Abstract
BackgroundHalf of the world’s population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal.MethodsA cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor PM2.5.ResultsBoth men and women exposed to biomass smoke reported more respiratory symptoms compared to those exposed to clean fuel. Women exposed to biomass were more likely to complain of ever wheeze (32.0 % vs. 23.5%; p = 0.004) and breathlessness (17.8% vs. 12.0%, p = 0.017) compared to males with tobacco smoking being a major risk factor. Chronic cough was similar in both the biomass and non-biomass smoke exposed groups whereas chronic phlegm was reported less frequently by participants exposed to biomass smoke. Higher PM2.5 levels (≥2 SDs of the 24-hour mean) were associated with breathlessness (OR = 2.10, 95% CI 1.47, 2.99) and wheeze (1.76, 1.37, 2.26).ConclusionsThe study suggests that while those exposed to biomass smoke had higher prevalence of respiratory symptoms, urban dwellers (who were exposed to higher ambient air pollution) were more at risk of having productive cough.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-13-92) contains supplementary material, which is available to authorized users.
Highlights
IntroductionSeveral studies have reported higher prevalence of respiratory ill-health among adults exposed to biomass smoke with estimated risk ratios between 1.2 and 7.9 [3]
While the major cause of respiratory health problems among adults in the developed world is smoking, exposure to particles generated from biomass smoke is a major cause of respiratory diseases in low income countries [1,2].Several studies have reported higher prevalence of respiratory ill-health among adults exposed to biomass smoke with estimated risk ratios between 1.2 and 7.9 [3]
The geometric mean (± geometric standard deviations (SD)) 24-h indoor PM2.5 concentration in biomass using homes was significantly greater than in non-biomass using homes (455 ± 2.4 vs. 101 ± 2.0 μg/m3, p
Summary
Several studies have reported higher prevalence of respiratory ill-health among adults exposed to biomass smoke with estimated risk ratios between 1.2 and 7.9 [3]. Most studies showing an association between household air pollution and respiratory health problems used proxy measurements of exposure such as the number of hours spent on cooking, or ever used particular fuels. This study aimed to investigate the relationship between respiratory symptoms and lung function and direct measures of exposure to emissions from biomass and nonbiomass ( liquefied petroleum gas [LPG]) fuels in rural and urban households in Nepal. We previously reported a 20% prevalence of COPD in the biomass exposed population compared to 11% in the urban population based on spirometry data [7].
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