1
|
Torres-Duque CA, Jaramillo C, Caballero A, Proaños-Jurado NJ, Pareja-Zabala MJ, Soriano JB, González-García M. Chronic obstructive pulmonary disease related to wood smoke and impact of the combined exposure to tobacco. IJTLD OPEN 2024; 1:130-135. [PMID: 38966405 PMCID: PMC11221582 DOI: 10.5588/ijtldopen.24.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/14/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 highlights the need to explore aetiotypes of chronic obstructive pulmonary disease (COPD) beyond the tobacco-smoking COPD. Exposure to wood smoke (WS) is a risk factor for COPD in women, but the effect of the combined exposure to tobacco smoke (TS) in the general population and among COPD patients, and the characteristics of WS-COPD are unclear. METHOD This was an analysis of data from PREPOCOL (Prevalence of COPD in Five Colombian Cities Situated at Low, Medium, and High Altitude), a random cross-sectional population-based study (n = 5,539) focusing on the effect of combined WS and TS exposure and WS-COPD characterisation. RESULTS Prevalence of COPD was significantly higher in those exposed to both WS and TS (16.0%) than in those exposed to WS (6.7%) or TS (7.8%) only (P < 0.001). Exposure to WS was associated with COPD in men (OR 1.53, P = 0.017). WS-COPD individuals were more frequently female, older, shorter and had higher forced expiratory volume in 1 sec (FEV1) (all P < 0.05). Those exposed to both WS and TS had more symptoms and worse airflow limitation (P < 0.001). CONCLUSIONS This was the first random population-based study showing that WS is an associated risk factor for COPD also in men, and that people exposed to both WS and TS have a significantly higher prevalence of COPD. Similarly, COPD subjects exposed to both types of smoke have more symptoms and greater airflow obstruction. This suggests an additive effect of WS and TS.
Collapse
Affiliation(s)
- C A Torres-Duque
- CINEUMO, Research Department, Fundación Neumológica Colombiana, Bogotá
- Doctoral Biosciences, Universidad de La Sabana, Chía
| | | | | | - N J Proaños-Jurado
- CINEUMO, Research Department, Fundación Neumológica Colombiana, Bogotá
- School of Medicine, Universidad de La Sabana, Chía, Colombia
| | - M J Pareja-Zabala
- CINEUMO, Research Department, Fundación Neumológica Colombiana, Bogotá
| | - J B Soriano
- Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - M González-García
- CINEUMO, Research Department, Fundación Neumológica Colombiana, Bogotá
- School of Medicine, Universidad de La Sabana, Chía, Colombia
| |
Collapse
|
2
|
Giraldo-Montoya ÁM, Torres-Duque CA, Giraldo-Cadavid LF, Laucho-Contreras ME, González-Flórez A, Santos AM, Tuta-Quintero EA, Celli BR, González-García M. Sputum Biomarkers in Wood and Tobacco Smoke Etiotypes of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 19:1-10. [PMID: 38179428 PMCID: PMC10763680 DOI: 10.2147/copd.s439064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction There is a need to better understand the etiotypes of chronic obstructive pulmonary disease (COPD) beyond the tobacco-smoke (TS-COPD). Wood smoke COPD (WS-COPD) is characterized by greater airway compromise, milder emphysema, and slower rate of lung function decline than TS-COPD. However, it is unclear if these two etiotypes of COPD have differences in sputum biomarker concentrations. Objective was to compare sputum levels of selected sputum biomarkers between WS-COPD and TS-COPD, and healthy controls. Methods Eighty-eight women (69±12 years) were recruited and classified into: WS-COPD (n=31), TS-COPD (n=29) and controls (n=28). Using ELISA, we determined induced sputum levels of metalloproteinase 9 (MMP-9), chemokine ligand 5 (CCL5), interleukin-8 (IL-8), chemokine ligand 16 (CCL16/HCC-4) and vascular endothelial growth factor (VEGF-1). Differences were analyzed by Kruskal-Wallis and Mann-Whitney-U tests and correlation between airflow limitation and biomarkers by Spearman's test. Results At similar degree of airflow obstruction, anthropometrics and medications use, the level of sputum CCL5 was higher in TS-COPD than WS-COPD (p=0.03) without differences in MMP-9, IL-8, CCL16/HCC-4, and VEGF-1. Women with WS-COPD and TS-COPD showed significantly higher sputum levels of MMP-9, IL-8 and CCL5 compared with controls (p<0.001). FEV1% predicted correlated negatively with levels of MMP-9 (rho:-0.26; P=0.016), CCL5 (rho:-0.37; P=0.001), IL-8 (rho:-0.42; P<0.001) and VEGF (rho:-0.22; P=0.04). Conclusion While sputum concentrations of MMP-9, IL-8, and CCL5 were higher in COPD women compared with controls, women with TS-COPD had higher levels of CCL5 compared with those with WS-COPD. Whether this finding relates to differences in pathobiological pathways remains to be determined.
