Occupational and Environmental Lung Diseases |

Cooking Fuel Type and Respiratory Symptoms Among a Cohort of People Living With HIV in Rural Uganda FREE TO VIEW

Crystal North, MD; Peter Hunt, MD; A Mocello; Jeffrey Martin, MD; Yap Boum, MD; Jessica Haberer, MD; David Bangsberg, MD; David Christiani, MD; Mark Siedner, MD
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University of California San Francisco, San Francisco, CA

Chest. 2015;148(4_MeetingAbstracts):769A. doi:10.1378/chest.2244637
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SESSION TITLE: Occupational and Environmental Lung Diseases Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Household air pollution from the burning of biomass fuels is a major cause of chronic respiratory disease in resource-limited settings, associated with an estimated 3.5 million deaths yearly. HIV infection is independently associated with chronic respiratory symptoms and decreased pulmonary function, but little is known about relationships between household air pollution and respiratory symptoms among people with HIV.

METHODS: We analyzed data from the Uganda AIDS Rural Treatment Outcomes Study, a longitudinal cohort of people living with HIV from the time of ART initiation. Participants completed questionnaires on sociodemographics and physical health quarterly, and underwent phlebotomy for CD4 count and viral load measurement. Primary outcomes of interest are the presence of cough or dyspnea in the last 30 days and cough of at least four weeks’ duration (chronic cough). The primary exposure of interest is cooking fuel type (self-reported use of charcoal or firewood for home cooking). Logistic regression models were fit using generalized estimating equations with clustering by participant to detect associations between the outcomes of interest and cooking fuel type.

RESULTS: 743 participants (69% female) completed 3,296 study visits (median 16 visits) from 2005 - 2014. At enrollment, median age for women was 32 years old, 12% of whom had ever smoked and 54% of whom reported firewood as the primary fuel for cooking in their homes. For men, median age was 37 years old, 47% of whom had ever smoked and 61% reported firewood as the primary cooking fuel. Cough or dyspnea in the last 30 days were reported in 26% (n = 248) and 29% (n=687) of study visits for men and women, respectively. Chronic cough was reported in 10% of all study visits for both men (n = 92) and women (n = 230). In adjusted models, among women, cooking with firewood was associated with increased odds of chronic cough (AOR 1.56, CI 1.08 - 2.23, p 0.02). There was no association between respiratory symptoms and cooking fuel type among men.

CONCLUSIONS: Cooking with firewood is independently associated with chronic cough in women with HIV in southwestern Uganda, despite a relatively young age and low prevalence of prior smoking in this cohort.

CLINICAL IMPLICATIONS: Women living with HIV who cook with biomass fuels represent a population particularly vulnerable to chronic respiratory disease. Further work is needed to understand the public health implications of relationships between HIV infection, biomass fuel exposure, and lung disease.

DISCLOSURE: The following authors have nothing to disclose: Crystal North, Peter Hunt, A Mocello, Jeffrey Martin, Yap Boum, Jessica Haberer, David Bangsberg, David Christiani, Mark Siedner

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