Effect of chronic exposure to biomass fuel smoke on pulmonary function test parameters

Priya Arora, Rajesh Gupta, Rahul Chopra, Anupama Gupta, Neena Mishra, Sushma Sood

Abstract


Background: Life in a typical Indian household revolves around the cooking area, and Indian women spend much of their time there. Cooking stoves in most households are nothing more than a pit, a chulha (a U-shaped construction made from mud), or three pieces of brick. Cooking under these conditions entails high levels of exposure to cooking smoke. Aim of this study was to evaluate the effect of Chronic Exposure to Biomass Fuel Smoke on Pulmonary Function Test Parameters.

Methods: 60 non-smoking women without any history of any major chronic illness in the past were selected for this study. The study group comprised of 30 rural female subjects who were chronically exposed to biomass fuel smoke combustion and 30 age matched urban female subjects exposed chronically to clean fuel combustion (Liquified Petroleum Gas–LPG) in Haryana (India). All the subjects were evaluated for pulmonary function tests by RMS Medspiror.

Results: Biomass exposure index came out to be 85.68±3.69 for women cooking on biomass and LPG index was 64.17±6.97 for women cooking on LPG. This implies significant chronic exposure of women to biomass fuel smoke. The lung function parameters were significantly lesser in biomass exposed rural women [FEV1 (p<0.01), FVC (p<0.01), FEF25-75 (p<0.01), FEV1/FVC ratio (p<0.01), PEFR (p<0.01), MVV (p<0.01)] than the LPG exposed urban women. The evaluation of PFT suggested obstructive type of pulmonary disease.

Conclusion: The derangement in pulmonary function parameters in women exposed to biomass smoke pollutants could be due to chronic significant exposure as suggested by high Biomass exposure Index. Inadequate ventilation in cooking area without chimney/vent also contributed to pulmonary function derangement and COPD.

 


Keywords


Biomass fuel, Clean fuel (LPG), COPD, Biomass exposure index, Pulmonary function tests, Spirometry

Full Text:

PDF

References


Smith KR. Indoor air pollution in India. Natl Med J India 1996;9:103-4.

Smith KR. Fuel combustion, air pollution exposure, and health: the situation in developing countries. Ann Rev Energy Environ 1993;18:529-66.

Balakrishnan K, Ramaswamy P, Thangavel G, Mukhopadhyay K, Venugopal V, Thanasekaraan V et al. Air pollution from household solid fuel combustion in India: an overview of exposure and health related information to inform health research priorities. Global Health Action 2011;4(5638):1-9.

Duque CT, Maldonado D, Padilla RP, Ezatti M, Viegi G. Biomass fuels and respiratory diseases: Forum of International respiratory societies report. Proc Am Thorac Soc 2008; 5:577-90.

Smith KRMS, Feuz MM, editors. Indoor air pollution from household use of solid fuels: comparative quantification of health risk. Geneva, Switzerland: World Health Organization;2004.

World Health Organization. The World Health Report 2007: A safer future: Global public health security in the 21st century [Internet]. Available from: http://www.who.int/whr/2007_en.

World health report. World health organization: Geneva [Internet]. Available from: http://www.who.int/whr/2000/en/statistics.htm.

Lopez AD, Mathers CD, Ezatti M, Jamison DT, Murray CJ. Global burden of disease and risk factors. Washington, DC: World Bank;2006.

Environmental Protection Agency. Respiratory health effects of passive smoking; lung cancer and other disorders. The report of the US Environment Protection Agency. Bethesda, MD, USA: National Institutes of Health, National Cancer Institute;1993.

Salvi SS, Barnes PJ. Chronic obstructive disease in non smokers. Lancet 2009;374:733-43.

International Institute of Population Sciences (IIPS). National Family Health Survey (MCH and Family Planning): India 2005-2006. Bombay: International Institute of Population Sciences,2007.

Government of India, Ministry of Statistics and program, New Delhi, India. Service sector implantation, NSSO Enterprises (extending trade) and consumer expenditure. National Sample Survey Report, 63rd round,2006-7.

Johnson P, Balakrishnan K, Ramaswamy P, Ghosh S, Sadhasivam M, Thanasekaraan V et al. Prevalence of chronic obstructive pulmonary disease in rural women of Tamilnadu: implications for refining disease burden assessments attributable to household biomass combustion. Global Health Action 2011;4(7226):1-8.

Behera D, Jindal SK. Respiratory symptoms in Indian women using domestic cooking fuels. Chest 1991;100:385-8.

Mahesh PA, Jayaraj BS, Prabhakar AK, Chaya SK, Vijaysimha R. Identification of a threshold for biomass exposure index for chronic bronchitis in rural women of Mysore district, Karnataka, India. Indian J Med Res 2013;137:87-94.

Smith KR. Indoor air pollution in developing countries: recommendations for research. Indoor Air 2002;12:198–207.

Prasad R, Singh A, Garg R, Hosmane GB. Biomass fuel exposure and respiratory diseases in India. Bioscience Trends 2012;6(5):219-28.