Collapse
Affiliation(s)
- Ángela María Giraldo-Montoya
- CINEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
- School of Medicine, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Carlos A Torres-Duque
- CINEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
- Biosciences Doctoral, Universidad de La Sabana, Chía, Colombia
| | - Luis F Giraldo-Cadavid
- Medical Department, Fundación Neumológica Colombiana, Bogotá, Colombia
- Epidemiology and Biostatistics Department, Universidad de La Sabana, Chía, Colombia
| | | | | | | | - Eduardo A Tuta-Quintero
- CINEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
- Epidemiology and Biostatistics Department, Universidad de La Sabana, Chía, Colombia
| | | | - Mauricio González-García
- CINEUMO, Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia
- School of Medicine, Universidad de La Sabana, Chía, Colombia
| |
Collapse
|
3
|
Byanova KL, Abelman R, North CM, Christenson SA, Huang L. COPD in People with HIV: Epidemiology, Pathogenesis, Management, and Prevention Strategies. Int J Chron Obstruct Pulmon Dis 2023; 18:2795-2817. [PMID: 38050482 PMCID: PMC10693779 DOI: 10.2147/copd.s388142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/09/2023] [Indexed: 12/06/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by airflow limitation and persistent respiratory symptoms. People with HIV (PWH) are particularly vulnerable to COPD development; PWH have demonstrated both higher rates of COPD and an earlier and more rapid decline in lung function than their seronegative counterparts, even after accounting for differences in cigarette smoking. Factors contributing to this HIV-associated difference include chronic immune activation and inflammation, accelerated aging, a predilection for pulmonary infections, alterations in the lung microbiome, and the interplay between HIV and inhalational toxins. In this review, we discuss what is known about the epidemiology and pathobiology of COPD among PWH and outline screening, diagnostic, prevention, and treatment strategies.
Collapse
Affiliation(s)
- Katerina L Byanova
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rebecca Abelman
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Crystal M North
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Stephanie A Christenson
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Laurence Huang
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
4
|
Feary J, Lindstrom I, Huntley CC, Suojalehto H, de la Hoz RE. Occupational lung disease: when should I think of it and why is it important? Breathe (Sheff) 2023; 19:230002. [PMID: 37377854 PMCID: PMC10292794 DOI: 10.1183/20734735.0002-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/05/2023] [Indexed: 06/29/2023] Open
Abstract
Exposure to toxic inhalants in the workplace has the potential to cause (in susceptible individuals) almost any major type of lung disease, such as asthma, COPD and interstitial lung diseases. Patients with occupational lung disease will often present to or will be managed by respiratory specialists without training in occupational respiratory medicine, and patients (or their clinicians) may not identify a link between their disease and their current or a past job. Without an awareness of the range of different occupational lung diseases that exist, their similarity to their non-occupational counterparts, and without directed questioning, these conditions may go unidentified. Patients with occupational lung diseases are often in lower paid work and are disproportionally affected by health inequality. Both clinical and socioeconomic outcomes generally improve if cases are identified early. This allows appropriate advice to be given about the risks of ongoing exposure, clinical management, occupational mobility and, in some cases, eligibility for legal compensation. As respiratory professionals, it is important that these cases are not missed, and if needed, are discussed with a physician with specialised expertise. Here we describe some of the most common occupational lung diseases and outline the diagnostic and treatment approach.
Collapse
Affiliation(s)
- Johanna Feary
- National Heart and Lung Institute, Imperial College London, London, UK
- Royal Brompton Hospital, London, UK
| | - Irmeli Lindstrom
- Finnish Institute of Occupational Health, Occupational Health Department, Helsinki, Finland
| | - Christopher C. Huntley
- Occupational and Interstitial Lung Disease Services, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Hille Suojalehto
- Finnish Institute of Occupational Health, Occupational Health Department, Helsinki, Finland
| | - Rafael E. de la Hoz
- Division of Occupational and Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
5
|
Ramírez-Venegas A, Montiel-Lopez F, Falfan-Valencia R, Pérez-Rubio G, Sansores RH. The "Slow Horse Racing Effect" on Lung Function in Adult Life in Chronic Obstructive Pulmonary Disease Associated to Biomass Exposure. Front Med (Lausanne) 2021; 8:700836. [PMID: 34307427 PMCID: PMC8295605 DOI: 10.3389/fmed.2021.700836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/15/2021] [Indexed: 01/31/2023] Open
Abstract
Although different trajectories in lung function decline have been identified in patients with COPD associated to tobacco exposure (TE-COPD), genetic, environmental, and infectious factors affecting lung function throughout life have not been fully elucidated in patients with COPD associated to biomass (BE-COPD). In this review, we present current epidemiological findings and notable advances in the natural history of lung decline in BE-COPD, as well as conditions modeling the FEV1 trajectory, such as health insults, during the first years of childhood. Evidence shows that women exposed to biomass smoke reach adult life with a lower FEV1 than expected. However, in contrast to the “horse racing effect” predicting an excessive lung-function decline in forthcoming years, as observed in smokers, this decline is slower in non-smokers, and no rapid decliners are observed. Accordingly, BE-COPD might be considered another phenotype of COPD based on assessments of lung function decline. Likewise, other functional and clinical aspects described in this review suggest that this condition might be similar to TE-COPD. More research is needed to fully characterize this subgroup of variants of COPD.
