The role of environmental exposure to non-cigarette smoke in lung disease

Abstract

Chronic exposure to household indoor smoke and outdoor air pollution is a major contributor to global morbidity and mortality. The majority of these deaths occur in low and middle-income countries. Children, women, the elderly and people with underlying chronic conditions are most affected. In addition to reduced lung function, children exposed to biomass smoke have an increased risk of developing lower respiratory tract infections and asthma-related symptoms. In adults, chronic exposure to biomass smoke, ambient air pollution, and opportunistic exposure to fumes and dust are associated with an increased risk of developing chronic bronchitis, chronic obstructive pulmonary disease (COPD), lung cancer and respiratory infections, including tuberculosis. Here, we review the evidence of prevalence of COPD in people exposed to non-cigarette smoke. We highlight mechanisms that are likely involved in biomass-smoke exposure-related COPD and other lung diseases. Finally, we summarize the potential preventive and therapeutic strategies for management of COPD induced by non-cigarette smoke exposure.

Keywords: Air pollution; Biomass smoke; Chronic obstructive pulmonary disease (COPD); Lung disease; Non-cigarette smoke; Occupational exposure.

Fig. 1

Global use of clean fuels in 2014, by the World Health Organization. Countries with the lowest (< 5%) and the highest (> 95%) proportion of people using clean fuels as the primary domestic source of energy are shaded dark and light blue, respectively. Reproduced with permission from the World Health Organization [8], Copyright (2016)