The association of biomass fuel combustion on pulmonary function tests in the adult population of Mid-Anatolia
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Objectives: To assess the association of biomass as domestic energy source on respiratory function in rural areas of Mid-Anatolia in Turkey where biomass use is frequent. Methods: In a cross-sectional study, pulmonary functions measurements of 112 cow-dung users and 153 modern energy source users, all non-smokers, were assessed and compared. Several sociodemographic factors were assessed by questionnaire, and ventilatory function measurements included forced expiratory volume in one second (FEV1, forced vital capacity (FVC), FEV1/FVC ratio and the flow between the first 25 and 75 of forced expiratory flow (FEF25-75), and were compared, deploying univariate and multivariate methods, between the two groups. Results: The individuals in the biomass exposed and unexposed group were similar regarding demographic characteristics: 67.0% were female (exposed) vs 60.1% (unexposed) with an age range of 17 to 64 (exposed) and 18 to 70 years (unexposed), and with 36% of biomass users having had pulmonary tract infections (20% in non-users). For all pulmonary function test parameters FEV1 FVC, FEV1/FVC, and FEF25-75 a highly significant (p < 0.0001) reduction was observed in biomass users. A 12.4% (95% confidence interval: 7.0% to 17.7%) reduction in forced vital capacity was observed in multivariate linear regression. Conclusions: It is well known that biomass combustion is a relevant public health problem. The substantial differences in pulmonary functions associated with biomass use as an energy source observed in this cross-sectional study in non-smokers support that also in rural Turkey measures may be in need to reduce this public health problem.