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Massongo M, Balkissou AD, Endale Mangamba LM, Poka Mayap V, Ngah Komo ME, Nsounfon AW, Kuaban A, Pefura Yone EW. Chronic Obstructive Pulmonary Disease in Cameroon: Prevalence and Predictors-A Multisetting Community-Based Study. Pulm Med 2023; 2023:1631802. [PMID: 37736149 PMCID: PMC10511289 DOI: 10.1155/2023/1631802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023] Open
Abstract
Objective Little is known concerning chronic obstructive pulmonary disease (COPD) in Sub-Saharan Africa (SSA), where the disease remains underdiagnosed. We aimed to estimate its prevalence in Cameroon and look for its predictors. Methods Adults aged 19 years and older were randomly selected in 4 regions of Cameroon to participate in a cross-sectional community-based study. Data were collected in the participant's home or place of work. Spirometry was performed on selected participants. COPD was defined as the postbronchodilator forced expiratory volume in 1 second/forced vital capacity ratio (FEV1/FVC) < lower limit of normal, using the global lung initiative (GLI) equations for Black people. Binomial logistic regression was used to seek COPD-associated factors. The strength of the association was measured using the adjusted odds ratio (aOR). Results A total of 5055 participants (median age (25th-75th percentile) = 43 (30-56) years, 54.9% of women) were enrolled. COPD prevalence (95% confidence interval (95% CI)) was 2.9% (2.4, 3.3)%. Independent predictors of COPD (aOR (95% CI)) were a high educational level (4.7 (2.0, 11.1)), living in semiurban or rural locality (1.7 (1.4, 3.0)), tobacco smoking (1.7 (1.1, 2.5)), biomass fuel exposure (1.9 (1.1, 3.3)), experience of dyspnea (2.2 (1.4, 3.5)), history of tuberculosis (3.6 (1.9, 6.7)), and history of asthma (6.3 (3.4, 11.6)). Obesity was protective factor (aOR (95%CI) = 0.3 (0.2, 0.5)). Conclusion The prevalence of COPD was relatively low. Alternative risk factors such as biomass fuel exposure, history of tuberculosis, and asthma were confirmed as predictors.
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Affiliation(s)
- Massongo Massongo
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Adamou Dodo Balkissou
- Faculty of Medicine and Biomedical Sciences, University of Ngaoundéré, Garoua, Cameroon
| | | | | | - Marie Elisabeth Ngah Komo
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Jamot Hospital, Yaoundé, Cameroon
| | | | - Alain Kuaban
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Jamot Hospital, Yaoundé, Cameroon
| | - Eric Walter Pefura Yone
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
- Jamot Hospital, Yaoundé, Cameroon
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Tesfaye AH, Engdaw GT, Desye B, Abere G. Occupational respiratory morbidity and associated factors among hairdressers in Ethiopia: a cross-sectional study. BMJ Open 2023; 13:e074299. [PMID: 37344118 DOI: 10.1136/bmjopen-2023-074299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVE This study was designed to determine the prevalence and factors associated with occupational respiratory morbidity among hairdressers in Northwestern Ethiopia. DESIGN A cross-sectional study was conducted from 6 July 2022 to 17 August 2022. The data were collected using a standardised American Thoracic Society questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was conducted to identify factors associated with occupational respiratory morbidity. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05. SETTING The study was conducted in Gondar city, Northwestern Ethiopia. PARTICIPANTS A total of 403 hairdressers participated in this study. OUTCOME MEASURES The primary outcome is the prevalence of occupational respiratory morbidity. RESULTS The total response rate was 95.5%. The majority, 250 (62%) of the respondents were women. The mean age (±SD) of the respondents was 27 (±6.0) years. The overall prevalence of occupational respiratory morbidity during the past 12 months was found to be 134 (33.3%) (95% CI (28.7% to 38.1%)). Female hairdressers (18.6%) showed greater respiratory morbidity than male hairdressers (14.7%). Working experience 3-5 years (AOR: 3.05; 95% CI (1.76 to 5.30)) and working experience >5 years (AOR: 6.22; 95% CI (2.73 to 14.16)), overweight (body mass index (BMI)) (AOR: 3.01; 95% CI (1.19 to 7.58)) and working near roadsides (AOR: 2.15; 95% CI (1.33 to 3.37)) were risk factors of occupational respiratory morbidity among hairdressers. CONCLUSIONS This study concluded that one-third of hairdressers experienced occupational respiratory morbidity. Longer work experience, higher BMI and working near roadsides were identified as significant risk factors for respiratory morbidity in hairdressers. Dietary calorie restrictions for overweight individuals and the development and implementation of air pollution mitigation measures targeted at roadside workers are advised to curb the problem.
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Affiliation(s)
- Amensisa Hailu Tesfaye
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Garedew Tadege Engdaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belay Desye
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Giziew Abere
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zewdie A, Degefa GH, Donacho DO. Health risk assessment of indoor air quality, sociodemographic and kitchen characteristics on respiratory health among women responsible for cooking in urban settings of Oromia region, Ethiopia: a community-based cross-sectional study. BMJ Open 2023; 13:e067678. [PMID: 37328179 PMCID: PMC10277042 DOI: 10.1136/bmjopen-2022-067678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 06/02/2023] [Indexed: 06/18/2023] Open
Abstract
OBJECTIVES In Ethiopia, where biomass fuel is used by the majority of the population, women who are primarily responsible for cooking are at a higher risk of having respiratory symptoms. However, there is limited information on the respiratory symptoms of exposed women. This study assessed the magnitude of respiratory disease symptoms and associated factors among women responsible for cooking in Mattu and Bedele towns, south-west Ethiopia. METHODS A community-based cross-sectional study was conducted among 420 randomly selected women in urban settings in south-west Ethiopia. Data were collected through face-to-face interviews using a modified version of the American Thoracic Society Respiratory Questionnaire. The data were cleaned, coded and entered into EpiData V.3.1 and exported into SPSS V.22 for analysis. Bivariable and multivariable logistic regression analyses were used to identify factors associated with respiratory symptoms at a value of p<0.05. RESULTS It is found that 34.9% of the study participants have respiratory symptoms (95% CI 30.6% to 39.4%). Unimproved floor (adjusted OR (AOR)=2.4 at 95% CI 1.42 to 4.15), presence of thick black soot in the ceiling (AOR=2.1 at 95% CI 1.2 to 3.6), using fuel wood (AOR=2.3 at 95% CI 1.1 to 4.7), using a traditional stove (AOR=3.37 at 95% CI 1.85 to 6.16), long duration of cooking (AOR=2.52 at 95% CI 1.4 to 4.5) and cooking room without a window (AOR=2.4 at 95% CI 1.5 to 3.9) were significantly associated with women's respiratory symptoms. CONCLUSION More than two in six women who cook had respiratory symptoms. Floor, fuel and stove type, soot deposits in the ceiling, duration of cooking and cooking in a room without a window were the identified factors. Appropriate ventilation, improved floor and stove design and the switch to high-efficiency, low-emission fuels could help to lessen the effects of wood smoke on women's respiratory health.
