title: The association of biomass fuel combustion on pulmonary function tests in the adult population of Mid-Anatolia.
abstract: OBJECTIVE
  To assess the association of biomass as domestic energy source on respiratory function in rural areas of Mid-Anatolia in Turkey where biomass use is frequent.
  
  
  METHODS
  In a cross-sectional study, pulmonary functions measurements of 112 cow-dung users and 153 modern energy source users, all non-smokers, were assessed and compared. Several sociodemographic factors were assessed by questionnaire, and ventilatory function measurements included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio and the flow between the first 25 and 75 of forced expiratory flow (FEF(25-75)), and were compared, deploying univariate and multivariate methods, between the two groups.
  
  
  RESULTS
  The individuals in the biomass exposed and unexposed group were similar regarding demographic characteristics: 67.0% were female (exposed) vs 60.1% (unexposed) with an age range of 17 to 64 (exposed) and 18 to 70 years (unexposed), and with 36% of biomass users having had pulmonary tract infections (20% in non-users). For all pulmonary function test parameters FEV1, FVC, FEV1/FVC, and FEF(25-75) a highly significant (p < 0.0001) reduction was observed in biomass users. A 12.4% (95% confidence interval: 7.0% to 17.7%) reduction in forced vital capacity was observed in multivariate linear regression.
  
  
  CONCLUSIONS
  It is well known that biomass combustion is a relevant public health problem. The substantial differences in pulmonary functions associated with biomass use as an energy source observed in this cross-sectional study in non-smokers support that also in rural Turkey measures may be in need to reduce this public health problem.
authors.affiliation: Cumhuriyet University, Faculty of Medicine, Department of Public Health, Sivas. hsumer@cumhuriyet.edu.tr
authors.forename: Haldun
authors.initials: H
authors.lastname: Sümer
authors.forename: Ugur T
authors.initials: UT
authors.lastname: Turaçlar
authors.forename: Turhan
authors.initials: T
authors.lastname: Onarlioğlu
authors.forename: Levent
authors.initials: L
authors.lastname: Ozdemir
authors.forename: Marcel
authors.initials: M
authors.lastname: Zwahlen
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000818:Animals; D018533:Biomass; D002417:Cattle; D004736:Energy-Generating Resources; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects*; D006361:Heating / Q000009:adverse effects*; D006801:Humans; D008168:Lung / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012307:Risk Factors; D012424:Rural Population; D012722:Sewage / Q000009:adverse effects*; D013147:Spirometry; D014421:Turkey; D014505:Urban Population; D014797:Vital Capacity / Q000187:drug effects*
chemical_list: D012722:Sewage