Airflow Obstruction and Use of Solid Fuels for Cooking or Heating BOLD (Burden of Obstructive Lung Disease) Results

Andre F. S. Amaral*, Jaymini Patel, Bernet S. Kato, Daniel O. Obaseki, Herve Lawin, Wan C. Tan, Sanjay K. Juvekar, Imed Harrabi, Michael Studnicka, Emiel F. M. Wouters, Li-Cher Loh, Eric D. Bateman, Kevin Mortimer, A. Sonia Buist, Peter G. J. Burney, Burden Obstructive Lung Dis BOLD

*Corresponding author for this work

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Abstract

Rationale: Evidence supporting the association of chronic obstructive pulmonary disease or airflow obstruction with use of solid fuels is conflicting and inconsistent. Objectives: To assess the association of airflow obstruction with self-reported use of solid fuels for cooking or heating. Methods: We analyzed 18,554 adults from the BOLD (Burden of Obstructive Lung Disease) study, who had provided acceptable post-bronchodilator spirometry measurements, and information on use of solid fuels. The association of airflow obstruction with use of solid fuels for cooking or heating was assessed by sex, within each site, using regression analysis. Estimates were stratified by national income and meta-analyzed. We performed similar analyses for spirometric restriction, chronic cough, and chronic phlegm. Measurements and Main Results: We found no association between airflow obstruction and use of solid fuels for cooking or heating (odds ratio [OR] formen, 1.20 [95% confidence interval (CI), 0.94-1.53]; OR for women, 0.88 [95% CI, 0.67-1.15]). This was true for low-/middle- and high-income sites. Among never-smokers, there was also no evidence of an association of airflow obstruction with use of solid fuels (OR for men, 1.00 [95% CI, 0.57-1.76]; ORfor women, 1.00 [95% CI, 0.76-1.32]). Overall, we found no association of spirometric restriction, chronic cough, or chronic phlegm with the use of solid fuels. However, we found that chronic phlegm was more likely to be reported among female never-smokers and those who had been exposed for 20 years or longer. Conclusions: Airflow obstruction assessed from post-bronchodilator spirometry was not associated with use of solid fuels for cooking or heating.
Original languageEnglish
Pages (from-to)595-610
Number of pages16
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume197
Issue number5
DOIs
Publication statusPublished - 1 Mar 2018

Keywords

  • chronic obstructive pulmonary disease
  • airflow obstruction
  • solid fuels (biomass)
  • low-income countries
  • CHIMNEY STOVE INTERVENTION
  • PULMONARY-DISEASE
  • RISK-FACTORS
  • NEVER-SMOKERS
  • CHRONIC-BRONCHITIS
  • REFERENCE VALUES
  • BIOMASS SMOKE
  • YOUNG-ADULTS
  • LOWER LIMIT
  • POLLUTION

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