title: Evaluation of the effects of chronic biomass fuel smoke exposure on peripheral endothelial functions: an observational study.
abstract: OBJECTIVE
  To evaluate the effect of chronic biomass fuel (BMF) smoke exposure on peripheral endothelial functions.
  
  
  METHODS
  Forty-seven healthy subjects who have been exposed to BMF smoke since birth (mean age 31.6±6.8 years, 21 male) were enrolled in the present cross-sectional observational study. The control group consisted of 32 healthy subjects (mean age 27.9±4.4 years, 11 male). The carotid intima media thickness (CIMT), flow associated dilatation (FAD %) and endothelium independent vasodilatation (GTN %) were assessed in all subjects. The carotid CIMT was defined as the distance between the leading edge of the lumen-intima and the media-adventitia interfaces. FAD % was defined as the percentage change in the internal diameter of the brachial artery during reactive hyperemia related to the baseline. GTN % was defined as the change in diameter in response to the application of 400 µg of glyceril trinitrate relative to the baseline scan at the end of the fourth minute. Statistical analysis was performed using Student's t-test, Chi-square test and Spearman rank order correlation analysis.
  
  
  RESULTS
  The average exposure time of the subjects to biomass fuel smoke was 31.7±6.6 years. They have been exposed to dung inhalation products meanly 8.3±1.8 months in a year seasonally. The average daily exposure time was 15.7±3.3 hours. CIMT values of the two groups were not statistically different from each other (0.47±0.09 vs. 0.49±0.06 mm, p=0.138). However, a markedly reduced FAD % was determined in the study group (5.06±4.95 vs. 10.7±4.64, p<0.001). And GTN % of the BMF exposed group was significantly lower than the control group (14.41±8.47 vs. 21.85±7.87, p<0.001).
  
  
  CONCLUSIONS
  FAD % and GTN % are markedly reduced in the individuals who have been exposed to BMF smoke inhalation products. Therefore, chronic BMF smoke exposure may be a risk factor for the development of endothelial dysfunction.
authors.affiliation: Clinic of Cardiology, Ardahan Military Hospital, Ardahan, Turkey. alibuturak@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Buturak
authors.forename: Ahmet
authors.initials: A
authors.lastname: Genç
authors.forename: Ozden Sıla
authors.initials: OS
authors.lastname: Ulus
authors.forename: Egemen
authors.initials: E
authors.lastname: Duygu
authors.forename: Arda Sanlı
authors.initials: AS
authors.lastname: Okmen
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Uyarel
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects*; D018533:Biomass; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000139:chemically induced*; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D012906:Smoke / Q000009:adverse effects*; D014421:Turkey; D014664:Vasodilation / Q000187:drug effects
chemical_list: D000393:Air Pollutants; D012906:Smoke