title: Respiratory symptoms, lung function decrement and chronic obstructive pulmonary disease in pre-menopausal Indian women exposed to biomass smoke.
abstract: BACKGROUND
  The impact of chronic exposure to smoke from biomass burning on respiratory health has been examined.
  
  
  METHODS
  Six-hundred and eighty-one non-smoking women (median age 35 years) from eastern India who cook exclusively with biomass (wood, dung and crop residues) and 438 age-matched women from similar neighborhood who cook with liquefied petroleum gas (LPG) were examined. Pulmonary function test was done by spirometry. The concentrations of particulate matter having diameter of < 10 µm (PM10) and < 2.5 µm (PM2.5) in indoor air was measured by real-time aerosol monitor.
  
  
  RESULTS
  Compared with LPG users, biomass users had greater prevalence of upper (50.9 versus 28.5%) and lower respiratory symptoms (71.8 versus 30.8%) and dyspnea (58.4 versus 19.9%). They showed reduction in all parameters measured by spirometer especially in mid-expiratory volume. PM10 and PM2.5 concentration in biomass using kitchen were 2-3-times more than LPG-using kitchen, and the decline in spirometry values was positively associated PM10 and PM2.5 levels in indoor air after controlling education, family income and kitchen location as potential confounders. Overall, 29.7% of biomass users and 16.4% of LPG users had deficient lung function, and restrictive type of deficiency was predominant. Chronic obstructive pulmonary disease (COPD) was diagnosed in 4.6% of biomass and 0.9% of LPG users. Women who predominantly used dung cake and did not possess separate kitchen had poorer lung function.
  
  
  CONCLUSIONS
  Cumulative exposure to biomass smoke causes lung function decrement and facilitates COPD development even in non-smoking and relatively young pre-menopausal women.
authors.affiliation: Amity Institute of Biotechnology, Amity University Uttar Pradesh , Lucknow, Uttar Pradesh , India .
authors.forename: Sayali
authors.initials: S
authors.lastname: Mukherjee
authors.forename: Sanghita
authors.initials: S
authors.lastname: Roychoudhury
authors.forename: Shabana
authors.initials: S
authors.lastname: Siddique
authors.forename: Madhuchanda
authors.initials: M
authors.lastname: Banerjee
authors.forename: Purba
authors.initials: P
authors.lastname: Bhattacharya
authors.forename: Twisha
authors.initials: T
authors.lastname: Lahiri
authors.forename: Manas Ranjan
authors.initials: MR
authors.lastname: Ray
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis; D003296:Cooking; D005260:Female; D006801:Humans; D007194:India; D016015:Logistic Models; D015999:Multivariate Analysis; D052638:Particulate Matter / Q000009:adverse effects; D017697:Premenopause; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012906:Smoke / Q000009:adverse effects*; D013147:Spirometry; D014691:Ventilation; D055815:Young Adult
chemical_list: D052638:Particulate Matter; D012906:Smoke
keywords: Biomass smoke; COPD; india; lung function; women