Sana Adama, Somda Serge M A, Meda Nicolas, Bouland Catherine
Département de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso.
Département de Santé Publique, Universite Ouaga 1 Pr Joseph Ki-Zerbo, Ouagadougou, Burkina Faso.
BMJ Open Respir Res. 2018 Jan 12;5(1):e000246. doi: 10.1136/bmjresp-2017-000246. eCollection 2018.
Chronic obstructive pulmonary disease (COPD) is a major and growing cause of morbidity and mortality worldwide. The global prevalence of COPD is growing faster in women than in men. Women are often exposed to indoor pollutants produced by biomass fuels burning during household activities.
We conducted a meta-analysis to establish the association between COPD and exposure to biomass smoke in women.Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE and Scopus databases in 31December 2016, with the terms: "wood", "charcoal", "biomass", "solid fuels", "organic fuel", "biofuel", "female", "women", "COPD", "chronic bronchitis", "emphysema", "chronic obstructive pulmonary disease". Studies were eligible if they were case-control or cross-sectional studies involving exposure to indoor biomass smoke, conducted at any time and in any geographic location. Fixed-effects or random-effects meta-analysis was used to generate pooled OR.
24 studies were included: 5 case-control studies and 19 cross-sectional studies. Biomass-exposed individuals were 1.38 times more likely to be diagnosed with COPD than non-exposed (OR 1.38, 95% CI 1.28 to 1.57).Spirometry-diagnosed COPD studies failed to show a significant association (OR 1.20, 95% CI 0.99 to 1.40). Nevertheless, the summary estimate of OR for chronic bronchitis (CB) was significant (OR 2.11, 95% CI 1.70 to 2.52). The pooled OR for cross-sectional studies and case-control studies were respectively 1.82 (95% CI 1.54 to 2.10) and 1.05 (95% CI 0.81 to 1.30). Significant association was found between COPD and biomass smoke exposure for women living as well in rural as in urban areas.
This study showed that biomass smoke exposure is associated with COPD in rural and urban women.In many developing countries, modern fuels are more and more used alongside traditional ones, mainly in urban area. Data are needed to further explore the benefit of the use of mixed fuels for cooking on respiratory health, particularly on COPD reduction.
慢性阻塞性肺疾病（COPD）是全球发病率和死亡率的主要且不断上升的原因。COPD在全球的患病率在女性中增长速度快于男性。女性经常暴露于家庭活动期间生物质燃料燃烧产生的室内污染物中。
我们进行了一项荟萃分析，以确定女性COPD与生物质烟雾暴露之间的关联。按照系统评价和荟萃分析的首选报告项目指南，我们于2016年12月31日在MEDLINE和Scopus数据库中进行搜索，搜索词为：“木材”、“木炭”、“生物质”、“固体燃料”、“有机燃料”、“生物燃料”、“女性”、“妇女”、“COPD”、“慢性支气管炎”、“肺气肿”、“慢性阻塞性肺疾病”。如果研究是涉及室内生物质烟雾暴露的病例对照研究或横断面研究，且在任何时间和任何地理位置进行，则该研究符合纳入标准。使用固定效应或随机效应荟萃分析来生成合并的比值比（OR）。
纳入24项研究：5项病例对照研究和19项横断面研究。暴露于生物质的个体被诊断为COPD的可能性比未暴露个体高1.38倍（OR 1.38，95%置信区间1.28至1.57）。通过肺功能测定诊断的COPD研究未显示出显著关联（OR 1.20，95%置信区间0.99至1.40）。然而，慢性支气管炎（CB）的OR汇总估计值具有显著性（OR 2.11，95%置信区间1.70至2.52）。横断面研究和病例对照研究的合并OR分别为1.82（95%置信区间1.54至2.10）和1.05（95%置信区间0.81至1.30）。在农村和城市地区生活的女性中，均发现COPD与生物质烟雾暴露之间存在显著关联。
本研究表明，农村和城市女性中，生物质烟雾暴露与COPD有关。在许多发展中国家，现代燃料越来越多地与传统燃料一起使用，主要是在城市地区。需要数据来进一步探索使用混合燃料烹饪对呼吸健康的益处，特别是对减少COPD的益处。
