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Original Research: COPD |

Risk of COPD From Exposure to Biomass Smoke: A Metaanalysis

Guoping Hu, MD, PhD; Yumin Zhou, MD, PhD; Jia Tian, MD; Weimin Yao, MD, PhD; Jianguo Li, MD, PhD; Bing Li, MD; Pixin Ran, MD, PhD, FCCP
Author and Funding Information

From the Guangzhou Institute of Respiratory Diseases (Drs Hu, Zhou, Tian, J. Li, and Ran), State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University; the Department of Respiratory Medicine (Dr Hu), The Third Affiliated Hospital, Guangzhou Medical University; the Department of Respiratory Medicine (Dr J. Li), The Second Affiliated Hospital of Sun Yat-sen University; the Experiment of Medical Central of Guangzhou Medical University (Dr B. Li); Guangzhou, Guangdong; and the Department of Respiratory Medicine (Dr Yao), Affiliated Hospital of Guangdong Medical College, Zhanjiang, China.

Correspondence to: Pixin Ran, MD, PhD, FCCP, Guangzhou Institute of Respiratory Diseases, State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, 151 Yanjiang Rd, Guangzhou, Guangdong, 510120, China; e-mail: pxran@gzhmc.edu.cn


For editorial comment see page 3

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(1):20-31. doi:10.1378/chest.08-2114
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Background:  Although many studies have suggested that biomass smoke is a risk factor for COPD, the relationship between the two has not been firmly established. In particular, the extent of the association between exposure of biomass smoke and COPD in different populations, as well as the relationship between biomass smoke and cigarette smoke, is not clear. To ascertain the relationship between biomass smoke and COPD, we performed a metaanalysis.

Methods:  We searched MEDLINE, EMBASE, and the Latin American and Caribbean Literature in Health Sciences Database and analyzed 15 epidemiologic (11 cross-sectional and four case-control) studies that met our criteria. Data were extracted and analyzed independently by two investigators using a standardized protocol.

Results:  Overall, people exposed to biomass smoke have an odds ratio (OR) of 2.44 (95% CI, 1.9-3.33) for developing COPD, relative to those not exposed to biomass smoke. Biomass smoke exposure was clearly identified as a risk factor for developing COPD in both women (OR, 2.73; 95% CI, 2.28-3.28) and men (OR, 4.30; 95% CI, 1.85-10.01), and in both the Asian population (OR, 2.31; 95% CI, 1.41-3.78) and the non-Asian population (OR, 2.56; 95% CI, 1.71-3.83). This risk factor has also been revealed in patients with chronic bronchitis (OR, 2.56; 95% CI, 1.77-3.70) and COPD (OR, 2.65; 95% CI, 1.75-4.03), and in cigarette smokers (OR, 4.39; 95% CI, 1.40-4.66) and non-cigarette smokers (OR, 2.55; 95% CI, 2.06-3.15).

Conclusions:  Exposure to biomass smoke is a risk factor for COPD.

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