Abstract
Background
Wood smoke has been associated with respiratory symptoms. This study examined the prevalence of respiratory symptoms and health effects of wood smoke exposures (from home heating, curing meat, and tanning hides) among residents of Deline, Northwest Territories (NWT).
Methods
A survey was conducted of all residents. Relationships between wood smoke and respiratory symptoms were examined.
Results
The response rate was 70.2% (n=402). 71% of people at least 18 years old were current smokers. Prevalence of symptoms was higher for women (odds ratios (ORs) 1.3−3.1). Women who smoked were more likely to be exposed to indoor smoke from curing and tanning. ORs for respiratory symptoms were higher for females, increased with age, and were strongly affected by smoking. Among those at least 18 years old, phlegm on winter mornings (6.5 (95% CI: 2.3−18.1)), dyspnoea (5.1 (95% CI: 1.9−13.2)), and watery or itchy eyes (3.6 (95% CI: 1.4−9.0)) were significantly related to self-reported outdoor wood smoke and smoke curing. Home heating was marginally associated with wheeze. No significant associations were found for males.
Conclusions
Women engaged in curing/tanning demonstrated increased prevalence of respiratory symptoms. The cultural importance of these activities precludes abandoning them. Smoking cessation, limiting wood smoke exposure times, and process modifications in curing and tanning could reduce risk of adverse health effects.
Résumé
Contexte
La fumée de bois est associée à divers symptômes d’atteinte de l’appareil respiratoire. Nous avons étudié la prévalence des symptômes respiratoires et les effets sur la santé de l’exposition à la fumée de bois (provenant du chauffage domestique, du fumage des viandes et du tannage des peaux) chez les résidants de Deline (Territoires du Nord-Ouest).
Méthode
Sondage auprès de tous les résidants et examen des liens entre la fumée de bois et les symptômes respiratoires.
Résultats
Le taux de réponse était de 70,2 % (n=402). Soixante-et-onze p. cent des personnes de 18 ans et plus étaient des fumeurs actuels. La prévalence des symptômes était supérieure chez les femmes (rapports de cotes [RC] de 1,3-3,1). Les fumeuses étaient aussi plus susceptibles d’être exposées à la fumée provenant du fumage et du tannage à l’intérieur des habitations. Les RC des symptômes respiratoires étaient supérieurs chez les femmes, augmentaient avec l’âge et étaient très influencés par le tabagisme. Chez les femmes de 18 ans et plus, la mucosité les matins d’hiver (6,5 [IC de 95 % = 2,3-18,1]), la dyspnée (5,1 [IC de 95 % = 1,9-13,2]) et le larmoiement ou les yeux qui piquent (3,6 [IC de 95 % = 1,4-9,0]) présentaient des liens significatifs avec la fumée de bois à l’extérieur et le fumage déclarés par les intéressées. Le chauffage domestique présentait un lien marginal avec la respiration sifflante. Aucune association significative n’a été constatée chez les hommes.
Conclusions
La prévalence des symptômes respiratoires était plus élevée chez les femmes qui s’adonnaient au fumage ou au tannage. L’importance culturelle de ces activités écarte la possibilité qu’elles soient abandonnées, mais le renoncement au tabac, la réduction des durées d’exposition à la fumée de bois et la modification des méthodes de fumage et de tannage pourraient réduire le risque d’effets indésirables sur la santé.
