COPD and chronic bronchitis risk of indoor air pollution from solid fuel

a systematic review and meta-analysis

Om P. Kurmi, Sean Semple, Padam Simkhada, W. Cairns S. Smith, Jon Ayres

Research output: Contribution to journalArticle

220 Citations (Scopus)

Abstract

Background Over half the world is exposed daily to the smoke from combustion of solid fuels. Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease and can be caused by biomass smoke exposure. However, studies of biomass exposure and COPD show a wide range of effect sizes. The aim of this systematic review was to quantify the impact of biomass smoke on the development of COPD and define reasons for differences in the reported effect sizes.

Methods A systematic review was conducted of studies with sufficient statistical power to calculate the health risk of COPD from the use of solid fuel, which followed standardised criteria for the diagnosis of COPD and which dealt with confounding factors. The results were pooled by fuel type and country to produce summary estimates using a random effects model. Publication bias was also estimated.

Results There were positive associations between the use of solid fuels and COPD (OR=2.80, 95% CI 1.85 to 4.0) and chronic bronchitis (OR=2.32, 95% CI 1.92 to 2.80). Pooled estimates for different types of fuel show that exposure to wood smoke while performing domestic work presents a greater risk of development of COPD and chronic bronchitis than other fuels.

Conclusion Despite heterogeneity across the selected studies, exposure to solid fuel smoke is consistently associated with COPD and chronic bronchitis. Efforts should be made to reduce exposure to solid fuel by using either cleaner fuel or relatively cleaner technology while performing domestic work.
Original languageEnglish
Pages (from-to)221-228
Number of pages8
JournalThorax
Volume65
Issue number3
DOIs
Publication statusPublished - Mar 2010

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Indoor Air Pollution
Chronic Bronchitis
Chronic Obstructive Pulmonary Disease
Meta-Analysis
Smoke
Biomass
Publication Bias
Technology
Health

Cite this

COPD and chronic bronchitis risk of indoor air pollution from solid fuel : a systematic review and meta-analysis. / Kurmi, Om P.; Semple, Sean; Simkhada, Padam; Smith, W. Cairns S.; Ayres, Jon.

In: Thorax, Vol. 65, No. 3, 03.2010, p. 221-228.

Research output: Contribution to journalArticle

Kurmi, Om P. ; Semple, Sean ; Simkhada, Padam ; Smith, W. Cairns S. ; Ayres, Jon. / COPD and chronic bronchitis risk of indoor air pollution from solid fuel : a systematic review and meta-analysis. In: Thorax. 2010 ; Vol. 65, No. 3. pp. 221-228.
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abstract = "Background Over half the world is exposed daily to the smoke from combustion of solid fuels. Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease and can be caused by biomass smoke exposure. However, studies of biomass exposure and COPD show a wide range of effect sizes. The aim of this systematic review was to quantify the impact of biomass smoke on the development of COPD and define reasons for differences in the reported effect sizes. Methods A systematic review was conducted of studies with sufficient statistical power to calculate the health risk of COPD from the use of solid fuel, which followed standardised criteria for the diagnosis of COPD and which dealt with confounding factors. The results were pooled by fuel type and country to produce summary estimates using a random effects model. Publication bias was also estimated. Results There were positive associations between the use of solid fuels and COPD (OR=2.80, 95{\%} CI 1.85 to 4.0) and chronic bronchitis (OR=2.32, 95{\%} CI 1.92 to 2.80). Pooled estimates for different types of fuel show that exposure to wood smoke while performing domestic work presents a greater risk of development of COPD and chronic bronchitis than other fuels. Conclusion Despite heterogeneity across the selected studies, exposure to solid fuel smoke is consistently associated with COPD and chronic bronchitis. Efforts should be made to reduce exposure to solid fuel by using either cleaner fuel or relatively cleaner technology while performing domestic work.",
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AB - Background Over half the world is exposed daily to the smoke from combustion of solid fuels. Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease and can be caused by biomass smoke exposure. However, studies of biomass exposure and COPD show a wide range of effect sizes. The aim of this systematic review was to quantify the impact of biomass smoke on the development of COPD and define reasons for differences in the reported effect sizes. Methods A systematic review was conducted of studies with sufficient statistical power to calculate the health risk of COPD from the use of solid fuel, which followed standardised criteria for the diagnosis of COPD and which dealt with confounding factors. The results were pooled by fuel type and country to produce summary estimates using a random effects model. Publication bias was also estimated. Results There were positive associations between the use of solid fuels and COPD (OR=2.80, 95% CI 1.85 to 4.0) and chronic bronchitis (OR=2.32, 95% CI 1.92 to 2.80). Pooled estimates for different types of fuel show that exposure to wood smoke while performing domestic work presents a greater risk of development of COPD and chronic bronchitis than other fuels. Conclusion Despite heterogeneity across the selected studies, exposure to solid fuel smoke is consistently associated with COPD and chronic bronchitis. Efforts should be made to reduce exposure to solid fuel by using either cleaner fuel or relatively cleaner technology while performing domestic work.

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