Collapse
Affiliation(s)
- Alejandra Ramírez-Venegas
- Department of Tobacco Smoking and COPD Research, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Francisco Montiel-Lopez
- Department of Tobacco Smoking and COPD Research, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Ramces Falfan-Valencia
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Gloria Pérez-Rubio
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Raúl H Sansores
- Department of Respiratory Medicine, Medica Sur Clinic and Foundation, Mexico City, Mexico
| |
Collapse
|
6
|
Aghaeimeybodi F, Samadzadeh G, Haji Safari Z, Nouri S, Talebi HR, Shahcheraghi SH. Comparison of Chronic Obstructive Pulmonary Diseases Induced by Wood Smoke and Tobacco Smoke. TANAFFOS 2021; 20:268-276. [PMID: 35382087 PMCID: PMC8978041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/13/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a progressive airflow limitation and decline in lung function. Although tobacco smoke is the leading risk factor for COPD, air contamination by wood-burning smoke is also of great concern. About half of the world's populations, especially in developing countries such as Iran, exploit this energy source for cooking and heating. It is remained unknown if COPD induced by wood smoke from baking bread (COPD-B) and COPD induced by tobacco smoke (COPD-S) have different symptoms and clinical presentations. To fill this gap, the present study was to describe such differences. MATERIALS AND METHODS This retrospective cohort study was performed in Afshar COPD clinics affiliated with the Shahid Sadoughi University of Medical Sciences, Yazd, Iran. The clinical records of 231 patients with the COPD diagnosis were reviewed. After considering inclusion and exclusion criteria, 91 patients (46 with COPD -B and 45 with COPD-S) underwent physical examination and para-clinical assessments (i.e., respiratory function tests, Chest X-ray, and quality of life test). RESULTS The COPD-B patients were mainly women at older age and had higher FEV 1 /FVC and FEF-75; however, they had fewer post-bronchodilator positive responses to FEV 1 (suggesting a restriction pattern) and sputum production, compared to the COPD-S patients. Regarding the other parameters, there were no statistically significant differences between the two groups. CONCLUSION This was the first study evaluating and revealing some differences in the clinical and paraclinical characteristics of the COPD-B patients (with prolonged exposure to wood smoke from bread baking; >100 hours per year, for at least 10 years) and COPD-S patients (>10 packs per year of exposure to tobacco smoke).
Collapse
Affiliation(s)
- Fatemeh Aghaeimeybodi
- Department of Internal Medicine, Division of Pulmonology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,,Correspondence to: Aghaeimeybodi F, Address: Department of Internal Medicine, Division of Pulmonology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Email address:
| | | | | | - Sina Nouri
- Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Seyed Hossein Shahcheraghi
- Infectious Diseases Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
7
|
Salvi SS, Brashier BB, Londhe J, Pyasi K, Vincent V, Kajale SS, Tambe S, Mandani K, Nair A, Mak SM, Madas S, Juvekar S, Donnelly LE, Barnes PJ. Phenotypic comparison between smoking and non-smoking chronic obstructive pulmonary disease. Respir Res 2020; 21:50. [PMID: 32050955 PMCID: PMC7017521 DOI: 10.1186/s12931-020-1310-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/29/2020] [Indexed: 12/22/2022] Open
Abstract
Background Although COPD among non-smokers (NS-COPD) is common, little is known about this phenotype. We compared NS-COPD subjects with smoking COPD (S-COPD) patients in a rural Indian population using a variety of clinical, physiological, radiological, sputum cellular and blood biomarkers. Methods Two hundred ninety subjects (118 healthy, 79 S-COPD, 93 NS-COPD) performed pre- and post-bronchodilator spirometry and were followed for 2 years to study the annual rate of decline in lung function. Body plethysmography, impulse oscillometry, inspiratory-expiratory HRCT, induced sputum cellular profile and blood biomarkers were compared between 49 healthy, 45 S-COPD and 55 NS-COPD subjects using standardized methods. Spirometric response to oral corticosteroids was measured in 30 female NS-COPD patients. Results Compared to all male S-COPD subjects, 47% of NS-COPD subjects were female, were younger by 3.2 years, had greater body mass index, a slower rate of decline in lung function (80 vs 130 mL/year), more small airways obstruction measured by impulse oscillometry (p < 0.001), significantly less emphysema (29% vs 11%) on CT scans, lower values in lung diffusion parameters, significantly less neutrophils in induced sputum (p < 0.05) and tended to have more sputum eosinophils. Hemoglobin and red cell volume were higher and serum insulin lower in S-COPD compared to NS-COPD. Spirometric indices, symptoms and quality of life were similar between S-COPD and NS-COPD. There was no improvement in spirometry in NS-COPD patients after 2 weeks of an oral corticosteroid. Conclusions Compared to S-COPD, NS-COPD is seen in younger subjects with equal male-female predominance, is predominantly a small-airway disease phenotype with less emphysema, preserved lung diffusion and a slower rate of decline in lung function.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Arjun Nair
- Department of Radiology, Royal Brompton Hospital, London, UK
| | - Sze Mun Mak
- Department of Radiology, Royal Brompton Hospital, London, UK
| | | | | | - Louise E Donnelly
- National Heart & Lung Institute, Imperial College, Dovehouse Street, London, SW3 6lY, UK
| | - Peter J Barnes
- National Heart & Lung Institute, Imperial College, Dovehouse Street, London, SW3 6lY, UK.
