Moreira Maria Auxiliadora Carmo, Moraes Maria Rosedália de, Silva Daniela Graner Schwartz Tannus, Pinheiro Thayssa Faria, Vasconcelos Júnior Huber Martins, Maia Lanucy Freita de Lima, Couto Daine Vargas do
Pulmonology Department, Federal University of Goiás, School of Medicine. Goiânia, Brazil.
J Bras Pneumol. 2008 Sep;34(9):667-74. doi: 10.1590/s1806-37132008000900006.
OBJECTIVE: To describe and analyze clinical symptoms and spirometric alterations of patients with chronic obstructive pulmonary disease (COPD) and history of exposure to wood and tobacco smoke. METHODS: We retrospectively evaluated data related to 170 patients distributed into 3 groups: 34 exposed only to wood smoke, 59 patients exposed only to tobacco smoke and 77 patients exposed to both. RESULTS: The groups did not differ significantly in terms of age (p = 0.225) or degree of exposure, considering each type of exposure in isolation or in combination (p = 0.164 and p = 0.220, respectively). Females predominated in the group exposed to wood smoke. There were no differences among the groups regarding respiratory symptoms (p > 0.05), and moderate dyspnea predominated in the three groups (p = 0.141). The group exposed to wood smoke presented higher percentages of forced expiratory volume in one second/forced vital capacity ratio and of forced expiratory volume in one second (p < 0.05). Positive results on bronchodilator testing occurred more frequently in the group exposed to tobacco smoke. The percentage of severe and extremely severe obstruction was significantly higher in the group exposed to tobacco smoke (44.1%) than in that exposed to wood smoke (11.8%; p = 0.006). CONCLUSIONS: Respiratory symptoms and pulmonary function alterations consistent with COPD were observed in the groups of patients exposed to wood smoke. However, those alterations were not as significant as the alterations observed in the groups exposed to tobacco smoke. This study emphasizes the importance of prospective studies in evaluating the risk of wood-smoke-related COPD in Brazil, as well as the need for preventive measures in this area.
目的:描述并分析患有慢性阻塞性肺疾病(COPD)且有木材烟雾和烟草烟雾暴露史患者的临床症状及肺量计变化。 方法:我们回顾性评估了170例患者的数据,这些患者分为3组:34例仅暴露于木材烟雾,59例仅暴露于烟草烟雾,77例同时暴露于两者。 结果:就年龄而言,各组间无显著差异(p = 0.225);单独或综合考虑每种暴露类型时,暴露程度也无显著差异(分别为p = 0.164和p = 0.220)。暴露于木材烟雾的组中女性占多数。各组在呼吸症状方面无差异(p > 0.05),三组中均以中度呼吸困难为主(p = 0.141)。暴露于木材烟雾的组一秒用力呼气容积/用力肺活量比值和一秒用力呼气容积的百分比更高(p < 0.05)。支气管扩张试验阳性结果在暴露于烟草烟雾的组中更常见。暴露于烟草烟雾的组中重度和极重度阻塞的百分比(44.1%)显著高于暴露于木材烟雾的组(11.8%;p = 0.006)。 结论:在暴露于木材烟雾的患者组中观察到了与COPD一致的呼吸症状和肺功能改变。然而,这些改变不如暴露于烟草烟雾的组中观察到的改变显著。本研究强调了前瞻性研究在评估巴西与木材烟雾相关的COPD风险方面的重要性,以及该领域预防措施的必要性。
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