Respiratory Disease Evaluation Using Peak Flow Measurement and Environmental Exposure Analysis in Rural Peru

Abstract

Multiple environmental health risks affect the Alto Mayo region of northern Peru, including deforestation, indoor smoke exposure, and poorly controlled pesticide/herbicide use. As part of our development of a GEOHealth Hub in this region, a first aim is to generate an environmental health needs assessment, including identification and evaluation of prevalent health problems such as respiratory disease, through medical evaluations of representative groups and targeted environmental sampling. History and physical examination was performed by regional health providers on patients aged 4-68 years in five representative communities of the Alto Mayo. Respiratory evaluation included peak flow (PF) measurement. Information regarding burning and smoke exposure, pesticide and herbicide use was collected via patient interview. Each subject then wore silicone passive sampling devices (PSD) to quantify personal environmental exposures. Nine of 21 patients (43%) had PF < 80% predicted by published standards. Low PF showed statistically significant correlation with burning of trash (p=0.04) and exposure to pesticides, herbicides or farm fumigation (p=0.02). Living near a farm or deforestation area (p=0.12) and the use of an in-home wood stove (p=0.35) were not found to be significantly associated with low PF. Results from PSD data are currently in analysis. Little is known regarding Peruvian asthma, particularly in rural areas. We found that almost half of the Alto Mayo residents in our study have evidence of obstruction on PF measurement and that low PF was associated with trash burning and pesticide and herbicide exposures rather than the use of in-home wood stoves or local deforestation.