| |
Collapse
|
8
|
Meneghini A, Koenigkam-Santos M, Pereira M, Tonidandel P, Terra-Filho J, Cunha F, de Menezes M, Vianna E. Biomass smoke COPD has less tomographic abnormalities but worse hypoxemia compared with tobacco COPD. Braz J Med Biol Res 2019; 52:e8233. [PMID: 31038579 PMCID: PMC6487741 DOI: 10.1590/1414-431x20198233] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 02/07/2019] [Indexed: 11/22/2022] Open
Abstract
Special attention has emerged towards biomass smoke-induced chronic obstructive pulmonary disease (COPD), providing new knowledge for prevention and therapeutic approach of non-smoker COPD patients. However, the understanding of biomass smoke COPD is still limited and somewhat controversial. The aim of the present study was to compare COPD exclusively caused by tobacco smoking with COPD exclusively caused by environmental or occupational exposures. For this cross-sectional study, COPD patients were recruited from outpatient clinics and formed two groups: non-smoker COPD group (n=16) with exposure to biomass smoke who did not smoke cigarette and tobacco smoker COPD group (n=15) with people who did not report biomass smoke exposure. Subjects underwent pulmonary function tests, thoracic high-resolution computed tomography, 6-min walk test, and sputum induction. The non-smoker COPD group had biomass smoke exposure of 133.3±86 hour-years. The tobacco COPD group smoked 48.5±27.4 pack-years. Women were 62.5 and 66.7%, respectively, of non-smokers and smokers. The non-smoker COPD group showed higher prevalence of dyspnea, lower arterial oxygen tension (PaO2), and lower arterial oxygen saturation (SaO2%) with similar spirometry results, lung volumes, and diffusion capacity. Regarding inflammatory biomarkers, differences were detected in sputum number of lymphomononuclear cells and in sputum concentrations of interleukin (IL)-6 and IL-8 with higher values in the smoker group. Emphysema was more prevalent in the tobacco smoker group, which also showed higher relative bronchial wall thickness and lower lung density by quantitative analysis. Biomass smoke induced more hypoxemia compared to tobacco in COPD patients with similar severity.
Collapse
Affiliation(s)
- A.C. Meneghini
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M. Koenigkam-Santos
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M.C. Pereira
- Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - P.R. Tonidandel
- Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - J. Terra-Filho
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - F.Q. Cunha
- Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M.B. de Menezes
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - E.O. Vianna
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| |
Collapse
|
9
|
Abstract
The PLATINO and PREPOCOL population-based studies documented the prevalence of chronic obstructive pulmonary disease (COPD) in several Latin American (Mexico City, Sao Paulo, Montevideo, Santiago and Caracas) and Colombian (Medellin, Bogota, Barranquilla, Bucaramanga and Cali) cities. COPD ranged between 6.2 and 19.6% in individuals ≥40 years of age, with substantial rates of underdiagnosis (up to 89%) but also overdiagnosis, mostly due to the lack of spirometric confirmation. The main risk factor was tobacco smoking, but male gender and age were also associated with COPD. COPD in never smokers represented about one third of the cases and was associated with previous history of tuberculosis or a diagnosis of asthma. COPD associated with biomass smoke exposure was a common clinical phenotype in Latin America, found as a risk factor in PREPOCOL and other observational studies in the region. Smoking has been decreasing in Latin America and efforts have been made to implement cleaner biomass stoves. Unfortunately, treatment of COPD in Latin America remains highly variable with low rates of smoking cessation counselling, low use of inhaled bronchodilators and influenza vaccination. A primary-care approach to COPD, particularly in the form of integrated programs is lacking but would be critical to improving rates of diagnosis and treatment of COPD.
Collapse
|
10
|
Increased Airway Wall Thickness is Associated with Adverse Longitudinal First-Second Forced Expiratory Volume Trajectories of Former World Trade Center workers. Lung 2018; 196:481-489. [PMID: 29797069 DOI: 10.1007/s00408-018-0125-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/13/2018] [Indexed: 12/26/2022]
Abstract
RATIONALE Occupational exposures at the WTC site after September 11, 2001 have been associated with several presumably inflammatory lower airway diseases. In this study, we describe the trajectories of expiratory air flow decline, identify subgroups with adverse progression, and investigate the association of a quantitative computed tomography (QCT) imaging measurement of airway wall thickness, and other risk factors for adverse progression. METHODS We examined the trajectories of expiratory air flow decline in a group of 799 former WTC workers and volunteers with QCT-measured (with two independent systems) wall area percent (WAP) and at least 3 periodic spirometries. We calculated individual regression lines for first-second forced expiratory volume (FEV1), identified subjects with rapidly declining and increasing ("gainers"), and compared them to subjects with normal and "stable" FEV1 decline. We used multivariate logistic regression to model decliner vs. stable trajectories. RESULTS The mean longitudinal FEV1slopes for the entire study population, and its stable, decliner, and gainer subgroups were, respectively, - 35.8, - 8, - 157.6, and + 173.62 ml/year. WAP was associated with "decliner" status (ORadj 1.08, 95% CI 1.02, 1.14, per 5% increment) compared to stable. Age, weight gain, baseline FEV1 percent predicted, bronchodilator response, and pre-WTC occupational exposures were also significantly associated with accelerated FEV1 decline. Analyses of gainers vs. stable subgroup showed WAP as a significant predictor in unadjusted but not consistently in adjusted analyses. CONCLUSIONS The apparent normal age-related rate of FEV1 decline results from averaging widely divergent trajectories. WAP is significantly associated with accelerated air flow decline in WTC workers.
