Lung Function in Rural Guatemalan Women Before and After a Chimney Stove Intervention to Reduce Woodsmoke Exposure:Results From RESPIRE and CRECER. Chest, June 2015.
Authors: Michael Guarnieri; Esperanza Diaz; Daniel Pope; Ellen Eisen; Jennifer Mann; Kirk R. Smith; Tone Smith-Sivertsen; Nigel Bruce; John Balmes
Background: Chronic Obstructive Pulmonary Disease (COPD) is the third most frequent cause of death globally with much of this burden attributable to household biomass smoke exposure in developing countries. As biomass smoke exposure is also associated with cardiovascular disease, lower respiratory infection, lung cancer, and cataracts, it presents an important target for public health intervention.
Methods: Lung function in Guatemalan women exposed to woodsmoke from open fires was measured throughout the RESPIRE stove intervention trial, and continued during the CRECER cohort study. In RESPIRE, early stove households received a chimney woodstove at the beginning of the 18-month trial while delayed stove households received a stove at trial completion. Personal exposure to woodsmoke was assessed with exhaled breath carbon monoxide and personal CO tubes. Change in lung function between intervention groups and as a function of woodsmoke exposure was assessed using random effects models.
Results: Of 306 women participating in both studies, acceptable spirometry was collected in 129 early stove and 136 delayed stove households (n=265), with 5.6 years mean follow-up. Despite reduced woodsmoke exposures in early stove households, there were no significant differences in any of the measured spirometric variables during the study period; FEV1, FVC, FEV1/FVC ratio, and annual change, after adjustment for confounding.
Conclusion: In these young Guatemalan women, there was no association between lung function and early randomization to a chimney stove or personal woodsmoke exposure. Future stove intervention trials should incorporate cleaner stoves, longer follow-up, or potentially susceptible groups to identify meaningful differences in lung function.
