title: Effects of biomass smoke on pulmonary functions: a case control study.
abstract: BACKGROUND
  Biomass smoke is the leading cause of COPD in developing countries such as Turkey. In rural areas of Turkey, females are more exposed to biomass smoke because of traditional lifestyles.
  
  
  OBJECTIVE
  The aim of this study was to determine the adverse effects of biomass smoke on pulmonary functions and define the relationship between duration in years and an index (cumulative exposure index) with altered pulmonary function test results.
  
  
  METHODS
  A total of 115 females who lived in the village of Kağizman (a borough of Kars located in the eastern part of Turkey) and were exposed to biomass smoke were included in the study. The control group was generated with 73 individuals living in the same area who were never exposed to biomass smoke.
  
  
  RESULTS
  Twenty-seven (23.8%) females in the study group and four (5.5%) in the control group had small airway disease (P=0.038). Twenty-two (19.1%) females in the study group and ten (13.7%) in the control group had obstruction (P=0.223). Twenty (17.3%) females in the study group who were exposed to biomass smoke had restriction compared with ten (13%) in the control group (P=0.189). The duration needed for the existence of small airway disease was 16 years, for obstructive airway disease was 17 years, and for restrictive airway disease was 17 years. The intensity of biomass smoke was defined in terms of cumulative exposure index; it was calculated by multiplying hours per day, weeks per month, and total years of smoke exposure and dividing the result by three.
  
  
  CONCLUSIONS
  Exposure to biomass smoke is a serious public health problem, especially in rural areas of developing countries, because of its negative effects on pulmonary functions. As the duration and the intensity of exposure increase, the probability of having altered pulmonary function test results is higher.
authors.affiliation: Department of Pulmonary Medicine, Baskent University Faculty of Medicine, Istanbul.
authors.forename: Baran
authors.initials: B
authors.lastname: Balcan
authors.affiliation: Department of Internal Medicine, Ankara Education and Teaching Hospital, Ankara.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Akan
authors.affiliation: Department of Pulmonary Medicine, Baskent University Faculty of Medicine, Istanbul.
authors.forename: Aylin Ozsancak
authors.initials: AO
authors.lastname: Ugurlu
authors.affiliation: Department of Pulmonary Medicine, Irmet Hospital.
authors.forename: Bahar Ozcelik
authors.initials: BO
authors.lastname: Handemir
authors.affiliation: Department of Pulmonary Medicine, Marmara University Faculty of Medicine.
authors.forename: Berrin Bagcı
authors.initials: BB
authors.lastname: Ceyhan
authors.affiliation: Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
authors.forename: Sevket
authors.initials: S
authors.lastname: Ozkaya
mesh_terms: D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018533:Biomass; D016022:Case-Control Studies; D003296:Cooking; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008019:Life Style; D008168:Lung / Q000503:physiopathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health; D012737:Sex Factors; D012906:Smoke / Q000009:adverse effects*; D013997:Time Factors; D014421:Turkey; D014797:Vital Capacity; D016387:Women's Health; D055815:Young Adult
chemical_list: D012906:Smoke
keywords: biomass; duration; exposure; intensity; pulmonary function