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Free Content Wood smoke exposure, poverty and impaired lung function in Malawian adults

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Abstract:

BACKGROUND: Household air pollution from burning biomass fuel is increasingly recognised as a major global health concern. Biomass smoke is associated with chronic obstructive pulmonary disease (COPD) in Asian and Central American countries, but there are few data from Africa.

METHODS: We hypothesised that reported wood smoke as compared to charcoal smoke exposure would be associated with a reduction in forced expiratory volume in 1 second in Malawian adults. Volunteers from urban and rural locations performed spirometry and completed a questionnaire assessing lifestyle, including smoke exposure and symptoms.

RESULTS: In total, 374 adults were recruited; 61% were female; 160 cooked using charcoal and 174 used wood. Individuals who used wood as their main domestic fuel had significantly worse lung function than those who used charcoal. Significant factors associated with impaired lung function in the multivariate model were age, sex, height, wood smoke exposure, poverty, smoking and previous tuberculosis.

CONCLUSION: Our data suggest that wood smoke and poverty contribute to reduced lung function in rural Africans and that COPD is common in this population. The use of charcoal in rural populations may be relatively protective, and this idea merits further study. The risk factors for impaired lung function in Malawi are multiple and require more detailed characterisation to plan appropriate health interventions.

Keywords: air pollution; chronic obstructive pulmonary disease; spirometry

Document Type: Regular Paper

Affiliations: 1: Malawi-Liverpool-Wellcome Clinical Research Laboratories, Universities of Malawi and Liverpool (UK), Blantyre, Malawi; and Liverpool School of Tropical Medicine, Liverpool, UK 2: Scottish Centre for Indoor Air, Population Health, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK 3: Malawi-Liverpool-Wellcome Clinical Research Laboratories, Universities of Malawi and Liverpool (UK), Blantyre, Malawi 4: School of Clinical Sciences, University of Liverpool, Liverpool, UK 5: Liverpool School of Tropical Medicine, Liverpool, UK

Publication date: March 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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