Prevalence of chronic obstructive pulmonary disease in rural women of Tamilnadu: implications for refining disease burden assessments attributable to household biomass combustion

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is the 13th leading cause of burden of disease worldwide and is expected to become 5th by 2020. Biomass fuel combustion significantly contributes to COPD, although smoking is recognized as the most important risk factor. Rural women in developing countries bear the largest share of this burden resulting from chronic exposures to biomass fuel smoke. Although there is considerable strength of evidence for the association between COPD and biomass smoke exposure, limited information is available on the background prevalence of COPD in these populations.ObjectiveThis study was conducted to estimate the prevalence of COPD and its associated factors among non-smoking rural women in Tiruvallur district of Tamilnadu in Southern India.DesignThis cross-sectional study was conducted among 900 non-smoking women aged above 30 years, from 45 rural villages of Tiruvallur district of Tamilnadu in Southern India in the period between January and May 2007. COPD assessments were done using a combination of clinical examination and spirometry. Logistic regression analysis was performed to examine the association between COPD and use of biomass for cooking. R software was used for statistical analysis.ResultsThe overall prevalence of COPD in this study was found to be 2.44% (95% CI: 1.43–3.45). COPD prevalence was higher in biomass fuel users than the clean fuel users 2.5 vs. 2%, (OR: 1.24; 95% CI: 0.36–6.64) and it was two times higher (3%) in women who spend >2 hours/day in the kitchen involved in cooking. Use of solid fuel was associated with higher risk for COPD, although no statistically significant results were obtained in this study.ConclusionThe estimates generated in this study will contribute significantly to the growing database of available information on COPD prevalence in rural women. Moreover, with concomitant indoor air pollution measurements, it may be possible to increase the resolution of the association between biomass use and COPD prevalence and refine available attributable burden of disease estimates.

Effects of cooking fuel smoke on respiratory symptoms and lung function in semi-rural women in Cameroon

“…In Latin America and Asia, studies have found an association of exposure to solid fuel smoke with COPD and chronic bronchitis, especially in women. 1,[17][18][19][20][21] In Sub-Saharan Africa, a study conducted by Fullerton in Malawi reported a COPD prevalence of 16%, higher than this study (1.6% among wood users). 10 The difference in results may be explained by the fact that the Malawian study included men and women whereas our study population comprised only women.…”

Impact of Socio-Economic Status, Rural Background and Gender on the Prevalence of Chronic Obstructive Pulmonary Disease

“…Use of solid fuel was associated with higher risk for COPD. [11] From the present study we conclude that COPD although a smoker's disease is becoming common in women with passive smoking, and using kerosene stove and Biomass combustion as cooking medium in home due to smoke inhalation in the rural areas, although the disease was also present in the patients living in urban areas but the cause in them was cigarette smoking. Also the onset of the disease start earlier in women as compared to men as in our study most females were of younger age group.…”

Up in Smoke: The Influence of Household Behavior on the Long-Run Impact of Improved Cooking Stoves

“…About 7.5 meals per week were cooked outside. It is noteworthy that open-fire stoves pollute enough that they produce significant exposure even when used outdoors, and rates of COPD appear similar for those who cook inside or outside with open flame stoves (Balakrishnan et al 2002 andJohnson et al 2011).…”