References
- 1.Morrison HI, Semenciw RM, Mao Y, Wigle DT. Infant mortality on Canadian Indian Reserves 1976–1983. Can J Public Health. 1986;77:269–73. [PubMed] [Google Scholar]
- 2.Mao Y, Morrison H, Semenciw R, Wigle DT. Mortality on Canadian Indian Reserves 1977–1982. Can J Public Health. 1986;77:263–68. [PubMed] [Google Scholar]
- 3.Fraser-Lee NJ, Hessel PA. Acute respiratory infections in the Canadian Native Indian population: A review. Can J Public Health. 1994;85:197–200. [PubMed] [Google Scholar]
- 4.MacMillan HL, MacMillan AB, Offord DR, Dingle JL. Aboriginal health. CMAJ. 1996;155:1569–78. [PMC free article] [PubMed] [Google Scholar]
- 5.Rhoades ER. The major respiratory diseases of American Indians. Am Rev Respir Dis. 1990;141:595–600. doi: 10.1164/ajrccm/141.3.595. [DOI] [PubMed] [Google Scholar]
- 6.Postl B, Moffatt M. The health of Canada’s native people: An overview. Can Fam Phys. 1988;34:2413–20. [PMC free article] [PubMed] [Google Scholar]
- 7.Department of HealthSocial Services. The NWT Health Status Report. 1999. [Google Scholar]
- 8.Harris SB, Glazier R, Eng K, McMurray L. Disease patterns among Canadian aboriginal children. Study in a remote rural setting. Can Fam Phys. 1998;44:1869–77. [PMC free article] [PubMed] [Google Scholar]
- 9.Sin DD, Wells H, Svenson LW, Man SFP. Asthma and COPD among aboriginals in Alberta, Canada. Chest. 2002;121:1841–46. doi: 10.1378/chest.121.6.1841. [DOI] [PubMed] [Google Scholar]
- 10.U.S. Census Statistical briefs. Housing of American Indians on reservations: Equipment and fuels. 1995. [Google Scholar]
- 11.Larson TV, Koenig JQ. Wood smoke: Emissions and noncancer respiratory effects. Annu Rev Public Health. 1994;15:133–56. doi: 10.1146/annurev.pu.15.050194.001025. [DOI] [PubMed] [Google Scholar]
- 12.Smith KR, Samet JM, Romieu I, Bruce N. Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax. 2000;55:518–32. doi: 10.1136/thorax.55.6.518. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Burney PG, Luczynska C, Chinn S, Jarvis D. The European Community Respiratory Health Survey. Eur Respir J. 1994;7:954–60. doi: 10.1183/09031936.94.07050954. [DOI] [PubMed] [Google Scholar]
- 14.Bruce N, Neufeld L, Boy E, West C. Indoor biofuel air pollution and respiratory health: The role of confounding factors among women in highland Guatemala. Int J Epidemiol. 1998;27:454–58. doi: 10.1093/ije/27.3.454. [DOI] [PubMed] [Google Scholar]
- 15.Xu X, Wang L. Association of indoor and outdoor particulate level with chronic respiratory illness. Am Rev Respir Dis. 1993;148:1516–22. doi: 10.1164/ajrccm/148.6_Pt_1.1516. [DOI] [PubMed] [Google Scholar]
- 16.Ng TP, Hui KP, Tan WC. Respiratory symptoms and lung function effects of domestic exposure to tobacco smoke and cooking by gas in non-smoking women in Singapore. J Epidemiol Community Health. 1993;47:454–58. doi: 10.1136/jech.47.6.454. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Viegi G, Paoletti P, Prediletto R, Carrozzi L, Fazzi P, Di Pede F, et al. Prevalence of respiratory symptoms in an unpolluted area of northern Italy. Eur Respir J. 1988;1:311–18. [PubMed] [Google Scholar]
- 18.Viegi G, Paoletti P, Carrozzi L, Vellutini M, Ballerin L, Biavati P, et al. Effects of home environment on respiratory symptoms and lung function in a general population sample in north Italy. Eur Respir J. 1991;4:580–86. [PubMed] [Google Scholar]
- 19.Peters EJ, Esin RA, Immananagha KK, Siziya S, Osim EE. Lung function status of some Nigerian men and women chronically exposed to fish drying using burning firewood. Cent Afr J Med. 1999;45:119–24. doi: 10.4314/cajm.v45i5.8467. [DOI] [PubMed] [Google Scholar]
- 20.Ellegard A. Tears while cooking: An indicator of indoor air pollution and related health effects in developing countries. Environ Res. 1997;75:12–22. doi: 10.1006/enrs.1997.3771. [DOI] [PubMed] [Google Scholar]
- 21.Maier WC, Arrighi HM, Morray B, Llewellyn C, Redding GJ. Indoor risk factors for asthma and wheezing among Seattle school children. Environ Health Perspect. 1997;105:208–14. doi: 10.1289/ehp.97105208. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Ellegard A. Cooking fuel smoke and respiratory symptoms among women in low-income areas in Maputo. Environ Health Perspect. 1996;104:980–85. doi: 10.1289/ehp.104-1469451. [DOI] [PMC free article] [PubMed] [Google Scholar]