Association between the duration of exposure to biomass fuel smoke with increased respiratory symptoms and impaired respiratory functions of women in Sri Lanka

Clinical Research Results Abstract Introduction: Women using biomass fuel for cooking (WBMF) in Sri Lanka have shown increased respiratory symptoms and impaired respiratory functions which may be influenced by the duration of exposure to smoke. The objective of this study was to determine the association between the duration of exposure to biomass fuel smoke with increased respiratory symptoms and impaired respiratory functions of WBMF. Methods: Descriptive cross-sectional study was conducted among adult WBMF in the selected villages in the Colombo District, Sri Lanka (n=363) recruited using a two-stage cluster sampling method. Duration of exposure was assessed using biomass fuel smoke exposure index (BMF-EI) calculated by hours of cooking per day multiplied by years of cooking. Respiratory symptoms were assessed using a questionnaire and respiratory functions were assessed using spirometry, fractional exhaled Nitric Oxide (FENO), and exhaled breath Carbon monoxide (eCO). Data were analysed using SPSS ver 23 statistical package at p<0.05. Results: BMF-EI >150 hours-years was significantly associated with cough (OR = 2.74; 95% CI 1.12 – 6.69) and both cough and phlegm (OR = 2.68; 95% CI 1.04 – 8.26). WBMF with BMF-EI >150 hours-years had a significantly lower mean FEV1 (1.49L ±0.43SD vs 1.92L ±0.47SD) and a significantly higher eCO level (2.40ppb ±1.39SD vs. 2.20ppb ±1.37SD) compared to WBMF with BMF-EI ≤150 hours-years. However, the mean FENO level did not show a significant difference between the groups. Discussion: With increasing age, the years of cooking and thus, BMF-EI also increased. Thus, both ageing and increased duration of exposure have a substantial contribution to the increased respiratory symptoms and impaired respiratory functions observed in WBMF. The use of thermally efficient cookstoves and cooking utensils can reduce the duration of cooking and thus, the duration of exposure to biomass fuel smoke to reduce the progression of respiratory illnesses. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Funding - University Research Grants of University of Sri Jayewardenepura, Sri Lanka (ASP/01/RE/MED/2017/35) References and Clinical Trial Registry Information