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Affiliation(s)
- Asrat Zewdie
- Department of Public Health, College of Health Science, Mattu University, Mattu, Oromia region, Ethiopia
| | - Gutama Haile Degefa
- Department of Environmental Health Science and Technology, Jimma University, Jimma, Ethiopia
| | - Dereje Oljira Donacho
- Department of Health Informatics, College of Health Science, Mattu University, Mattu, Oromia region, Ethiopia
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Sreeja AT, Dhengle A, Kumar D, Pradhan AK. Does access to clean cooking fuels reduce environmental degradation? Evidence from BRICS nations. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27619-5. [PMID: 37277588 DOI: 10.1007/s11356-023-27619-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/09/2023] [Indexed: 06/07/2023]
Abstract
Promotion of clean cooking fuel and technologies helps countries in achieving its sustainable development goals, thereby fulfilling environmental sustainability and empowering the status of women. Against this backdrop, the prime focus of this paper is to examine the impact of clean cooking fuels and technologies on overall greenhouse gas emissions. To do so, we draw data from BRICS nations since 2000-2016, employ the fixed-effect model, and show the robustness of the results by using Driscoll-Kraay standard error approach to address the panel data econometric issues. The empirical results show that energy use (LNEC), trade openness (LNTRADEOPEN), and urbanization (LNUP) promote emissions of greenhouse gases. Further, the finding also indicates that the use of clean cooking (LNCLCO) and foreign capital (FDI_NI) can help reduce the environmental degradation in achieving environmental sustainability in the BRICS nations. Overall findings endorse the development of clean energy at macro level, subsidizing and financing the clean cooking fuel and technologies, and promoting its usage at the household level to combat environmental degradation.
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Affiliation(s)
- Ajayan Thamarakshan Sreeja
- Department of Humanities and Social Sciences, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India.
| | - Anjali Dhengle
- Department of Humanities and Social Sciences, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
| | - Deepak Kumar
- Department of Humanities and Social Sciences, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
| | - Ashis Kumar Pradhan
- Department of Humanities and Social Sciences, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
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Njoku CM, Hurst JR, Kinsman L, Balogun S, Obamiro K. COPD in Africa: risk factors, hospitalisation, readmission and associated outcomes-a systematic review and meta-analysis. Thorax 2023; 78:596-605. [PMID: 36635039 DOI: 10.1136/thorax-2022-218675] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 11/30/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND This review aims to synthesise available evidence on the prevalence of chronic obstructive pulmonary disease (COPD), associated risk factors, hospitalisations and COPD readmissions in Africa. METHOD Using the Met-Analyses and Systematic Reviews of Observational Studies guideline, electronic databases were searched from inception to 1 October 2021. The quality of studies was assessed using the Newcastle-Ottawa Scale. Evidence from retrieved articles was synthesised, and a random-effect model meta-analysis was conducted. The protocol was registered on PROSPERO. RESULTS Thirty-nine studies met the inclusion criteria, with 13 included in the meta-analysis. The prevalence of COPD varied between the Global Initiative for Chronic Obstructive Lung Disease (2%-24%), American Thoracic Society/European Respiratory Society (1%-17%) and Medical Research Council chronic bronchitis (2%-11%) criteria, respectively. Increasing age, wheezing and asthma were consistent risk factors for COPD from studies included in the narrative synthesis. Our meta-analysis indicated that prior tuberculosis ((OR 5.98, 95% CI 4.18 to 8.56), smoking (OR 2.80, 95% CI: 2.19 to 3.59) and use of biomass fuel (OR 1.52, 95% CI: 1.39 to 1.67)) were significant risk factors for COPD. Long-term oxygen therapy (HR 4.97, 95% CI (1.04 to 23.74)) and frequent hospitalisation (≥3 per year) (HR 11.48, 95% CI (1.31 to 100.79)) were risk factors associated with 30-day COPD readmission. CONCLUSION This study not only highlights specific risk factors for COPD risk in Africa but also demonstrates the paucity and absence of research in several countries in a continent with substantial COPD-related mortality. Our findings contribute towards the development of evidence-based clinical guidelines for COPD in Africa.PROSPERO registration numberCRD42020210581.
