Smoke, Biomass Exposure, and COPD Risk in the Primary Care Setting: The PUMA Study

de, María Montes; Zabert, Gustavo; Moreno, Dolores; Laucho-Contreras, María E.; Varela, María Victorina López; Surmont, Filip

doi:10.4187/respcare.05440

Cited by 29 publications

(21 citation statements)

References 37 publications

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“…[33][34][35] Other evidence has illustrated via the possible roles regarding aging hallmarks including genomic instability, deregulated nutrient sensing, cellular senescence and stem cell exhaustion that disturb the repair and remodeling structural cells and lung tissues, resulting in COPD. [35][36][37][38] In concordance with related reports, [39][40][41] we found that COPD was linked to cigarette smoking intensity with a significant dose-response relationship. The finding was consistent with the related study of Forey et al (2011) reporting that the amount smoked and packs-years was attributable to increased risk of COPD, and affirming the causal relationship between COPD and cigarette smoking.…”

Section: Discussionsupporting

confidence: 91%

<p>Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand</p>

Hongyantarachai

et al. 2020

COPD

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The present study aimed to determine the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among agriculturists in a remote rural community in central Thailand. Methods: A cross-sectional study was conducted in January 2020. Face-to-face interviews were conducted using standardized questionnaires to determine demographic characteristics and risk behaviors. COPD was defined by the spirometric criterion for airflow limitation constituting a postbronchodilator fixed ratio of FEV1/FVC <0.70 following the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines 2019. Multivariable logistic regression analysis was used to determine the risk factors for COPD, and the magnitude of association was presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI). Results: A total of 546 agriculturists were enrolled in the study. The overall prevalence of COPD was 5.5% (95% CI: 3.6-7.4). The prevalence of COPD among males was 8.0% (95% CI: 4.7-11.3), and 3.2% (95% CI: 1.1-5.2) among females. The risk factors of COPD included age ≥60 years old (AOR 2.7, 95% CI: 1.1-7.0), higher intensity of smoking (AOR 1.1, 95% CI: 1.0-1.1), swine farm worker (AOR 4.1, 95% CI: 1.7-10.3), cattle farm worker (AOR 3.3, 95% CI: 1.4-8.2) and home cooking (AOR 2.7, 95% CI: 0.8-9.7). Conclusion: Our data emphasized that COPD was one of the significant health problems among agriculturists in a rural community. Agricultural jobs such as animal farmers and behavioral factors such as smoking were associated with COPD. Effective public health interventions, especially, modifying risk behaviors, should be promoted in remote rural areas to prevent the disease and reduce its morbidity and mortality.

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Section: Discussionsupporting

confidence: 91%

<p>Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand</p>

Hongyantarachai

et al. 2020

COPD

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“…Although the nature and extent of these benefits remain unclear, we previously reported that in vivo AM carbon particulate loading is inversely related to capacity to produce an effective antibacterial response ( Rylance et al, 2015 ) and thus speculate that reduced AMBC loading from use of a cleaner cookstove reduces the risk of lower respiratory tract infection. In addition, since chronic exposure to biomass smoke is associated with lung function changes that are compatible with chronic obstructive airways disease, significant reductions in inhaled PM dose from cleaner cookstoves may attenuate the accelerated lung function decline thought to occur in this population of women ( Montes de Oca et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Use of cleaner-burning biomass stoves and airway macrophage black carbon in Malawian women