Collapse
|
11
|
Perret JL, Abramson MJ. Biomass smoke COPD: A phenotype or a different disease? Respirology 2018; 23:124-125. [PMID: 29215182 DOI: 10.1111/resp.13227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/14/2017] [Indexed: 02/05/2023]
Abstract
See related Article
Collapse
Affiliation(s)
- Jennifer L Perret
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
12
|
Olloquequi J, Jaime S, Parra V, Cornejo-Córdova E, Valdivia G, Agustí À, Silva O R. Comparative analysis of COPD associated with tobacco smoking, biomass smoke exposure or both. Respir Res 2018; 19:13. [PMID: 29347936 PMCID: PMC5774164 DOI: 10.1186/s12931-018-0718-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/08/2018] [Indexed: 01/26/2023] Open
Abstract
Background Exposure to noxious gases and particles contained in both tobacco smoking (TS) and biomass smoke (BS) are well recognized environmental risk factors for chronic obstructive pulmonary disease (COPD). COPD is characterized by an abnormal inflammatory response, both in the pulmonary and systemic compartments. The differential effects of TS, BS or their combined exposure have not been well characterized yet. This study sought to compare the lung function characteristics and systemic inflammatory response in COPD patients exposed to TS, BS or their combination. Methods Sociodemographic, clinical and lung functional parameters were compared across 49 COPD patients with a history of smoking and no BS exposure (TS COPD), 31 never-smoker COPD patients with BS exposure (BS COPD), 46 COPD patients with a combined exposure (TS + BS COPD) and 52 healthy controls (HC) who have never been exposed neither to TS or BS. Blood cell counts, C-reactive protein (CRP), fibrinogen and immunoglobulin E (IgE) levels were quantified in all four groups. Results TS + BS COPD patients exhibited significantly lower oxygen saturation than the rest of groups (p < 0.01). Spirometry and diffusing capacity were significantly higher in BS than in TS or TS + BS patients. CRP levels were significantly higher in TS COPD patients than in BS COPD group (p < 0.05), whereas fibrinogen was raised in COPD patients with a history of smoking (TS and TS + BS) when compared to control subjects (p < 0.01). Finally, COPD patients with BS exposure (BS and BS + TS groups) showed higher IgE levels than TS and HC (p < 0.05). Conclusions There are significant physiological and inflammatory differences between COPD patients with TS, BS and TS + BS exposures. The latter had worse blood oxygenation, whereas the raised levels of IgE in BS exposed patients suggests a differential Th2 systemic inflammatory pattern triggered by this pollutant.
Collapse
Affiliation(s)
- Jordi Olloquequi
- Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 5 Poniente #1670, 3460000, Talca, Chile.
| | - Sergio Jaime
- Unidad Respiratorio, Centro de Diagnóstico Terapéutico, Hospital Regional de Talca, 1 Norte #1990, 3460000, Talca, Chile
| | - Viviana Parra
- Unidad Respiratorio, Centro de Diagnóstico Terapéutico, Hospital Regional de Talca, 1 Norte #1990, 3460000, Talca, Chile
| | | | - Gonzalo Valdivia
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Av. Libertador Bernardo O'Higgins #340, 35420000, Santiago, Chile
| | - Àlvar Agustí
- Respiratory Institute, Hospital Clínic, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona, Rosselló #149-153, 08036, Barcelona, Catalonia, Spain
| | - Rafael Silva O
- Unidad Respiratorio, Centro de Diagnóstico Terapéutico, Hospital Regional de Talca, 1 Norte #1990, 3460000, Talca, Chile
| |
Collapse
|
13
|
Sood A, Assad NA, Barnes PJ, Churg A, Gordon SB, Harrod KS, Irshad H, Kurmi OP, Martin WJ, Meek P, Mortimer K, Noonan CW, Perez-Padilla R, Smith KR, Tesfaigzi Y, Ward T, Balmes J. ERS/ATS workshop report on respiratory health effects of household air pollution. Eur Respir J 2018; 51:51/1/1700698. [PMID: 29301918 DOI: 10.1183/13993003.00698-2017] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/08/2017] [Indexed: 12/18/2022]
Abstract
Exposure to household air pollution (HAP) from solid fuel combustion affects almost half of the world population. Adverse respiratory outcomes such as respiratory infections, impaired lung growth and chronic obstructive pulmonary disease have been linked to HAP exposure. Solid fuel smoke is a heterogeneous mixture of various gases and particulates. Cell culture and animal studies with controlled exposure conditions and genetic homogeneity provide important insights into HAP mechanisms. Impaired bacterial phagocytosis in exposed human alveolar macrophages possibly mediates several HAP-related health effects. Lung pathological findings in HAP-exposed individuals demonstrate greater small airways fibrosis and less emphysema compared with cigarette smokers. Field studies using questionnaires, air pollution monitoring and/or biomarkers are needed to better establish human risks. Some, but not all, studies suggest that improving cookstove efficiency or venting emissions may be associated with reduced respiratory symptoms, lung function decline in women and severe pneumonia in children. Current studies focus on fuel switching, stove technology replacements or upgrades and air filter devices. Several governments have initiated major programmes to accelerate the upgrade from solid fuels to clean fuels, particularly liquid petroleum gas, which provides research opportunities for the respiratory health community.
