FEV1/FVC <0.7) at two study visits. Hazard ratios with 95% confidence intervals for mortality (until December 30, 2018) were adjusted for age, sex, body mass index, current smoking and pack-years.Of 5487 subjects (age 69.1±8.9 years; 7.1% PRISm), 1603 were re-examined after 4.5 years. Of the re-examined PRISm subjects, 15.7% transitioned to normal spirometry and 49.4% to COPD. Median lung function decline was highest in subjects with incident PRISm (FEV1 -92.8 mL·year-1, interquartile range (IQR) -131.9- -65.8 mL·year-1; FVC -93.3 mL·year-1, IQR -159.8- -49.1 mL·year-1), but similar in persistent PRISm (FEV1 -30.2 mL·year-1, IQR -67.9- -7.5 mL·year-1; FVC -20.1 mL·year-1, IQR -47.7-21.7 mL·year-1) and persistent controls (FEV1 -39.6 mL·year-1, IQR -64.3--12.7 mL·year-1; FVC -20.0 mL·year-1, IQR -55.4-18.8 mL·year-1). Of 5459 subjects with informed consent for follow-up, 692 (12.7%) died during 9.3 years (maximum) follow-up: 10.3% of controls, 18.7% of PRISm subjects and 20.8% of COPD subjects. Relative to controls, subjects with PRISm and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2-4 had increased all-cause mortality (PRISm: HR 1.6, 95% CI 1.2-2.0; COPD GOLD 2-4: HR 1.7, 95% CI 1.4-2.1) and cardiovascular mortality (PRISm: HR 2.8, 95% CI 1.5-5.1; COPD 2-4: HR 2.1, 95% CI 1.2-3.6). Mortality within <1 year was highest in PRISm, with patients often having cardiovascular comorbidities (heart failure or coronary heart disease; 70.0%).PRISm is associated with increased mortality and this population encompasses at least three distinct subsets: one that develops COPD during follow-up, a second with high cardiovascular burden and early mortality, and a third with persistent PRISm and normal age-related lung function decline.
91 citations
TL;DR: In this paper, the authors conducted a meta-analysis to establish the association between COPD and exposure to biomass smoke in women and found that smoke exposure is associated with COPD in rural and urban women.
Abstract: Introduction Chronic obstructive pulmonary disease (COPD) is a major and growing cause of morbidity and mortality worldwide. The global prevalence of COPD is growing faster in women than in men. Women are often exposed to indoor pollutants produced by biomass fuels burning during household activities. Methods We conducted a meta-analysis to establish the association between COPD and exposure to biomass smoke in women. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE and Scopus databases in 31December 2016, with the terms: “wood”, “charcoal”, “biomass”, “solid fuels”, “organic fuel”, “biofuel”, “female”, “women”, “COPD”, “chronic bronchitis”, “emphysema”, “chronic obstructive pulmonary disease”. Studies were eligible if they were case–control or cross-sectional studies involving exposure to indoor biomass smoke, conducted at any time and in any geographic location. Fixed-effects or random-effects meta-analysis was used to generate pooled OR. Results 24 studies were included: 5 case–control studies and 19 cross-sectional studies. Biomass-exposed individuals were 1.38 times more likely to be diagnosed with COPD than non-exposed (OR 1.38, 95% CI 1.28 to 1.57). Spirometry-diagnosed COPD studies failed to show a significant association (OR 1.20, 95% CI 0.99 to 1.40). Nevertheless, the summary estimate of OR for chronic bronchitis (CB) was significant (OR 2.11, 95% CI 1.70 to 2.52). The pooled OR for cross-sectional studies and case–control studies were respectively 1.82 (95% CI 1.54 to 2.10) and 1.05 (95% CI 0.81 to 1.30). Significant association was found between COPD and biomass smoke exposure for women living as well in rural as in urban areas. Conclusions This study showed that biomass smoke exposure is associated with COPD in rural and urban women. In many developing countries, modern fuels are more and more used alongside traditional ones, mainly in urban area. Data are needed to further explore the benefit of the use of mixed fuels for cooking on respiratory health, particularly on COPD reduction.
90 citations
TL;DR: The recent literature supports the contention that air pollution might contribute to transmission of epimutations from gametes to zygotes by involving mitochondrial DNA, parental allele imprinting, histone withholding and non-coding RNAs, and larger prospective studies using innovative, integrated epigenome-wide metabolomic strategy are highly warranted.
90 citations
References
More filters
6,204 citations
TL;DR: List of participants (GOLD Scientific Committee): Nicholas Anthonisen, Winnipeg, Canada, William C. Bailey, Birmingham, US, Tim Clark, London, UK, Leonardo Fabbri, Modena, Italy, Yoshinosuke Fukuchi, Tokyo, Japan; Lawrence Grouse, Seattle, US; James C. Hogg, Vancouver, Canada; Dirkje S. Postma, Groningen, the Netherlands.
5,740 citations
"Respiratory symptoms, lung function..." refers methods in this paper
...Among biomass users, the severity of the disease was mild (GOLD stage I) in 2.6% women, moderate (GOLD stage IIA) in 1.5% women and severe (GOLD stage IIB) in 0.4% women....
[...]
...Confirmation of diagnosis and further classification of COPD (stage I, mild; IIA, moderate; IIB severe and stage III, very severe) were based on spirometric measurements following the criteria of Global Initiative for Chronic Obstructive Lung Diseases (GOLD) (Pauwels et al., 2001)....
[...]
2,653 citations
TL;DR: Indoor air pollution is a major global public health threat requiring greatly increased efforts in the areas of research and policy-making and research on its health effects should be strengthened, particularly in relation to tuberculosis and acute lower respiratory infections.
Abstract: Around 50% of people, almost all in developing countries, rely on coal and biomass in the form of wood, dung and crop residues for domestic energy. These materials are typically burnt in simple stoves with very incomplete combustion. Consequently, women and young children are exposed to high levels of indoor air pollution every day. There is consistent evidence that indoor air pollution increases the risk of chronic obstructive pulmonary disease and of acute respiratory infections in childhood, the most important cause of death among children under 5 years of age in developing countries. Evidence also exists of associations with low birth weight, increased infant and perinatal mortality, pulmonary tuberculosis, nasopharyngeal and laryngeal cancer, cataract, and, specifically in respect of the use of coal, with lung cancer. Conflicting evidence exists with regard to asthma. All studies are observational and very few have measured exposure directly, while a substantial proportion have not dealt with confounding. As a result, risk estimates are poorly quantified and may be biased. Exposure to indoor air pollution may be responsible for nearly 2 million excess deaths in developing countries and for some 4% of the global burden of disease. Indoor air pollution is a major global public health threat requiring greatly increased efforts in the areas of research and policy-making. Research on its health effects should be strengthened, particularly in relation to tuberculosis and acute lower respiratory infections. A more systematic approach to the development and evaluation of interventions is desirable, with clearer recognition of the interrelationships between poverty and dependence on polluting fuels.
1,574 citations
"Respiratory symptoms, lung function..." refers background in this paper
...In a typical Indian household, the concentration of particulate pollutant during cooking with biomass reaches levels several times higher than the National Ambient Air Quality Standard recommended by the US Environmental Protection Agency (Balakrishnan et al., 2002, 2011; Bruce et al., 2000)....
[...]
...But the association of biomass smoke with asthma, a multifactorial disease having both environmental and genetic component, is not conclusive (Bruce et al., 2000)....
[...]
Journal Article•
1,356 citations