title: Effect of reducing indoor air pollution on women's respiratory symptoms and lung function: the RESPIRE Randomized Trial, Guatemala.
abstract: Exposure to household wood smoke from cooking is a risk factor for chronic obstructive lung disease among women in developing countries. The Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) is a randomized intervention trial evaluating the respiratory health effects of reducing indoor air pollution from open cooking fires. A total of 504 rural Mayan women in highland Guatemala aged 15-50 years, all using traditional indoor open fires, were randomized to either receive a chimney woodstove (plancha) or continue using the open fire. Assessments of chronic respiratory symptoms and lung function and individual measurements of carbon monoxide exposure were performed at baseline and every 6 months up to 18 months. Use of a plancha significantly reduced carbon monoxide exposure by 61.6%. For all respiratory symptoms, reductions in risk were observed in the plancha group during follow-up; the reduction was statistically significant for wheeze (relative risk = 0.42, 95% confidence interval: 0.25, 0.70). The number of respiratory symptoms reported by the women at each follow-up point was also significantly reduced by the plancha (odds ratio = 0.7, 95% confidence interval: 0.50, 0.97). However, no significant effects on lung function were found after 12-18 months. Reducing indoor air pollution from household biomass burning may relieve symptoms consistent with chronic respiratory tract irritation.
authors.affiliation: Department of Public Health and Primary Health Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: Tone
authors.initials: T
authors.lastname: Smith-Sivertsen
authors.forename: Esperanza
authors.initials: E
authors.lastname: Díaz
authors.forename: Dan
authors.initials: D
authors.lastname: Pope
authors.forename: Rolv T
authors.initials: RT
authors.lastname: Lie
authors.forename: Anaite
authors.initials: A
authors.lastname: Díaz
authors.forename: John
authors.initials: J
authors.lastname: McCracken
authors.forename: Per
authors.initials: P
authors.lastname: Bakke
authors.forename: Byron
authors.initials: B
authors.lastname: Arana
authors.forename: Kirk R
authors.initials: KR
authors.lastname: Smith
authors.forename: Nigel
authors.initials: N
authors.lastname: Bruce
mesh_terms: D000293:Adolescent; D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000517:prevention & control*; D002248:Carbon Monoxide / Q000633:toxicity; D016001:Confidence Intervals; D003296:Cooking / Q000379:methods; D003297:Cooking and Eating Utensils; D003906:Developing Countries; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D005390:Fires; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D055370:Lung Injury / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D016017:Odds Ratio; D015995:Prevalence; D012129:Respiratory Function Tests; D012137:Respiratory System / Q000293:injuries* / Q000503:physiopathology; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects*; D014934:Wood / Q000009:adverse effects; D055815:Young Adult
chemical_list: D012906:Smoke; D002248:Carbon Monoxide