Collapse
Affiliation(s)
- Akshay Sood
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Nour A Assad
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Peter J Barnes
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew Churg
- University of British Columbia, Vancouver, BC, Canada
| | | | - Kevin S Harrod
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hammad Irshad
- Lovelace Respiratory Research Institute, Albuquerque, NM, USA
| | | | | | - Paula Meek
- University of Colorado at Denver, Denver, CO, USA
| | | | | | | | - Kirk R Smith
- University of California School of Public Health, Berkeley, CA, USA
| | | | - Tony Ward
- University of Montana, Missoula, MT, USA
| | - John Balmes
- University of California School of Public Health, Berkeley, CA, USA.,University of California, San Francisco, CA, USA
| |
Collapse
|
14
|
Zhao D, Zhou Y, Jiang C, Zhao Z, He F, Ran P. Small airway disease: A different phenotype of early stage COPD associated with biomass smoke exposure. Respirology 2017; 23:198-205. [PMID: 28906034 DOI: 10.1111/resp.13176] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/18/2017] [Accepted: 06/26/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Dongxing Zhao
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - Yumin Zhou
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - Changbin Jiang
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - Zhuxiang Zhao
- Guangzhou First People's Hospital; Guangzhou Medical University; Guangzhou China
| | - Fang He
- The School of Basic Medicine; Guangzhou Medical University; Guangzhou China
| | - Pixin Ran
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| |
Collapse
|
15
|
López-Campos JL, Fernández-Villar A, Calero-Acuña C, Represas-Represas C, López-Ramírez C, Leiro Fernández V, Casamor R. Occupational and Biomass Exposure in COPD: Results of a Cross-Sectional Analysis of the On-Sint Study. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.arbr.2016.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
16
|
Pleasants RA, Riley IL, Mannino DM. Defining and targeting health disparities in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2016; 11:2475-2496. [PMID: 27785005 PMCID: PMC5065167 DOI: 10.2147/copd.s79077] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The global burden of chronic obstructive pulmonary disease (COPD) continues to grow in part due to better outcomes in other major diseases and in part because a substantial portion of the worldwide population continues to be exposed to inhalant toxins. However, a disproportionate burden of COPD occurs in people of low socioeconomic status (SES) due to differences in health behaviors, sociopolitical factors, and social and structural environmental exposures. Tobacco use, occupations with exposure to inhalant toxins, and indoor biomass fuel (BF) exposure are more common in low SES populations. Not only does SES affect the risk of developing COPD and etiologies, it is also associated with worsened COPD health outcomes. Effective interventions in these people are needed to decrease these disparities. Efforts that may help lessen these health inequities in low SES include 1) better surveillance targeting diagnosed and undiagnosed COPD in disadvantaged people, 2) educating the public and those involved in health care provision about the disease, 3) improving access to cost-effective and affordable health care, and 4) markedly increasing the efforts to prevent disease through smoking cessation, minimizing use and exposure to BF, and decreasing occupational exposures. COPD is considered to be one the most preventable major causes of death from a chronic disease in the world; therefore, effective interventions could have a major impact on reducing the global burden of the disease, especially in socioeconomically disadvantaged populations.
Collapse
Affiliation(s)
- Roy A Pleasants
- Duke Asthma, Allergy, and Airways Center
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine
- Durham VA Medical Center, Durham, NC
| | - Isaretta L Riley
- Duke Asthma, Allergy, and Airways Center
- Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine
- Durham VA Medical Center, Durham, NC
| | - David M Mannino
- Division of Pulmonary, Critical Care, and Sleep Medicine, Pulmonary Epidemiology Research Laboratory, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
17
|
Is Chronic Obstructive Pulmonary Disease Caused by Wood Smoke a Different Phenotype or a Different Entity? ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.arbr.2016.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
18
|
Torres-Duque CA, García-Rodriguez MC, González-García M. Is Chronic Obstructive Pulmonary Disease Caused by Wood Smoke a Different Phenotype or a Different Entity? Arch Bronconeumol 2016; 52:425-31. [PMID: 27207325 DOI: 10.1016/j.arbres.2016.04.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 04/03/2016] [Accepted: 04/04/2016] [Indexed: 01/29/2023]
Abstract
Around 40% of the world's population continue using solid fuel, including wood, for cooking or heating their homes. Chronic exposure to wood smoke is a risk factor for developing chronic obstructive pulmonary disease (COPD). In some regions of the world, this can be a more important cause of COPD than exposure to tobacco smoke from cigarettes. Significant differences between COPD associated with wood smoke (W-COPD) and that caused by smoking (S-COPD) have led some authors to suggest that W-COPD should be considered a new COPD phenotype. We present a review of the differences between W-COPD and S-COPD. On the premise that wood smoke and tobacco smoke are not the same and the physiopathological mechanisms they induce may differ, we have analyzed whether W-COPD can be considered as another COPD phenotype or a distinct nosological entity.