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Affiliation(s)
- Chidiamara Maria Njoku
- College of Health Sciences, Sport and Exercise Science, James Cook University Division of Tropical Health and Medicine, Townsville, Queensland, Australia
| | - John R Hurst
- Academic Unit of Respiratory Medicine, UCL Medical School, London, UK
| | - Leigh Kinsman
- School of Nursing and Midwifery, The University of Newcastle School of Nursing and Midwifery, Callaghan, New South Wales, Australia
| | - Saliu Balogun
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kehinde Obamiro
- Centre for Rural Health, University of Tasmania School of Health Sciences, Launceston, Tasmania, Australia
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Fei F, J Siegert R, Zhang X, Gao W, Koffman J. Symptom clusters, associated factors and health-related quality of life in patients with chronic obstructive pulmonary disease: A structural equation modelling analysis. J Clin Nurs 2023; 32:298-310. [PMID: 35098602 PMCID: PMC10078635 DOI: 10.1111/jocn.16234] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To identify symptom clusters and develop a symptom cluster model among people living with chronic obstructive pulmonary disease (COPD). BACKGROUND The examination of symptom clusters in COPD patients is an emerging field of scientific inquiry directed towards symptom management. However, no studies have modelled the relationships among symptom clusters, associated factors and health-related quality of life. DESIGN A cross-sectional design with convenience sampling following STROBE guidelines. METHODS Data were collected from 450 COPD participants in three university teaching hospitals. Participants were invited to complete a structured questionnaire comprised of a socio-demographic/clinical questionnaire, Integrated Palliative Care Outcome Scale and Clinical Respiratory Questionnaire. Exploratory factor analysis and confirmatory factor analysis were used to identify symptom clusters. Structural equation modelling was used to examine the proposed model. RESULTS The respiratory related symptom cluster, psychological symptom cluster and cough-insomnia related symptom cluster were identified. The final model demonstrated a good fit with the data. Gender, stage of disease and monthly income were significant factors associated with symptom clusters. Respiratory related and cough-insomnia related symptom clusters had a direct negative impact on health-related quality of life, while the psychological symptom cluster was found to have a direct and indirect negative effect on health-related quality of life. CONCLUSIONS Final COPD symptom cluster model should serve as a framework to guide intervention research targeting symptom clusters to improve health-related quality of life of people living with COPD. RELEVANCE TO CLINICAL PRACTICE Nurses should be especially attuned to identify those at most risk of facing a higher symptom burden in this case those who are female, have advanced stage COPD and/or lower income. During the clinical symptom assessment, nurses should pay attention to the close relationships among symptoms within a cluster to identify any 'trigger' symptom that could cause the development or exacerbation of other symptoms.
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Affiliation(s)
- Fei Fei
- Florence Nightingale Faculty of NursingMidwifery and Palliative CareCicely Saunders InstituteKing’s College LondonLondonUK
- School of Nursing and MidwiferyJiangsu College of NursingHuai'anJiangsuChina
| | - Richard J Siegert
- Faculty of Health and Environmental SciencesAuckland University of TechnologyAucklandNew Zealand
| | - Xiaohan Zhang
- School of Nursing and MidwiferyJiangsu College of NursingHuai'anJiangsuChina
| | - Wei Gao
- Florence Nightingale Faculty of NursingMidwifery and Palliative CareCicely Saunders InstituteKing’s College LondonLondonUK
| | - Jonathan Koffman
- Florence Nightingale Faculty of NursingMidwifery and Palliative CareCicely Saunders InstituteKing’s College LondonLondonUK
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Glenn BE, Espira LM, Larson MC, Larson PS. Ambient air pollution and non-communicable respiratory illness in sub-Saharan Africa: a systematic review of the literature. Environ Health 2022; 21:40. [PMID: 35422005 PMCID: PMC9009030 DOI: 10.1186/s12940-022-00852-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa's rapid pace of urbanization, economic expansion, and population growth raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide. METHODS We searched three major databases (PubMed, Web of Science, and Scopus) using the key words "asthma", "chronic bronchitis", "allergic rhinitis", and "COPD" with "carbon monoxide (CO)", "sulfuric oxide (SO)", "ozone (O3)", "nitrogen dioxide (NO2)", and "particulate matter (PM)", restricting the search to the 46 countries that comprise SSA. Only papers published in scholarly journals with a defined health outcome in individuals and which tested associations with explicitly measured or modelled air exposures were considered for inclusion. All candidate papers were entered into a database for review. RESULTS We found a total of 362 unique research papers in the initial search of the three databases. Among these, 14 met the inclusion criteria. These papers comprised studies from just five countries. Nine papers were from South Africa; two from Malawi; and one each from Ghana, Namibia, and Nigeria. Most studies were cross-sectional. Exposures to ambient air pollutants were measured using spectrometry and chromatography. Some studies created composite measures of air pollution using a range of data layers. NCRD outcomes were measured by self-reported health status and measures of lung function (spirometry). Populations of interest were primarily schoolchildren, though a few studies focused on secondary school students and adults. CONCLUSIONS The paucity of research on NCRDs and ambient air pollutant exposures is pronounced within the African continent. While capacity to measure air quality in SSA is high, studies targeting NCRDs should work to draw attention to questions of outdoor air pollution and health. As the climate changes and SSA economies expand and countries urbanize, these questions will become increasingly important.
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Affiliation(s)
- Bailey E. Glenn
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Leon M. Espira
- Center for Global Health Equity, University of Michigan, Ann Arbor, USA
| | | | - Peter S. Larson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA USA
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI USA
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Socio-Economic Analysis of Wood Charcoal Production as a Significant Output of Forest Bioeconomy in Africa. FORESTS 2021. [DOI: 10.3390/f12050568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Wood charcoal (WCH) is a sustainable biofuel for rural and urban users because of its higher energy density and emission of marginal smoke when compared with firewood. Besides helping the poor majority who cannot afford kerosene, electricity or liquid petroleum gas (LPG), WCH is a key source of income and livelihood. This work aimed at quantifying the volume of WCH production as well as appraising its socio-economics, including environmental impacts, especially the impact of long-term deforestation and forest degradation in Africa. Historically robust data from the databases of UN-FAO, FAOSTAT, International Energy Agency (IEA), United Nations Statistics Division, UN-DESA energy statistics yearbook, and the Forest Resources Assessment (FRA) were used. The data analysis involved descriptive statistics, multivariate analysis, and geospatial techniques. The result revealed that East Africa had the highest average wood charcoal production which was 32,058,244 tonnes representing 43.2% of the production whereas West Africa had 23,831,683 tonnes denoting 32.1%. Others were North Africa (8,650,207 tonnes), Middle Africa (8,520,329 tonnes), and South Africa (1,225,062 tonnes) representing 11.6%, 11.5% and 1.6% respectively. The correlation matrix showed that WCH production for the three decades had a significant positive correlation with all the measured parameters (such as areas of forest cover, export quantity, export value, GDP, human population, climate season, average income per citizen, and literacy rate). Wood charcoal is an essential livelihood support system. New policies including commercial wood charcoal production and licensing for revenue and ecological sustainability are required. Enterprise-based approaches for poverty reduction, smallholders’ tree-growing, wood charcoal-energy conserving technologies, improved electricity supply and agricultural productivity are encouraged. The novelty of this study can also be explained by the diverse parameters examined in relation to WCH production which no other studies in the region have done.
