Trishul Siddharthan1,2, Matthew R Grigsby1,2, Dina Goodman1,2, Muhammad Chowdhury3, Adolfo Rubinstein4, Vilma Irazola4, Laura Gutierrez4, J Jaime Miranda5,6, Antonio Bernabe-Ortiz5,6, Dewan Alam7, Bruce Kirenga8, Rupert Jones9, Frederick van Gemert10, Robert A Wise1, William Checkley1,2. 1. 1 Division of Pulmonary and Critical Care and. 2. 2 Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, Maryland. 3. 3 Centre for Control of Chronic Diseases, icddr,b, Dhaka, Bangladesh. 4. 4 Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina. 5. 5 CRONICAS Centre of Excellence in Chronic Diseases and. 6. 6 Departamento de Medicina, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru. 7. 7 School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada. 8. 8 Makerere Lung Institute, Makerere University, Kampala, Uganda. 9. 9 Plymouth University, Plymouth, United Kingdom; and. 10. 10 University of Groningen, University Medical Centre Groningen, Harlingen, the Netherlands.
Abstract
RATIONALE: Forty percent of households worldwide burn biomass fuels for energy, which may be the most important contributor to household air pollution. OBJECTIVES: To examine the association between household air pollution exposure and chronic obstructive pulmonary disease (COPD) outcomes in 13 resource-poor settings. METHODS: We analyzed data from 12,396 adult participants living in 13 resource-poor, population-based settings. Household air pollution exposure was defined as using biomass materials as the primary fuel source in the home. We used multivariable regressions to assess the relationship between household air pollution exposure and COPD outcomes, evaluated for interactions, and conducted sensitivity analyses to test the robustness of our findings. MEASUREMENTS AND MAIN RESULTS: Average age was 54.9 years (44.2-59.6 yr across settings), 48.5% were women (38.3-54.5%), prevalence of household air pollution exposure was 38% (0.5-99.6%), and 8.8% (1.7-15.5%) had COPD. Participants with household air pollution exposure were 41% more likely to have COPD (adjusted odds ratio, 1.41; 95% confidence interval, 1.18-1.68) than those without the exposure, and 13.5% (6.4-20.6%) of COPD prevalence may be caused by household air pollution exposure, compared with 12.4% caused by cigarette smoking. The association between household air pollution exposure and COPD was stronger in women (1.70; 1.24-2.32) than in men (1.21; 0.92-1.58). CONCLUSIONS: Household air pollution exposure was associated with a higher prevalence of COPD, particularly among women, and it is likely a leading population-attributable risk factor for COPD in resource-poor settings.
RATIONALE: Forty percent of households worldwide burn biomass fuels for energy, which may be the most important contributor to household air pollution. OBJECTIVES: To examine the association between household air pollution exposure and chronic obstructive pulmonary disease (COPD) outcomes in 13 resource-poor settings. METHODS: We analyzed data from 12,396 adult participants living in 13 resource-poor, population-based settings. Household air pollution exposure was defined as using biomass materials as the primary fuel source in the home. We used multivariable regressions to assess the relationship between household air pollution exposure and COPD outcomes, evaluated for interactions, and conducted sensitivity analyses to test the robustness of our findings. MEASUREMENTS AND MAIN RESULTS: Average age was 54.9 years (44.2-59.6 yr across settings), 48.5% were women (38.3-54.5%), prevalence of household air pollution exposure was 38% (0.5-99.6%), and 8.8% (1.7-15.5%) had COPD. Participants with household air pollution exposure were 41% more likely to have COPD (adjusted odds ratio, 1.41; 95% confidence interval, 1.18-1.68) than those without the exposure, and 13.5% (6.4-20.6%) of COPD prevalence may be caused by household air pollution exposure, compared with 12.4% caused by cigarette smoking. The association between household air pollution exposure and COPD was stronger in women (1.70; 1.24-2.32) than in men (1.21; 0.92-1.58). CONCLUSIONS: Household air pollution exposure was associated with a higher prevalence of COPD, particularly among women, and it is likely a leading population-attributable risk factor for COPD in resource-poor settings.
Entities:
Keywords:
COPD; air pollution; biomass; indoor/adverse effects
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