Collapse
|
19
|
López-Campos JL, Fernández-Villar A, Calero-Acuña C, Represas-Represas C, López-Ramírez C, Fernández VL, Casamor R. Occupational and Biomass Exposure in Chronic Obstructive Pulmonary Disease: Results of a Cross-Sectional Analysis of the On-Sint Study. Arch Bronconeumol 2016; 53:7-12. [PMID: 27432162 DOI: 10.1016/j.arbres.2016.04.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/19/2016] [Accepted: 04/20/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although tobacco smoke is the main risk factor for chronic obstructive pulmonary disease (COPD), other inhaled toxics have also been associated with the disease. The present study analyzes data from exposure to these substances in a cohort of patients with COPD and assesses their impact on the clinical presentation of the disease. METHODS This is a cross-sectional analysis of the Clinical presentation, diagnosis and course of chronic obstructive pulmonary disease (On-Sint) study. All patients were smokers or ex-smokers as per protocol. In addition, during the inclusion visit patients were enquired about their occupational and biomass exposure history. The clinical features of patients with and without an added risk factor to tobacco were compared and those significant were entered in a multivariate logistic regression analysis, expressed as odds ratio (OR). RESULTS The sample size was 1214 patients with COPD, of which 1012 (83.4%) had tobacco as the only risk factor and 202 (16.6%) had additional ones, mainly 174 (14.3%) with occupational gases and 32 (2.6%) with biomass exposure. The geographical distribution of this exposure showed a preference for the northern parts of the country and the East coast. The biomass exposure was rather low. Male gender (OR: 2.180), CAT score (OR: 1.036) and the use of long-term oxygen therapy (OR: 1.642) were associated with having an additional risk factor in the multivariate analysis. CONCLUSIONS Occupational exposures are more common than biomass in Spain. COPD caused by tobacco plus other inhalants has some differential features and a more impaired quality of life.
Collapse
Affiliation(s)
- José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
| | - Alberto Fernández-Villar
- Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España
| | - Carmen Calero-Acuña
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España
| | - Cristina Represas-Represas
- Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España
| | - Cecilia López-Ramírez
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España
| | - Virginia Leiro Fernández
- Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España
| | - Ricard Casamor
- Departamento Médico, Novartis Farmacéutica, Barcelona, España
| |
Collapse
|
20
|
The chronic bronchitis phenotype in chronic obstructive pulmonary disease: features and implications. Curr Opin Pulm Med 2016; 21:133-41. [PMID: 25575367 DOI: 10.1097/mcp.0000000000000145] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Chronic obstructive pulmonary disease (COPD) is a major public health problem that is projected to rank fifth worldwide in terms of disease burden and third in terms of mortality. Chronic bronchitis is associated with multiple clinical consequences, including hastening lung function decline, increasing risk of exacerbations, reducing health-related quality of life, and possibly raising all-cause mortality. Recent data suggest greater elucidation on the risk factors, radiologic characteristics, and treatment regimens. Our goal was to review the literature on chronic bronchitis that has been published in the past few years. RECENT FINDINGS A growing body of literature that more carefully describes environmental risk factors, epidemiology, and genetics associated with chronic bronchitis. In addition, as computed tomography technology continues to improve, the radiologic phenotype associated with chronic bronchitis is better understood. SUMMARY With these new data, the clinician can recognize the newly described risk factors and the associated phenotype for chronic bronchitis and entertain new treatment options for this high-risk population.
Collapse
|
21
|
Gordon SB, Bruce NG, Grigg J, Hibberd PL, Kurmi OP, Lam KBH, Mortimer K, Asante KP, Balakrishnan K, Balmes J, Bar-Zeev N, Bates MN, Breysse PN, Buist S, Chen Z, Havens D, Jack D, Jindal S, Kan H, Mehta S, Moschovis P, Naeher L, Patel A, Perez-Padilla R, Pope D, Rylance J, Semple S, Martin WJ. Respiratory risks from household air pollution in low and middle income countries. THE LANCET RESPIRATORY MEDICINE 2014; 2:823-60. [PMID: 25193349 DOI: 10.1016/s2213-2600(14)70168-7] [Citation(s) in RCA: 516] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A third of the world's population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5-4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.