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Esong MB, Goura AP, Mbatchou BHN, Walage B, Simo HSY, Medjou RM, Sonkoue MP, Djouda CD, Ngnewa RSF, Guiagain MST, Agokeng BDK, Homla OTM, Pope D, Ateudjieu J. Distribution of sources of household air pollution: a cross-sectional study in Cameroon. BMC Public Health 2021; 21:318. [PMID: 33557788 PMCID: PMC7871547 DOI: 10.1186/s12889-021-10350-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 01/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background Household air pollution (HAP) is a recognised risk factor for many diseases, including respiratory diseases, cardiovascular/circulatory disorders, adverse pregnancy outcomes and cataracts. Population exposure to biomass fuels, including wood, varies among countries and from one fuel source to the other. This study aimed to investigate the different sources of HAP in peri-urban and rural communities in Cameroon. Methods A cross-sectional survey was conducted in a representative sample of households from the Dschang Health District (DHD) region. This included 848 homes in which a range of fuels for cooking including biomass (firewood, charcoal, sawdust), kerosene and liquefied petroleum gas (LPG) were used both indoors and outdoors. Results Of the study households, 651 (77%) reported exclusive use of firewood and 141 (17%) reported using more than one source of fuel. Exclusive use of firewood was greater in rural communities (94%) than in peri-urban communities (38%). In peri-urban communities, use of multiple fuels including LPG, wood, sawdust and kerosene, was more common (44.75%). A total of 25.03% of households in both peri-urban and rural communities reported using bottled gas (or liquified petroleum gas (LPG) for cooking. Motivations for choice of fuel included, affordability, availability, rapidity, and cultural factors. Conclusion Wood is the main cooking fuel in both peri-urban and rural communities in the Dschang Health District. Supporting households (especially those with limited resources) to adopt LPG equipment for cooking, and use in a more exclusive way is required to help reduce household air pollution.
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Affiliation(s)
- Miranda Baame Esong
- National institute of Human Research (HIHR) CLEAN-Air (Africa) Global Health Research Group (GHRG), Mbalmayo, Cameroon.
| | | | - Bertrand Hugo Ngahane Mbatchou
- National institute of Human Research (HIHR) CLEAN-Air (Africa) Global Health Research Group (GHRG), Mbalmayo, Cameroon.,Douala General Hospital, Douala, Cameroon
| | - Berenice Walage
- Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
| | - Herman Styve Yomi Simo
- Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
| | - Romarique Mboumo Medjou
- Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
| | - Martial Pianta Sonkoue
- Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
| | - Cyrielle Douanla Djouda
- Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
| | - Rose Suzie Fowoh Ngnewa
- Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
| | | | - Brice-Donald Kemnang Agokeng
- Meilleur Accès aux Soins de Santé (M.A. SANTE), Yaoundé, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
| | - Olivia Tania Megaptche Homla
- Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
| | - Dan Pope
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Jerome Ateudjieu
- Meilleur Accès aux Soins de Santé (M.A. SANTE), Yaoundé, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, Department of Public Health, University of Dschang, Dschang, Cameroon
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Exposure to Wood Smoke and Associated Health Effects in Sub-Saharan Africa: A Systematic Review. Ann Glob Health 2020; 86:32. [PMID: 32211302 PMCID: PMC7082829 DOI: 10.5334/aogh.2725] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Observational studies suggest that exposure to wood smoke is associated with a variety of adverse health effects in humans. Objective We aimed to summarise evidence from sub-Saharan Africa on levels of exposure to pollutants in wood smoke and the association between such exposures and adverse health outcomes. Methods PubMed and Google scholar databases were searched for original articles reporting personal exposure levels to pollutants or health outcomes associated with wood smoke exposure in Sub-Saharan African population. Results Mean personal PM2.5 and carbon monoxide levels in the studies ranged from 26.3 ± 1.48 μg/m3 to 1574 ± 287μg/m3 and from 0.64 ± 2.12 ppm to 22 ± 2.4 ppm, respectively. All the reported personal PM2.5 exposure levels were higher than the World Health Organization's Air Quality Guideline (AQG) for 24-hour mean exposure. Use of wood fuels in domestic cooking is the major source of wood smoke exposure in this population. Occupational exposure to wood smoke included the use of wood fuels in bakery, fish drying, cassava processing and charcoal production. Females were exposed to higher levels of these pollutants than males of the same age range. Major determinants for higher exposure to wood smoke in SSA included use of unprocessed firewood, female gender and occupational exposure. We recorded strong and consistent associations between exposure to wood smoke and respiratory diseases including acute respiratory illness and impaired lung function. Positive associations were reported for increased blood pressure, low birth weight, oesophageal cancer, sick building syndrome, non-syndromic cleft lip and/or cleft palate and under-five mortality. Conclusion There is high level of exposure to wood smoke in SSA and this exposure is associated with a number of adverse health effects. There is urgent need for aggressive programs to reduce wood smoke exposure in this population.