Fullerton DG, Bruce N, Gordon SB. Indoor air pollution from biomass fuel smoke is a major health concern in the developing world. Trans R Soc Trop Med Hyg 2008;102:843-51.

Saha A, Rao NM, Kulkarni PK, Majumdar PK, Saiyed HN. Pulmonary function and fuel use: a population survey. Respir Res 2005;6:127.

Regalado J, Padilla RP, Sansores R, Ramirez JIP, Brauer M, Pare P et al. The effect of biomass burning on respiratory symptoms and lung function in rural Mexican women. Am J Respir Crit Care Med 2006;174:901-5.

Ekici A, Ekici M, Kurtipek E, Akin A, Arslan M, Kara T et al. Obstructive airway diseases in women exposed to biomass smoke. Environ Res 2005;99:93-8.

Reddy TS, Guleria R, Sinha S, Sharma SK, Pande JN. Domestic cooking fuel and lung functions in healthy non-smoking women. Indian J Chest Dis Allied Sci 2004;46:85-90.

Priscilla J, Padmavathi R, Ghosh S, Paul P, Ramadoss S, Balakrishnan K et al. Evaluation of mucociliary clearance among women using biomass and clean fuel in a periurban area of Chennai: A preliminary study. Lung India 2011;28:30-3.

Sankar S, Padmavathi R, Balakrishnan K, Thanasekaraan V. Exposures to respirable particulate matter from biofuel combustion and pulmonary function in women of rural households in southern India: A preliminary report. Biomedicine 2001;21:31-7.

Agarwal A, Patil SN. Pulmonary function tests in rural women exposed to biomass fumes. Indian Journal of Basic & Applied Medical Research 2013;2(7):673-8.

Bindu KP, Susan C, Nair RHK, Shashidhar S. Effect of domestic cooking fuel on lung function of women. Polln Res 1997;16(3):149-54.

Venegas AR, Sansores RH, Padilla RP, Regalado J, Velazquez A, Sanchez C et al. Survival of patients with chronic obstructive pulmonary disease due to biomass smoke and tobacco. Am J Respir Crit Care Med 2006;173:393-7.

Brusasco V, Gapo R, Viegi G. Standardization of spirometry. Series “ATS/ERS task force: Standardization of lung function testing”. Eur Resp J 2005;26:319-38.

Balakrishnan K, Sankar S, Parikh J, Padmavathi R, Srividya K, Venugopal V et al. Daily average exposures to respirable particulate matter from combustion of biomass fuels in rural households of Southern India. Environ Health Perspect 2002;110:1069-75.

Caballero A, Duque CT, Jaramillo C, Bolivar F, Sanabria F, Osorio P et al. Prevalence of COPD in five Colombian cities situated at low, medium, and high altitude (PREPOCOL study). Chest 2008;133:343-9.

Oluwole O, Arinola GO, Ana GR, Wiskel T, Huo D, Olopade OI et al. Relationship between Household Air Pollution from Biomass Smoke Exposure, and Pulmonary Dysfunction, Oxidant-Antioxidant Imbalance and Systemic Inflammation in Rural Women and Children in Nigeria. Global Journal of Health Science 2013;5(4):28-38.

Revathi M, Kutty TK, Annamalai N. Pulmonary Function in Rural Women Exposed to Biomass Fuel. J Pulmon Resp Med 2012;2(7):1-4.

Turaclar UT, Sumer H, Akyurek O. The effect of biomass fuel combustion on pulmonary function tests in the adult population of Sivas Province. Indian J Physiol Pharmacol 1993;43(1):121-4.

Hu G, Zhou Y, Tian J, Yao W, Li J, Li B et al. Risk of COPD from exposure to biomass smoke: a metaanalysis. Chest 2010;138:20-31.

Salvi S, Barnes PJ. Is exposure to biomass smoke the biggest risk factor for COPD globally? Chest 2010;138:3-6.

Behera D, Chakrabarti T, Khanduja KL. Effect of exposure to domestic cooking fuels on bronchial asthma. Indian J Chest Dis Allied Sci 2001;43:27-31.

Liu S, Zhou Y, Wang X, Wang D, Lu J, Zheng J et al. Biomass fuels are the probable risk factor for chronic obstructive pulmonary disease in rural South China. Thorax 2007;62:889-97.

Levi MO, Aymerich JG, Villar J, Venegas AR, Sarmiento A, Anto JM et al. Wood smoke exposure and risk of chronic obstructive pulmonary disease. Eur Respir J 2006;27:542-6.

Mehra D, Geraghty PM, Hardigan AA, Foronjy R. A Comparison of the Inflammatory and Proteolytic Effects of Dung Biomass and Cigarette Smoke Exposure in the Lung. PLoS ONE 2012;7(12):1-7.

Arbex MA, Cancado JED, Pereira LAA, Braga ALF, Saldiva PHN. Biomass burning and its effects on health. J Bras Pneumol 2004;30(2):158-75.