Diaz Janet V, Koff Jonathan, Gotway Michael B, Nishimura Stephen, Balmes John R
Department of Medicine, Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California at San Francisco, San Francisco, California 94110, USA.
Environ Health Perspect. 2006 May;114(5):759-62. doi: 10.1289/ehp.8489.
Biomass serves as a major fuel source for >50% of the world's population. The global burden of disease attributed to indoor air pollution from biomass combustion accounts for approximately 3% of worldwide disability-adjusted life-years lost. This is due to pneumonia in children and chronic obstructive pulmonary disease and lung cancer in women.
A 53-year-old man from Mexico was referred to the pulmonary clinic for evaluation of chronic productive cough and pulmonary nodules. In his youth, he worked at a charcoal plant in Mexico, where he burned wood and was exposed to massive amounts of smoke. His evaluation revealed thickened bronchovascular bundles with nodules on thoracic computed tomography, dark black plaques in large airways on bronchoscopy, and carbon-laden macrophages and fibrotic scars on lung biopsy.
The patient was diagnosed with "hut lung," a term that refers to the noninfectious, nonmalignant respiratory manifestations of chronic, high-level exposures to biomass smoke. This is the first reported case of hut lung associated with charcoal production. This case highlights that histopathologic abnormalities of the lung parenchyma may be present in patients with only mild symptoms and that clinical progression is likely a function of both the duration and intensity of exposure.
As residents of lesser developed countries continue to be exposed to high levels of biomass smoke at work or at home and continue to immigrate to developed countries, it is important that health care providers in developed countries be aware of biomass-smoke-related pulmonary disease.
生物质是世界上超过50%人口的主要燃料来源。生物质燃烧导致的室内空气污染造成的全球疾病负担约占全球伤残调整生命年损失的3%。这是由儿童肺炎以及女性慢性阻塞性肺疾病和肺癌所致。
一名来自墨西哥的53岁男性因慢性咳痰和肺结节被转诊至肺科门诊。他年轻时在墨西哥的一家木炭厂工作，在那里他烧木材并接触大量烟雾。他的检查显示胸部计算机断层扫描有支气管血管束增粗并伴有结节，支气管镜检查发现大气道有深黑色斑块，肺活检有含碳巨噬细胞和纤维化瘢痕。
该患者被诊断为“茅屋肺”，这一术语指的是长期、大量接触生物质烟雾所导致的非感染性、非恶性呼吸系统表现。这是首例与木炭生产相关的茅屋肺报告病例。该病例凸显出仅有轻微症状的患者肺部实质可能存在组织病理学异常，且临床进展可能是接触时间和强度共同作用的结果。
由于欠发达国家的居民在工作或家中持续接触高浓度的生物质烟雾，且不断移民至发达国家，发达国家的医疗保健人员了解与生物质烟雾相关的肺部疾病很重要。