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Hou J, Yin W, Li P, Hu C, Xu T, Cheng J, Li T, Wang L, Yu Z, Yuan J. Joint effect of polycyclic aromatic hydrocarbons and phthalates exposure on telomere length and lung function. JOURNAL OF HAZARDOUS MATERIALS 2020; 386:121663. [PMID: 31784133 DOI: 10.1016/j.jhazmat.2019.121663] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 06/10/2023]
Abstract
Exposure to polycyclic aromatic hydrocarbons and phthalates are linked to lung function decline and altered relative telomere length (RTL) accompanying with oxidative stress and inflammatory events in human body. However, limited data are available about impacts of co-exposure of PAHs and phthalates on lung function and RTL. We conducted a pilot study with repeated measures during the winter of 2014 and summer of 2015 in Wuhan city, China. Participants took part in the measures of lung function, RTL, urinary monohydroxylated-PAHs (OH-PAHs) and phthalate metabolites over three consecutive days in each season. Linear mixed-effect (LME) models and Bayesian kernel machine regression (BKMR) were used to analyze the relations of OH-PAHs or phthalate metabolites with lung function or RTL. LME models showed the negative associations of 3-day average of hydroxyphenanthrene (2 + 3-, 4-OHPhe) or 1-hydroxypyrene with FEV1, 3-day average of 2 + 3-OHPhe with FVC. BKMR models revealed the negative relation of eight OH-PAHs with FEV1, FVC or RTL; nine phthalate metabolites may counteract an overall effect of eight OH-PAHs on FEV1, FVC or RTL. The findings indicated that urinary phthalate metabolites may counteract the negative association of urinary OH-PAHs on FEV1 or FVC, which may be partially linked to shorter RTL regarding biological aging.
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Affiliation(s)
- Jian Hou
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Wenjun Yin
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Pei Li
- State Key Laboratory of Organic Geochemistry, Guangdong Key Laboratory of Environment and Resources, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, PR China
| | - Chen Hu
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Tian Xu
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Juan Cheng
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Tian Li
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Lin Wang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Zhiqiang Yu
- State Key Laboratory of Organic Geochemistry, Guangdong Key Laboratory of Environment and Resources, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, 510640, PR China
| | - Jing Yuan
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China.
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Tamire M, Addissie A, Kumie A, Husmark E, Skovbjerg S, Andersson R, Lärstad M. Respiratory Symptoms and Lung Function among Ethiopian Women in Relation to Household Fuel Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E41. [PMID: 31861594 PMCID: PMC6982329 DOI: 10.3390/ijerph17010041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 11/23/2022]
Abstract
Exposure to household air pollution has been linked to chronic obstructive pulmonary disease, respiratory symptoms and reduced lung function. This study aims to assess respiratory symptoms and lung function among Ethiopian women in relation to exposure to HAP. We conducted a cross-sectional study among non-smoking women responsible for household cooking. Data was collected on socio-demographic characteristics, respiratory symptoms and risk factors using a validated questionnaire. Spirometry with reversibility testing was performed according to American Thoracic Society/European Respiratory Society guidelines. We used independent t-test and multivariable logistic regression to compare the means and measure association respectively. A total of 545 women participated in the study out of which 231 (42.3%) performed spirometry with at least three acceptable manoeuvres. Everyone in the rural group and 43% of the urban group were exposed to HAP from solid fuels during cooking. The odds of developing at least one respiratory symptom when compared with those using cleaner fuels are twice as high for women cooking within the living house. We also found significantly lower forced expiratory volume in the first second (FEV1) (L) among solid fuels users compared with cleaner energy users. Given the larger population settlement in the rural areas and the use of solid fuel as the only energy source, there is a higher risk of developing chronic respiratory health problems for those women in Ethiopia.
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Affiliation(s)
- Mulugeta Tamire
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia; (A.A.); (A.K.)
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, 41390 Gothenburg, Sweden;
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia; (A.A.); (A.K.)
| | - Abera Kumie
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, P.O. Box 9086, Ethiopia; (A.A.); (A.K.)
| | - Emma Husmark
- Bergsjön Primary Care Center, Rymdtorget 8D, 41519 Gothenburg, Sweden;
| | - Susann Skovbjerg
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden; (S.S.); (R.A.)
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Region Västra Götaland, Guldhedsgatan 10A, 41346 Gothenburg, Sweden
| | - Rune Andersson
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 41345 Gothenburg, Sweden; (S.S.); (R.A.)
| | - Mona Lärstad
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16A, 41390 Gothenburg, Sweden;
- Department of Respiratory Medicine and Allergology, Institute of Medicine, Sahlgrenska University Hospital, 41390 Gothenburg, Sweden
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Cooking smoke exposure and respiratory symptoms among those responsible for household cooking: A study in Phitsanulok, Thailand. Heliyon 2019; 5:e01706. [PMID: 31193378 PMCID: PMC6526227 DOI: 10.1016/j.heliyon.2019.e01706] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/08/2019] [Accepted: 05/08/2019] [Indexed: 12/29/2022] Open
Abstract
Cooking smoke affects the health of millions of people worldwide. In Thailand, however, information in regard to household cooking and the effects of cooking smoke is scarce. The objective of this descriptive study was to explore the risk factors and respiratory symptoms in household members responsible for household cooking. Participants from 1,134 rural households in Phitsanulok province, Thailand were randomly selected, using multistage sampling. Data on cooking activities and chronic respiratory problems, and symptoms identified in the past 30 days were collected using a modified questionnaire from the British Medical Research. Most of the participants were women aged over 40 years, who were responsible for food preparation in the household, and who usually cook with vegetable oil, using LPG gas, without a ventilation hood, according to the responses that we received, and our particular knowledge of household cooking facilities in rural areas in Thailand. The most common chronic respiratory symptoms were runny nose (24.5% males, 21.8% females), dyspnea (26.1% females, 19.0% males) and chronic cough (9.2% females, 6.4% males). The most common respiratory symptoms experienced in the past 30 days were having a cold (28.3% females, 18.7% males), coughing (25.5% females, 21.1% ,males) and having sputum (13.0% females, 8.2% males). These symptoms were associated with tears while cooking, the number of hours present in the kitchen grilling food, and the number of stir-fried and deep-fried dishes prepared. This study demonstrated that cooking even with a clean fuel can quantitatively increase the risk of respiratory difficulties and symptoms. Since cooking is undertaken in every household in Thailand, this is a serious public health matter that demands more attention.