Collapse
Affiliation(s)
- Stephen B Gordon
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Nigel G Bruce
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Jonathan Grigg
- Centre for Paediatrics, Blizard Institute, Queen Mary, University of London, London, UK
| | - Patricia L Hibberd
- Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
| | - Om P Kurmi
- Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kin-bong Hubert Lam
- Institute of Occupational and Environmental Medicine, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Kevin Mortimer
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kwaku Poku Asante
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India
| | - John Balmes
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Naor Bar-Zeev
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Michael N Bates
- Divisions of Epidemiology and Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Patrick N Breysse
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sonia Buist
- Oregon Health and Science University, Portland, OR, USA
| | - Zhengming Chen
- Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Deborah Havens
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Darby Jack
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China
| | - Sumi Mehta
- Health Effects Institute, Boston, MA, USA
| | - Peter Moschovis
- Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA
| | - Luke Naeher
- The University of Georgia, College of Public Health, Department of Environmental Health Science, Athens, GA, USA
| | | | | | - Daniel Pope
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Jamie Rylance
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Sean Semple
- University of Aberdeen, Scottish Centre for Indoor Air, Division of Applied Health Sciences, Royal Aberdeen Children's Hospital, Aberdeen, UK
| | - William J Martin
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, USA.
| |
Collapse
|
22
|
Golpe R, Sanjuán López P, Cano Jiménez E, Castro Añón O, Pérez de Llano LA. Distribution of clinical phenotypes in patients with chronic obstructive pulmonary disease caused by biomass and tobacco smoke. Arch Bronconeumol 2014; 50:318-24. [PMID: 24576449 DOI: 10.1016/j.arbres.2013.12.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 12/18/2013] [Accepted: 12/19/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Exposure to biomass smoke is a risk factor for chronic obstructive pulmonary disease (COPD). It is unknown whether COPD caused by biomass smoke has different characteristics to COPD caused by tobacco smoke. OBJECTIVE To determine clinical differences between these two types of the disease. METHODS Retrospective observational study of 499 patients with a diagnosis of COPD due to biomass or tobacco smoke. The clinical variables of both groups were compared. RESULTS There were 122 subjects (24.4%) in the biomass smoke group and 377 (75.5%) in the tobacco smoke group. In the tobacco group, the percentage of males was higher (91.2% vs 41.8%, P<.0001) and the age was lower (70.6 vs 76.2 years, P<.0001). Body mass index and FEV1% values were higher in the biomass group (29.4±5.7 vs 28.0±5.1, P=.01, and 55.6±15.6 vs 47.1±17.1, P<.0001, respectively). The mixed COPD-asthma phenotype was more common in the biomass group (21.3% vs 5%, P<.0001), although this difference disappeared when corrected for gender. The emphysema phenotype was more common in the tobacco group (45.9% vs 31.9%, P=.009). The prevalence of the chronic bronchitis and exacerbator phenotypes, the comorbidity burden and the rate of hospital admissions were the same in both groups. CONCLUSION Differences were observed between COPD caused by biomass and COPD caused by tobacco smoke, although these may be attributed in part to uneven gender distribution between the groups.
Collapse
Affiliation(s)
- Rafael Golpe
- Servicio de Neumología, Hospital Universitario Lucus Augusti, Lugo, España.
| | | | | | - Olalla Castro Añón
- Servicio de Neumología, Hospital Universitario Lucus Augusti, Lugo, España
| | | |
Collapse
|
23
|
Golpe R, Sanjuán López P, Cano Jiménez E, Castro Añón O, Pérez de Llano LA. Distribution of Clinical Phenotypes in Patients With Chronic Obstructive Pulmonary Disease Caused by Biomass and Tobacco Smoke. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.arbr.2014.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Pérez-Padilla R, Ramirez-Venegas A, Sansores-Martinez R. Clinical Characteristics of Patients With Biomass Smoke-Associated COPD and Chronic Bronchitis, 2004-2014. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2014; 1:23-32. [PMID: 28848808 PMCID: PMC5559138 DOI: 10.15326/jcopdf.1.1.2013.0004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2014] [Indexed: 12/16/2022]
Abstract
Individuals with chronic obstructive pulmonary disease (COPD) associated with biomass smoke inhalation tend to be women born in rural areas with lifelong exposure to open fires while cooking, but can also include persons with prenatal and childhood exposure. Compared with individuals with COPD due to tobacco smoking, individuals exposed to biomass smoke uncommonly have severe airflow obstruction, low diffusing capacity of the lung for carbon monoxide (DLCO) or emphysema in high-resolution computed tomography (HRCT) but cough, phlegm and airway thickening and air trapping are very common. Autopsies of patients with COPD from biomass smoke exposure show increased pulmonary artery small vessel intimal thickening which may explain pulmonary hypertension, in addition to emphysema and airway disease. Research on similarities and differences in lung damage produced by exposure to biomass fuel smoke while cooking vs. smoking tobacco may provide new insights on COPD. As a public health problem, COPD caused by inhalation of smoke from burning solid fuel is as relevant as COPD caused by smoking tobacco but mainly affects women and children from disadvantaged areas and countries and requires an organized effort for its control. Improved vented biomass stoves are currently the most feasible intervention, but even more efficient stoves are necessary to reduce the biomass smoke exposure and reduce incidence of COPD among this population.
Collapse
|
25
|
Kapoor S. Mounier-Kuhn syndrome: a rare and often overlooked cause of bronchial dilation and recurrent respiratory tract infections. J Bras Pneumol 2014; 40:96-7. [PMID: 24626279 PMCID: PMC4075921 DOI: 10.1590/s1806-37132014000100017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
|