title: Effect of biomass smoke on chronic obstructive pulmonary disease in rural localities of Colombia.
abstract: OBJECTIVE
  The aim of this study was to assess the differences associated to the change of biofuel used to cook as a way to estimate the proportion of respiratory abnormalities of respiratory function associated to biomass exposure.
  
  
  METHODS
  A cross-sectional study was designed to evaluate the respiratory function through spirometry in subjects cooking with biomass or natural gas. All patients were evaluated by a general physician and a pulmonologist. We compared the prevalence of spirometry abnormalities across those cooking with natural gas versus those cooking with biofuel. A multivariable logistic regression and multiple linear regression were used to adjust differences by potential confounding factors.
  
  
  RESULTS
  203 subjects were studied. There was a significant increase in the prevalence of severe obstructive pattern (OR 5.50; 95 % CI 1.17-25.79) in subjects who cook with biomass compared with natural gas users. Values of forced expired volume in one second (FEV1) and forced vital capacity (FVC) were statistically lower among those cooking with biomass. The prevalence of respiratory morbidity and symptoms were not statistically significant between both groups.
  
  
  CONCLUSIONS
  These findings suggest that replacing biomass fuel by natural gas may be an important public health intervention in Colombia, because it can reduce the prevalence of abnormal patterns of pulmonary function.
authors.affiliation: Grupo de Investigaciones en Economía de la Salud, Departamento de Investigaciones Económicas y Sociales -DIES, Universidad de Cartagena, Cartagena, Colombia.
authors.forename: Nelson
authors.initials: N
authors.lastname: Alvis-Guzman
authors.affiliation: Instituto de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Fernando
authors.initials: F
authors.lastname: De la Hoz-Restrepo
authors.affiliation: Grupo de Investigaciones en Economía de la Salud, Departamento de Investigaciones Económicas y Sociales -DIES, Universidad de Cartagena, Cartagena, Colombia.
authors.forename: Juan
authors.initials: J
authors.lastname: Montes-Farah
authors.affiliation: Grupo de Investigaciones en Economía de la Salud, Departamento de Investigaciones Económicas y Sociales -DIES, Universidad de Cartagena, Cartagena, Colombia.
authors.forename: Angel
authors.initials: A
authors.lastname: Paternina-Caicedo
mesh_terms: D000328:Adult; D000368:Aged; D056804:Biofuels / Q000009:adverse effects*; D018533:Biomass; D003105:Colombia; D003296:Cooking; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D012423:Rural Health; D012906:Smoke / Q000009:adverse effects*; D013147:Spirometry
chemical_list: D056804:Biofuels; D012906:Smoke