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Ofori SN, Maduka O. Association between choice of cooking fuel and peak expiratory flow rate among rural women in the Niger Delta, Nigeria. AAS Open Res 2019. [DOI: 10.12688/aasopenres.12937.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Long-term exposure to indoor air pollution from biomass fuel combustion is a risk factor for respiratory disease, which is an increasingly prevalent contributor to morbidity and mortality in low- and middle-income countries. This study evaluated the association between household fuel use and the peak expiratory flow rate (PEFR) of rural-dwelling women in selected communities of the Niger Delta. Methods: This was a cross-sectional study including 321 non-smoking women aged 18 years and older. Questionnaires were used to obtain data on predominant fuel used and a brief medical history. Women with current respiratory symptoms were excluded. Fuel use was classified into three categories: biomass fuels (BMF), such as wood, animal dung and coal, kerosene and liquefied petroleum gas (LPG). The PEFR was measured with an Omron peak flow meter using standard protocols and was abnormal if it was less than 80% of predicted value based on age and height. Results: The mean age of the 321 women was 38.5±14.2 years. The biomass fuel users had significantly lower PEFR (353.9±104.4) compared to kerosene users (376.2±70.1) and LPG users (393.6± 93.3) (p=0.030). The overall prevalence of abnormal PEFR was 22.4%. The PEFR was abnormal in more BMF users (28%) than kerosene users (13.4%) and LPG users (9.4%) (p=0.005). The PEFR of women who used LPG was 20.8 l/min higher than BMF users (p=0.012). The users of BMF were 5.8 times more likely to have abnormal PEFR than LPG users (OR 5.8, 95% CI 1.62, 20.52, p=0.007). Conclusion: In this population, the use of biomass fuel was significantly associated with abnormal PEFR. This needs to be further explored in this population with a larger study using more objective measures, such as spirometry testing, to guide policies for the implementation of preventive strategies to protect vulnerable women from chronic obstructive airway disease.
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15
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Nsoh M, Mankollo BOY, Ebongue M, Cyprien KN, Likeng JLN, Islam SMS, Collier A, Tsoka-Gwegweni JM, Cumber SN. Acute respiratory infection related to air pollution in Bamenda, North West Region of Cameroon. Pan Afr Med J 2019; 32:99. [PMID: 31223389 PMCID: PMC6560959 DOI: 10.11604/pamj.2019.32.99.15228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 02/13/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction Air pollution is a global health problem. It's responsible for over 4 million deaths each year and constitutes a risk factor for acute respiratory infections (ARI). The aims of this study was to assess knowledge about air pollution, and to determine environmental risk factors associated with ARIs occurence in the city of Bamenda, Cameroon. Methods We conducted a cross sectional study and performed a rectrospective analysis of ARI consultation within the period March 2016 to July 2016 in the Bamenda Health District. We interviewd 201 patients and recorded 1849 cases from hospital registers of patients diagnosed ARI from January 2013 to April 2016. Epi-info 7.2 was used for data entry and analysis. Logistic regression analysis was conducted to determine the importance of the different environmental risk factors. Results Over 70% of the participants used at least a form of solid fuel for cooking. The Odds of developing an ARI was 3.62 greater among those exposed to indoor cooking compared to the unexposed (OR 3.62, CI 1.45-4.90). Participants exposed to open fire burning were 1.91 times more like to develop ARI compared to unexposed (OR: 1.91, CI 1.03-3.55: p : 0.03). Particulate Matter (PM 2.5) levels was 13.2 times higher than the World Health Organization (WHO) recommended levels. Dry and dusty weathers increased the risk of ARIs (OR 3.24; CI 1.47-7.13). The prevalence of ARIs in the Bamenda Health District was 6% of all consultations. Conclusion Using solid fuels in poorly ventilated homes increase the total air particle suspension indoor. Inhalling this poor air irritates the repiratory tract, eyes while longterm exposure increases the odds of cancers. Ventilating homes with indoor cooking space reduces exposure while using clean fuels like electricity reduces the odds of ARI associated with pollution.
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Affiliation(s)
- Marius Nsoh
- School of Health Sciences, Department of Public Health, Catholic University of Central Africa, Yaounde, Cameroon
| | - Bassong Olga Yvonne Mankollo
- School of Health Sciences, Department of Public Health, Catholic University of Central Africa, Yaounde, Cameroon
| | - Mbondji Ebongue
- School of Health Sciences, Department of Public Health, Catholic University of Central Africa, Yaounde, Cameroon.,School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Kengne Nde Cyprien
- Bordeaux School of Public Health and Epidemiology University of Bordeaux, Bordeaux, France
| | - Julienne Louise Ngo Likeng
- School of Health Sciences, Department of Public Health, Catholic University of Central Africa, Yaounde, Cameroon
| | | | | | - Joyce Mahlako Tsoka-Gwegweni
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Samuel Nambile Cumber
- Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine (EPSO), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Ho T, Cusack RP, Chaudhary N, Satia I, Kurmi OP. Under- and over-diagnosis of COPD: a global perspective. Breathe (Sheff) 2019; 15:24-35. [PMID: 30838057 PMCID: PMC6395975 DOI: 10.1183/20734735.0346-2018] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Globally, chronic obstructive pulmonary disease (COPD) is the fourth major cause of mortality and morbidity and projected to rise to third within a decade as our efforts to prevent, identify, diagnose and treat patients at a global population level have been insufficient. The European Respiratory Society and American Thoracic Society, along with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy document, have highlighted key pathological risk factors and suggested clinical treatment strategies in order to reduce the mortality and morbidity associated with COPD. This review focuses solely on issues related to the under- and over-diagnosis of COPD across the main geographical regions of the world and highlights some of the associated risk factors. Prevalence of COPD obtained mainly from epidemiological studies varies greatly depending on the clinical and spirometric criteria used to diagnose COPD, i.e. forced expiratory volume in 1 s to forced vital capacity ratio <0.7 or 5% below the lower limit of normal, and this subsequently affects the rates of under- and over-diagnosis. Although under-utilisation of spirometry is the major reason, additional factors such as exposure to airborne pollutants, educational level, age of patients and language barriers have been widely identified as other potential risk factors. Co-existent diseases, such as asthma, bronchiectasis, heart failure and previously treated tuberculosis, are reported to be the other determinants of under- and over-diagnosis of COPD. COPD is a major cause of morbidity and mortality, but misdiagnosis of COPD is a huge problem worldwide. Its main causes are under-utilisation of spirometry and lack of uniformity in diagnosis criteria, particularly in resource poor settings.http://ow.ly/KfP330nonkh
