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PLoS One. 2014 Mar 13;9(3):e88455. doi: 10.1371/journal.pone.0088455. eCollection 2014.

Effects of woodsmoke exposure on airway inflammation in rural Guatemalan women.

Author information

1
Department of Medicine, University of California San Francisco, San Francisco, California, United States of America.
2
Medical Entomology Research, University del Valle, Guatemala City, Guatemala.
3
Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom.
4
Environmental Health Sciences, School of Public Health, University of California, Berkeley, California, United States of America.
5
Research Unit for General Practice, Uni Research, Bergen, Norway.
6
Department of Medicine, University of California San Francisco, San Francisco, California, United States of America; School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia.
7
Emerging Infectious Disease Unit, University del Valle, Guatemala City, Guatemala.
8
Department of Medicine, University of California San Francisco, San Francisco, California, United States of America; Environmental Health Sciences, School of Public Health, University of California, Berkeley, California, United States of America.

Abstract

BACKGROUND:

More than two-fifths of the world's population uses solid fuels, mostly biomass, for cooking. The resulting biomass smoke exposure is a major cause of chronic obstructive pulmonary disease (COPD) among women in developing countries.

OBJECTIVE:

To assess whether lower woodsmoke exposure from use of a stove with a chimney, compared to open fires, is associated with lower markers of airway inflammation in young women.

DESIGN:

We carried out a cross-sectional analysis on a sub-cohort of participants enrolled in a randomized controlled trial in rural Guatemala, RESPIRE.

PARTICIPANTS:

We recruited 45 indigenous women at the end of the 18-month trial; 19 women who had been using the chimney stove for 18-24 months and 26 women still using open fires.

MEASUREMENTS:

We obtained spirometry and induced sputum for cell counts, gene expression of IL-8, TNF-α, MMP-9 and 12, and protein concentrations of IL-8, myeloperoxidase and fibronectin. Exhaled carbon monoxide (CO) and 48-hr personal CO tubes were measured to assess smoke exposure.

RESULTS:

MMP-9 gene expression was significantly lower in women using chimney stoves. Higher exhaled CO concentrations were significantly associated with higher gene expression of IL-8, TNF-α, and MMP-9. Higher 48-hr personal CO concentrations were associated with higher gene expression of IL-8, TNF- α, MMP-9 and MMP-12; reaching statistical significance for MMP-9 and MMP-12.

CONCLUSIONS:

Compared to using an open wood fire for cooking, use of a chimney stove was associated with lower gene expression of MMP-9, a potential mediator of airway remodeling. Among all participants, indoor biomass smoke exposure was associated with higher gene expression of multiple mediators of airway inflammation and remodeling; these mechanisms may explain some of the observed association between prolonged biomass smoke exposure and COPD.

PMID:
24625755
PMCID:
PMC3953023
DOI:
10.1371/journal.pone.0088455
[Indexed for MEDLINE]
Free PMC Article

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