Abstract
This report summarizes the outcome of a workshop held in Mysuru, India in January 2020 addressing the adverse health effects of exposure to biomass smoke (BMS). The aim of the workshop was to identify uncertainties and gaps in knowledge and possible methods to address them in the Mysuru study on Determinants of Health in Rural Adults (MUDHRA) cohort. Specific aims were to discuss the possibility to improve and introduce new screening methods for exposure and effect, logistic limitations and other potential obstacles, and plausible strategies to overcome these in future studies. Field visits were included in the workshop prior to discussing these issues. The workshop concluded that multi-disciplinary approaches to perform: (a) indoor and personalized exposure assessment; (b) clinical and epidemiological field studies among children, adolescents, and adults; (c) controlled exposure experiments using physiologically relevant in vitro and in vivo models to understand molecular patho-mechanisms are warranted to dissect BMS-induced adverse health effects. It was perceived that assessment of dietary exposure (like phytochemical index) may serve as an important indicator for understanding potential protective mechanisms. Well trained field teams and close collaboration with the participating hospital were identified as the key requirements to successfully carry out the study objectives.
Highlights
Exposure to biomass smoke (BMS) is considered a risk factor for the development of chronic lung diseases like chronic obstructive pulmonary disease (COPD) [1,2,3]
Exposure-mediated adverse health outcome in the MUDHRA cohort, work that has been completed to date, difficulties faced and the work planned for the future, which can be applied in other settings as well
carbon monoxide (CO) and CO2 may be measured based on infrared spectrometry or electrochemical detection, volatile organic compounds (VOCs) based on photoionization detection, and particles based on, e.g., laser diffraction or dynamic light scattering [31,32,33]
Summary
Exposure to biomass smoke (BMS) is considered a risk factor for the development of chronic lung diseases like chronic obstructive pulmonary disease (COPD) [1,2,3]. BMS exposure is considered a global risk factor for the development of COPD and other chronic lung diseases in the same order of magnitude as tobacco smoking. BMS-induced COPD exhibits disproportionately greater bronchial involvement, less emphysema, more frequent hypoxia, and increased gas trappings compared to tobacco smoke-induced COPD [15,16,17,18] These observations suggest that the phenotype of COPD may be related to specific prototypes of environmental/extrinsic exposures, which in turn implicate exposure-specific molecular patho-mechanisms. Respiratory infections, hindered lung development, chronic lung diseases, cardiovascular-disease, endocrine disruption leading to metabolic disorders, and cognitive defects were considered as some of the most prominent and/or most plausible adverse health outcomes of BMS exposure in the MUDHRA cohort. This workshop summary may serve as a “statement of policy” for the ongoing and future MUDHRA projects and may be utilized in other projects with similar settings
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