Whitehouse

Miyashita

Liu

et al. 2018

Science of The Total Environment

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Exposure to particulate matter (PM) from burning of biomass for cooking is associated with adverse health effects. It is unknown whether or not cleaner burning biomass-fuelled cookstoves reduce the amount of PM inhaled by women compared with traditional open fires.We sought to assess whether airway macrophage black carbon (AMBC) - a marker of inhaled dose of carbonaceous PM from biomass and fossil fuel combustion - is lower in Malawian women using a cleaner burning biomass-fuelled cookstove compared with those using open fires for cooking. AMBC was assessed in induced sputum samples using image analysis and personal exposure to carbon monoxide (CO) and PM were measured using Aprovecho Indoor Air Pollution meters. A fossil-fuel exposed group of UK women was also studied.Induced sputum samples were obtained from 57 women from which AMBC was determined in 31. Median AMBC was 6.87 μm2 (IQR 4.47–18.5) and 4.37 μm2 (IQR 2.57–7.38) in the open fire (n = 11) and cleaner burning cookstove groups (n = 20), respectively (p = 0.028). There was no difference in personal exposure to CO and PM between the two groups. UK women (n = 5) had lower AMBC (median 0.89 μm2, IQR 0.56–1.13) compared with both Malawi women using traditional cookstoves (p < 0.001) and those using cleaner cookstoves (p = 0.022).We conclude that use of a cleaner burning biomass-fuelled cookstove reduces inhaled PM dose in a way that is not necessarily reflected by personal exposure monitoring.

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“…Ex-smokers and current-smokers were defined as those who smoked ≥100 cigarettes in their lifetime, the former having quitted smoking for at least a year at the time of interview [11]. Biomass exposure was defined as exposure to biomass smoke from the burning of wood or charcoal for ≥100 h per year [12]. PB-FEV 1 was expressed in percent of predicted value based on the patients' age, gender, height, and ethnicity (PB-FEV 1 % predicted) [13].…”

Section: Methodsmentioning

confidence: 99%

Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia – a cross-sectional study

Chai

Mos

et al. 2020

BMC Pulm Med

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Background The Spanish chronic obstructive pulmonary disease (COPD) guideline phenotypes patients according to the exacerbation frequency and COPD subtypes. In this study, we compared the patients’ health-related quality of life (HRQoL) according to their COPD phenotypes. Methods This was a cross-sectional study of COPD patients who attended the outpatient clinic of the Serian Divisional Hospital and Bau District Hospital from 23th January 2018 to 22th January 2019. The HRQoL was assessed using modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George’s Respiratory Questionnaire for COPD (SGRQ-c). Results Of 185 patients, 108 (58.4%) were non-exacerbators (NON-AE), 51 (27.6%) were frequent exacerbators (AE), and the remaining 26 (14.1%) had asthma-COPD overlap (ACO). Of AE patients, 42 (82.4%) had chronic bronchitis and only 9 (17.6%) had emphysema. Of the 185 COPD patients, 65.9% had exposure to biomass fuel and 69.1% were ex- or current smokers. The scores of mMRC, CAT, and SGRQ-c were significantly different between COPD phenotypes (p < 0.001). There were significantly more patients with mMRC 2–4 among AE (68.6%) (p < 0.001), compared to those with ACO (38.5%) and NON-AE (16.7%). AE patients had significantly higher total CAT (p = 0.003; p < 0.001) and SGRQ-c (both p < 0.001) scores than those with ACO and NON-AE. Patients with ACO had significantly higher total CAT and SGRQ-c (both p < 0.001) scores than those with NON-AE. AE patients had significantly higher score in each item of CAT and component of SGRQ-c compared to those with NON-AE (all p < 0.001), and ACO [(p = 0.003–0.016; p = < 0.001–0.005) except CAT 1, 2 and 7. ACO patients had significantly higher score in each item of CAT and component of SGRQ-c (p = < 0.001–0.040; p < 0.001) except CAT 2 and activity components of SGRQ-c. Conclusions The HRQoL of COPD patients was significantly different across different COPD phenotypes. HRQoL was worst in AE, followed by ACO and NON-AE. This study supports phenotyping COPD patients based on their exacerbation frequency and COPD subtypes. The treatment of COPD should be personalised according to these two factors.

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Smoke, Biomass Exposure, and COPD Risk in the Primary Care Setting: The PUMA Study

Abstract: Subjects with COPD from primary care had a higher exposure to biomass and smoking compared with non-COPD subjects. Smoking and biomass are both risk factors for COPD, but they do not appear to have an additive effect.

Cited by 29 publications

References 37 publications

<p>Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand</p>

<p>Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand</p>

Use of cleaner-burning biomass stoves and airway macrophage black carbon in Malawian women

Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia – a cross-sectional study

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