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Effects Of Woodsmoke Exposure Reduction On Airway Inflammation In Rural, Guatemalan Women
Abstract   Peer reviewed

Effects Of Woodsmoke Exposure Reduction On Airway Inflammation In Rural, Guatemalan Women

Michael Guarnieri, Janet V Diaz, Chandreyi Basu, Anaite Diaz, Daniel Pope, Kirk Smith, Tone Smith-Sivertsen, Nigel Bruce, Colin Solomon, John McCracken, …
American Journal of Respiratory and Critical Care Medicine, Vol.189
American Thoracic Society (ATS) International Conference: Where today's science meets tomorrow's care, 2014 (San Diego, United States, 16-May-2014–21-May-2014)
2014
url
https://cms.psav.com/cPaper2014/ats2014View
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Abstract

Medical and Health Sciences woodsmoke exposure airway inflammation women
Rationale: More than two-fifths of the world's population uses solid fuels, mostly biomass, for cooking. Household air pollution from solid fuels is the 4th largest risk factor contributing to the global burden of disease, much of this related to the development of chronic obstructive pulmonary disease (COPD) among non-smoking women in developing countries. To assess whether reducing woodsmoke exposure using a chimney-stove, compared to open fires, decreased markers of airway inflammation associated with COPD pathogenesis, we recruited young biomass smoke-exposed women who were participating in a randomized controlled stove intervention trial, RESPIRE. Design: We carried out a cross-sectional analysis on a sub-cohort of RESPIRE participants, including 45 indigenous women remaining at the end of the 18-month trial. Of these women,19 had previously been randomized to receive a chimney stove and 26 continued cooking over an open fire. We obtained spirometry and induced sputum for differential cell counts, gene expression of interleukin(IL)-8, tumor necrosis factor(TNF)-α, matrix metalloprotease (MMP)-9 and 12, and protein concentrations of IL-8, myeloperoxidase and fibronectin. Exposure-response regression analyses were performed using these outcomes with exhaled carbon monoxide (CO) and 48-hr personal CO tubes as markers of biomass smoke exposure. Results: MMP-9 gene expression was significantly reduced in women using chimney stoves compared to open fires. Exhaled CO concentration was significantly associated with IL-8, TNF-α, and MMP-9 gene expression. 48-hr personal CO concentrations were significantly associated with MMP-9 and MMP-12 gene expression. Percent neutrophils and fibronectin concentration were negatively correlated with FEV1. No significant associations were seen by stove-type or exposure for lung function or sputum cell counts in this small sample. Conclusions: Decreased biomass smoke exposure is associated with decreased gene expression of MMP-9, MMP-12, IL-8, and TNF-α, potential mediators of airway remodeling in COPD. Reducing biomass smoke exposure with a chimney stove may reduce airway inflammation, though larger studies are needed to clarify whether such reductions would be effective in decreasing COPD incidence or progression.

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