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Affiliation(s)
- Terence Ho
- Firestone Institute of Respiratory Health, Division of Respirology, Dept of Medicine, McMaster University, Hamilton, ON, Canada.,All authors contributed equally
| | - Ruth P Cusack
- Division of Respirology, Dept of Medicine, McMaster University, Hamilton, ON, Canada.,All authors contributed equally
| | - Nagendra Chaudhary
- Dept of Paediatrics, Universal College of Medical Sciences, Bhairahawa, Nepal.,All authors contributed equally
| | - Imran Satia
- Division of Respirology, Dept of Medicine, McMaster University, Hamilton, ON, Canada.,All authors contributed equally
| | - Om P Kurmi
- Population Health Research Institute, Division of Respirology, Dept of Medicine, McMaster University, Hamilton, ON, Canada.,All authors contributed equally
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Pathak U, Kumar R, Suri TM, Suri JC, Gupta NC, Pathak S. Impact of biomass fuel exposure from traditional stoves on lung functions in adult women of a rural Indian village. Lung India 2019; 36:376-383. [PMID: 31464208 PMCID: PMC6710971 DOI: 10.4103/lungindia.lungindia_477_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Introduction Exposure to biomass fuel (BMF) from traditional cookstoves inflicts an enormous burden of morbidities in women across the developing world. This study aims to assess the lung function and its association with the indoor air pollutants generated using BMF. Materials and Methods This cross-sectional study including 310 women was conducted in a rural village of India. Households were divided into two groups based on the cooking fuel, the BMF group and the liquefied petroleum gas (LPG) group. Information on respiratory symptoms and socioeconomic status was obtained using a standard questionnaire. Indoor air concentration for PM10and PM2.5was measured during cooking hours. Pulmonary function tests (PFTs) were conducted for the women inhabitants. Results On comparing the two groups, the concentration of PM10(890.26 ± 59.59 vs. 148.66 ± 31.97) μg/m3 and PM2.5(728.90 ± 50.20 vs. 99.76 ± 41.80) μg/m3 (P < 0.01) were higher in the group using BMF. The respiratory symptoms such as wheezing, dyspnea, chronic cough, and nocturnal cough, were significantly more common in the group using BMF. A significant difference was seen in the lung function indices between the two groups. A significant negative correlation of respiratory indices with duration of exposure and the particulate matter (PM) values suggested a greater decline on lung function among women exposed to increased concentrations of PM. On comparing participants with normal and abnormal PFT, it was seen that the use of BMF (odds ratio [OR] 8.01; 95% confidence interval [CI] 4.80, 13.36, P < 0.001) and the duration of exposure to BMF (OR 1.16; 95% CI 1.13, 1.20., P < 0.001) increased the odds of having an abnormal PFT. Conclusions This study shows a high prevalence of respiratory symptoms and an abnormal pulmonary function in women exposed to BMF.
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Affiliation(s)
- Utkarsha Pathak
- University School of Environment Management, Guru Gobind Singh Indraprastha University, Dwarka, New Delhi, India
| | - Rohit Kumar
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Tejas M Suri
- Department of Pulmonary, Critical Care and Sleep Medicine, AlIMS, New Delhi, India
| | - J C Suri
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - N C Gupta
- University School of Environment Management, Guru Gobind Singh Indraprastha University, Dwarka, New Delhi, India
| | - Sharmishtha Pathak
- Department of Neuroanaesthesiology and Neuro Critical Care, AIIMS, New Delhi, India
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Nwankwo ONO, Mokogwu N, Agboghoroma O, Ahmed FO, Mortimer K. Knowledge, attitudes and beliefs about the health hazards of biomass smoke exposure amongst commercial food vendors in Nigeria. PLoS One 2018; 13:e0191458. [PMID: 29377962 PMCID: PMC5788333 DOI: 10.1371/journal.pone.0191458] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 01/07/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Exposure to biomass smoke is a major cause of morbidity and mortality in Africa. Commercial food vendors in Nigeria and elsewhere in Africa are commonly exposed to biomass smoke from open fire cooking both at work and home. Little is known about the knowledge, attitudes and beliefs of food vendors about the health hazards of biomass smoke exposure in Nigeria. METHODS We did a descriptive cross sectional survey of the knowledge, attitudes and beliefs of commercial food vendors in the cities of Benin and Calabar in Nigeria. We recruited respondents using a multi-stage approach. Structured interviewer-administered questionnaires were used for data collection. RESULTS We recruited 308 participants (164, 53.2% female). The majority 185(60.2%) were married and had post-primary education 206(67.4%). The average monthly income was <30,000 Naira (US$150). Most 198(64.4%) were not aware that biomass smoke exposure is harmful to human health. About three-quarters (221; 71.8%) were unconcerned as to the effect of exposure to fumes from biomass fuels on their health. Less than half of respondents (110, 41.6%) believed biomass smoke was harmful to health. Male gender, being single, having post-primary education and preferring electricity or gas fuels were associated with good knowledge of the adverse health effects of biomass smoke exposure whilst female gender and having good knowledge of the adverse health effects of biomass smoke were associated with positive attitudes towards preventing exposure. CONCLUSION Commercial food vendors in our study had limited knowledge about the adverse health effects of biomass smoke exposure and negative attitudes towards preventing these adverse health effects. We suggest an educational intervention is needed to improve this knowledge.
