The impact of exposure to biomass smoke versus cigarette smoke on inflammatory markers and pulmonary function parameters in patients with chronic respiratory failure

• Published in: International journal of chronic obstructive pulmonary disease Vol. 13; pp. 1261 - 1267
• Main Authors: Ocakli, Birsen, Acarturk, Eylem, Aksoy, Emine, Gungor, Sinem, Ciyiltepe, Fulya, Oztas, Selahattin, Ozmen, Ipek, Agca, Meltem Coban, Salturk, Cuneyt, Adiguzel, Nalan, Karakurt, Zuhal
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2018; Dove Medical Press Ltd; Dove Medical Press
• Subjects: Age; Airway management; Analysis; Biomass; Biomass exposure; Blood gas analysis; Blood platelets; Bronchitis; C-reactive protein; Carbon; Care and treatment; Chronic obstructive pulmonary disease; chronic respiratory failure; cigarette smoke; Cigarettes; Crop residues; Gender; Heating; Inflammation; inflammatory markers; Lung cancer; Lung diseases; Lung volume measurement; Lymphocytes; Medical records; Medical research; Neutrophils; Original Research; Oxygen saturation; Patients; Pulmonary function tests; Respiratory diseases; Respiratory failure; Respiratory insufficiency; Respiratory tract diseases; Risk factors; Smoke inhalation; Smoking; Spirometry; Statistical analysis; Thoracic surgery; Tobacco smoke; Women; Womens health; Turkey; chronic respiratory failure; inflammatory markers; spirometry; cigarette smoke; biomass exposure
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S162658

The aim of this study was to evaluate the impact of exposure to biomass smoke vs cigarette smoke on serum inflammatory markers and pulmonary function parameters in patients with chronic respiratory failure (CRF).
A total of 106 patients with CRF divided into age and gender-matched groups of cigarette-smoke exposure (n=55, mean [SD] age: 71.0 [12.0] years, 92.7% were females) and biomass smoke exposure (n=51, mean [SD] age: 73.0 [11.0] years, 94.1% were females) were included in this retrospective study. Data on patient demographics (age and gender), inflammatory markers, including neutrophil-to-lymphocyte ratio, C-reactive protein, platelet/mean platelet volume ratio, arterial blood gas analysis, and pulmonary function test findings, including forced expiratory volume in 1 second (FEV
), forced vital capacity (FVC), and FEV
/FVC were obtained from medical records.
Carbon dioxide partial pressure levels were significantly higher in the biomass smoke exposure than in the cigarette smoke exposure group (mean [SD] 51.0 [8.0] vs 47.0 [8.0] mmHg,
=0.026, respectively). Spirometry revealed similarly low levels for FEV
(%) (38.0 [16.0] vs 40.0 [12.0]%) and FVC (%) (45.0 [19.0] vs 39.0 [19.0]%) in cigarette-smoke and biomass smoke exposure groups, whereas biomass smoke exposure was associated with significantly higher FEV
/FVC (75.0 [14.0] vs 58.0 [12.0]%,
=0.001), lower FVC (mL) (mean [SD] 744.0 [410.0] vs 1,063.0 [592.0] mL,
=0.035) and lower percentage of patients with FEV
/FVC <70% (36.8% vs 82.0%,
<0.001) than cigarette smoke exposure.
Our findings indicate similarly increased inflammatory markers and abnormally low pulmonary function test findings in both biomass smoke exposure and cigarette smoke exposure groups, emphasizing the adverse effects of biomass smoke exposure on lungs to be as significant as cigarette smoke exposure. Association of biomass smoke exposure with higher likelihood of FEV
/FVC ratio of >70% and more prominent loss of vital capacity than cigarette smoke exposure seems to indicate the likelihood of at least 18 years of biomass exposure to be sufficiently high to be responsible for both obstructive and restrictive pulmonary diseases.