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High altitude residents
Published in Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson, Ward, Milledge and West's High Altitude Medicine and Physiology, 2021
Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson
One important fact that may account for development of COPD in high altitude regions despite relatively low tobacco consumption is exposure to household air pollution from burning of biomass, a common problem across many rural high altitude regions. This has been shown in multiple studies to be associated with increased risk for COPD in low and middle income countries (Brakema et al. 2019; Kurmi et al. 2010; Siddharthan et al. 2018), although some more recent data have called this relationship into question (Amaral et al. 2018). Concerns have been raised about some of the methodological limitations of the studies on this question, including the utility of cross-section versus longitudinal designs, as well as the fact that a key variable in these studies, biomass exposure, is often measured based on self-report of solid fuel use and, therefore, subject to the effects of recall bias (Balmes and Eisen 2018). To the extent that it does affect the risk of COPD, public health interventions designed to improve access to safer heating and cooking systems can reduce the burden of lung disease among high altitude residents.
Respiratory Diseases
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
The major contributing factors to respiratory diseases include genetic mutations, exposure to environmental and occupational carcinogens, and tobacco use disorder. Ambient air pollution alone is considered a major public health concern globally and is thought to contribute to a mortality rate of 8.8 million per year through non-communicable diseases including cardiovascular and respiratory diagnoses (see Table 11.1).1 Air pollution, primarily associated with fossil fuel use, is estimated to cause a loss of life expectancy of 2.9 (2.3–3.5) years, which exceeds the effects of smoking and consequences of violence.1 Certain geographical and lower-income regions, such as Sub-Saharan Africa, experience lower life expectancy as well as higher than average air pollution-induced infant mortality rates, secondary to the additional risk factor of high household air pollution associated with indoor use of solid biofuels.1
Age and lifecourse transitions in health
Published in Kevin McCracken, David R. Phillips, Global Health, 2017
Kevin McCracken, David R. Phillips
‘Health risk’ is defined by the WHO (2009a, p. v) as ‘a factor that raises the probability of adverse health outcomes’. Adverse outcomes could include subsequently developing any given disease or health condition – physical, mental or emotional. Risk transition relates to the changing sources and levels of risk over time, for individuals, groups and places, so it is very relevant to age and lifecourse transitions in health. The WHO (2009a) sees major risks to health shifting over time. This shift would tend to be from ‘traditional’ risks (such as inadequate nutrition or exposure to infections via unsafe water and sanitation, often associated with poverty and affecting low-income populations) to modern risks with a greater lifestyle component (such as overweight and obesity, inactivity, or exposure to carcinogenic substances), often associated with chronic and non-communicable diseases. There are also varying health risk environments to which people are differentially exposed, as noted in Chapter 5. Comparative risk assessment and how this changes over time is reported by the GBD 2015 Risk Factors Collaborators (2016) (see also Chapter 7). For example, from 1990 and 2015, global exposure to some risks or clusters of risks decreased by over 25 per cent, including unsafe sanitation, household air pollution, childhood underweight, childhood stunting and smoking. By contrast, over the same period they found ‘global exposure for several occupational risks, high body-mass index, and drug use increased by more than 25 per cent’.
Household use of biomass fuel, especially traditional stove is associated with childhood wheeze and eczema: a cross sectional study of rural communities in Kandy, Sri Lanka
Published in Journal of Asthma, 2023
Olivia Lall, Gayan Bowatte, Samath Dharmaratne, Adrian J. Lowe, Alicia Vakalopoulos, Isabella Ambrose, Pasan Jayasinghe, Duminda Yasaratne, Jane Heyworth, Shyamali C. Dharmage
Exposure to household air pollution was assessed by the following:Primary fuel type—the type of fuel primarily used for cooking in a household, with the options of clean fuel (LPG, electricity, or biogas) or biomass fuel (firewood or crop residue—coconut shells/husks/leaves and rice husks).Primary stove type—the type of stove primarily used in a household, with the options of the clean stove (gas or electric), improved biomass cookstove, or traditional biomass cookstove.Chimney—The presence or not of a chimney on the primary biomass cookstove.
Strategies for the prevention, diagnosis and treatment of COPD in low- and middle- income countries: the importance of primary care
Published in Expert Review of Respiratory Medicine, 2021
Foteini M Rossaki, John R Hurst, Frederik van Gemert, Bruce J Kirenga, Siân Williams, Ee Ming Khoo, Ioanna Tsiligianni, Aizhamal Tabyshova, Job FM van Boven
The major source of household air pollution is the use of biomass fuels (e.g. wood, crop waste, and animal dung) for cooking and heating. Other examples include kerosene lamps, burning incense sticks in religious places and burning mosquito repellent coils [44]. Three billion people worldwide, accounting for 40% of households, make use of solid fuels and 90% of rural households located in LMICs rely on them [45]. The epicenter of solid fuel consumption are LMICs and especially Africa [46,47]. Exposure to household air pollution is a serious health hazard. In a recent study focusing on household air pollution in 13 LMICs, exposure increased the risk of COPD by 41% [45]. The population that is most at risk for developing COPD due to biomass exposure are women living in rural areas, possibly due to extended hours spent indoors. Interestingly, it appears that different etiologies of COPD influence the phenotype of the disease. For example, biomass-induced COPD is often observed in younger patients and is associated with more acute symptoms compared to smoking-induced COPD. In addition, biomass-induced COPD is characterized by more frequent acute exacerbations and greater number of hospitalizations [44].
Acute changes in lung function following controlled exposure to cookstove air pollution in the subclinical tests of volunteers exposed to smoke (STOVES) study
Published in Inhalation Toxicology, 2020
Kristen M. Fedak, Nicholas Good, Ethan S. Walker, John Balmes, Robert D. Brook, Maggie L. Clark, Tom Cole-Hunter, Robert Devlin, Christian L’Orange, Gary Luckasen, John Mehaffy, Rhiannon Shelton, Ander Wilson, John Volckens, Jennifer L. Peel
Nearly 40% of the world’s population cooks over open fires or with rudimentary stoves that burn solid fuels, which generates high levels of household air pollution (Bonjour et al. 2013). Exposures to this pollution were estimated to contribute to approximately 59 million disability-adjusted life-years in 2017, including over 1.6 million premature deaths - primarily in the form of respiratory and cardiovascular diseases (Stanaway et al. 2018). Approaches to reduce disease burden from household air pollution have included switching to cookstoves designed to emit lower levels of fine particulate matter mass (PM2.5) and/or carbon monoxide (CO). Cookstove emissions can vary substantially across different stoves and fuels however (Bilsback et al. 2018), and it is unclear how these differences in exposures across stoves contribute to different health responses. Although some research has demonstrated the potential for improved stoves to reduce human exposures (Thomas et al. 2015) and associated pulmonary effects (Fullerton et al. 2011; da Silva et al. 2012), other studies have not demonstrated the expected health benefits following dissemination of improved stoves (Romieu et al. 2009; Smith-Sivertsen et al. 2009; Smith et al. 2011; Mortimer et al. 2017).