Chronic obstructive pulmonary disease (COPD) produced by woodsmoke in women

Comparison with COPD due to cigarette smoking

Abstract

Aim: to describe the clinical, radiological and functional characteristics of women with pulmonary disease due to woodsmoke and to compare them to women with COPD due to cigarette smoking in Bogotá Colombia (2640 m).

Methods: cross-sectional study in women with chronic exposure to wood or cigarette smoke. Clinical evaluation, chest X-rays, spirometry and measurement of lung volumes, carbon monoxide diffusion capacity (DLco) and arterial blood gases were performed.

Results: 139 women were studied, 86 exposed to wood and 53 to cigarette smoke. The clinical characteristics in the women exposed to woodsmoke were cough, expectoration and dyspnea; peribronchial infiltrates, atelectasias (28.6%) mainly of middle lobe and pulmonary hypertension (33.7%) in the chest X-ray. In the arterial blood gases hypoxemia (47.2 ± 7 mmHg) and hypercapnia (34.5 ± 5 mmHg) which increased with the severity of the obstruction. Spirometry and lung volumes showed an obstructive defect with hyperinflation. In the women exposed to cigarette smoke the impairment of the DLco was more severe than in the group exposed to wood smoke and there was a decrease in the DLco/alveolar volume ratio that was not observed in the women exposed to wood smoke. In the group with cigarette smoke COPD there was a significant correlation of the decrease of the DLco and the decrease in the FEV, (ρ <0.001, r = 0.60).

Conclusion: women chronically exposed to woodsmoke develop obstructive pulmonary disease with clinical and radiological characteristics of chronic bronchitis and pulmonary hypertension. Hypoxemia and hypercapnia are very frequent in the advanced disease. The slight impairment of the DLco with a normal DLco/VA ratio suggests the absence of clinically significant emphysema.