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.
ABSTRACT
Background & objectives: Exposure to air pollution due to combustion of biomass fuels remains one of the significant risk factors for chronic respiratory diseases such as chronic bronchitis. There is a need to identify the minimum threshold level of biomass index that is significantly associated with chronic bronchitis. This study was undertaken to identify a threshold for biomass exposure index in a rural women population in Mysore district, south India. Methods: A cross-sectional survey was conducted in a representative population of Mysore and Nanjangud taluks. Eight villages each from Mysore and Nanjangud were randomly selected based on the list of villages from census 2001. A house-to-house survey was carried out by trained field workers using the Burden of Obstructive Diseases questionnaire, which evaluated the biomass smoke exposure and chronic bronchitis. All the women aged above 30 yr were included in the study. Results: A total of 2011 women from Mysore and 1942 women from Nanjangud participated in the study. All women were non-smoking and used biomass fuels as the primary fuel for cooking. A threshold of biomass fuel exposure of 60 was identified on multivariate analysis in Mysore district after adjusting for age, passive smoking and working in a occupational exposure to dust, as the minimum required for a significant association with chronic bronchitis. One in every 20 women in Mysore district exposed to biomass fuel exposure index of 110 or more developed chronic bronchitis. Interpretation & conclusions: The minimum threshold of biomass exposure index of 60 is necessary to have a significant risk of developing chronic bronchitis in women. The number needed to harm to develop chronic bronchitis reduces with increasing biomass exposure index and women residing in rural Nanjangud have a higher risk for developing chronic bronchitis as compared to women in Mysore.