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Affiliation(s)
- Ogonna N. O. Nwankwo
- Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Ndubuisi Mokogwu
- Department of Community Health, University of Benin Teaching Hospital, Benin, Nigeria
| | | | - Fahmi O. Ahmed
- College Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kevin Mortimer
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Pastro LDM, Lemos M, Fernandes FLA, Saldiva SRDM, Vieira SE, Romanholo BMS, Saldiva PHN, Francisco RPV. Longitudinal study of lung function in pregnant women: Influence of parity and smoking. Clinics (Sao Paulo) 2017; 72:595-599. [PMID: 29160421 PMCID: PMC5666444 DOI: 10.6061/clinics/2017(10)02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/10/2017] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To evaluate pulmonary function in the first and third trimesters of pregnancy and analyze the influence of parity and smoking on spirometry parameters. METHODS This longitudinal prospective study included a cohort of 120 pregnant women. The inclusion criteria were as follows: singleton pregnancy, gestational age less than 13.86 weeks, and no preexisting maternal diseases. The exclusion criteria were as follows: change of address, abortion, and inadequate spirometry testing. ClinicalTrials.gov: NCT02807038. RESULTS A decrease in values of forced vital capacity and forced expiratory volume were noted in the first second from the first to third trimester. In the first and third trimesters, multiparous women demonstrated lower absolute forced vital capacity and forced expiratory volume values in the first second compared with nulliparous women (p<0.0001 and p=0.001, respectively). Multiparous women demonstrated reduced forced expiratory flow in 25% to 75% of the maneuver compared with nulliparous women in the first (p=0.005) and third (p=0.031) trimesters. The absolute values of forced expiratory flow in 25% to 75%, forced expiratory volume in the first second and predicted peak expiratory flow values in the third trimester were higher in smokers compared with nonsmokers (p=0.042, p=0.039, p=0.024, and p=0.021, respectively). CONCLUSION There was a significant reduction in forced vital capacity and forced expiratory volume values in the first second during pregnancy. Parity and smoking significantly influence spirometric variables.
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Affiliation(s)
- Luciana Duzolina Manfré Pastro
- Departamento de Ginecologia e Obstetricia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Miriam Lemos
- Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Frederico Leon Arrabal Fernandes
- Laboratorio de Funcao Pulmonar, Disciplina de Pulmonologia, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Sandra Elisabete Vieira
- Departamento de Pediatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Beatriz Mangueira Saraiva Romanholo
- Departamento de Medicina (LIM 20), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Universidade Cidade de Sao Paulo (UNICID), Sao Paulo, SP, BR
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Awopeju OF, Nemery B, Afolabi OT, Poels K, Vanoirbeek J, Obaseki DO, Adewole OO, Lawin HA, Vollmer W, Erhabor GE. Biomass smoke exposure as an occupational risk: cross-sectional study of respiratory health of women working as street cooks in Nigeria. Occup Environ Med 2017; 74:737-744. [PMID: 28780568 DOI: 10.1136/oemed-2016-104107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 06/29/2017] [Accepted: 07/05/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Little is known about respiratory health of women who are occupationally exposed to biomass smoke outside their homes. This study reports the exposure and respiratory health of street cooks in Ile-Ife, Nigeria. METHODS We assessed exposure to biomass smoke by questionnaire in 188 street cooks and 197 control women and by personal diffusive samplers to quantify volatile organic compounds (VOCs) in a subsample of the women. Respiratory symptoms were assessed by a standardised questionnaire, and pulmonary function was assessed by spirometry before and after bronchodilation. Regression analysis was conducted to compare the outcome between the two groups. RESULTS The study included 188 women (median age 40, IQR 30-50 years) who had worked as street cooks for a median of 7 years (IQR 3-15 years) and 197 control women with similar demographics. Benzene concentration in passive samplers worn by the street cooks was significantly higher compared with controls (median (IQR) 119.3 (82.7-343.7) µg/m3 vs 0.0 (0.0-51.2) µg/m3, p<0.001). The odds of reported respiratory symptoms were significantly higher among the street cooks than controls: cough (adjusted OR 4.4, 95% CI 2.2 to 8.5) and phlegm (adjusted OR 3.9, 95% CI 1.5 to 7.3). The street cooks also had higher odd of airway obstruction as measured by forced expiratory volume in 1 s/forced vital capacity <0.7: 11% 3% (adjusted OR of 3.3 (95% CI 1.3 to 8.7)). CONCLUSIONS This study provides evidence of adverse respiratory effects among street cooks using biomass fuels.
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Affiliation(s)
| | - Benoit Nemery
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | | | - Katrien Poels
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Jeroen Vanoirbeek
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | | | | | - Hervé Anicet Lawin
- Department of Public Health, Unit of Teaching and Research in Occupational and Environmental Health, University of Abomey-Calavi, Cotonou, Benin
| | - William Vollmer
- Centre for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
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JIE Y, KEBIN L, YIN T, JIE X. Indoor Environmental Factors and Occurrence of Lung Function Decline in Adult Residents in Summer in Southwest China. IRANIAN JOURNAL OF PUBLIC HEALTH 2016; 45:1436-1445. [PMID: 28032061 PMCID: PMC5182252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 03/20/2016] [Indexed: 10/27/2022]
Abstract
BACKGROUND There is conflicting reports on the respiratory health effects of indoor risk factor exposure. The aim of this study was to assess the association of indoor environmental factors to pulmonary function in an adult population in Zunyi City of Southwest China. METHODS Between July and Sep 2012, we conducted a cross-sectional survey of people aged ≥18 yr in 11 inner-city areas of Zunyi. Data on asthma and asthma-related symptoms and selected home environmental factors were assessed by questionnaire. Lung function measurements, including FVC, FEV1, FEV1/FVC and PEFR, were assessed and compared. Exposure to indoor and outdoor PM2.5 was monitored by measurement of PM2.5 emission relative concentration. RESULTS Cooking oil fumes, environmental tobacco smoke (ETS) and coal fuel use were associated with impaired lung function among adults in summer season (P<0.05). Subjects exposed coal fuel combustion, cooking oil fumes, pest in kitchen, mosquito repellent, fluffy blanket, pets, visible mold in bedroom and ETS (active and passive smoking) tended to exhibit greater decreases in FVC, FEV1 and PEFR values compared with their non-exposed counterparts (P<0.05). Median PM2.5 relative concentrations in kitchen, sleeping area and outdoor were 486.0cpm, 463.0cpm and 459.0cpm, respectively. PM2.5 relative concentration in indoor kitchen and sleeping area were significant higher than outdoor (P<0.001). CONCLUSION A negative association between kitchen, sleeping area risk factors and ETS exposure and a reduction in lung function in summer was revealed in Zunyi.
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