Symptoms and functional limitations related to respiratory health and carbon monoxide poisoning in Tanzania: a cross sectional study.


Journal

Environmental health : a global access science source
ISSN: 1476-069X
Titre abrégé: Environ Health
Pays: England
ID NLM: 101147645

Informations de publication

Date de publication:
02 04 2022
Historique:
received: 21 09 2021
accepted: 10 03 2022
entrez: 2 4 2022
pubmed: 3 4 2022
medline: 6 4 2022
Statut: epublish

Résumé

The burden of chronic respiratory symptoms and respiratory functional limitations is underestimated in Africa. Few data are available on carbon monoxide (CO) poisoning in sub-Saharan Africa and existing data is derived from CO in ambient air, but not from biomarkers in the blood. Data from the Tanzanian Lung Health study, a cross-sectional study on lung health among outpatients and visitors to an urban as well as a rural hospital in Tanzania, was analyzed to describe respiratory symptoms and functional limitations. Saturation of peripheral blood with carbon monoxide (SpCO) was measured transcutaneously and non-invasively in participants using a modified pulse oxymeter indicative of CO poisoning. Univariate and multivariate analysis was performed. Nine hundred and ninety-seven participants were included in the analysis, the median age of participants was 46 years (49% male). 38% of participants reported some degree of chronic shortness of breath and 26% felt limited in their daily activities or at work by this symptom. The median SpCO was 7% (IQR 4-13, range 2-31%) among all participants without active smoking status (N = 808). Participants cooking with gas or electricity had the lowest SpCO (median 5%), followed by participants cooking with charcoal (median 7%). Cooking with wood, particularly using a stove, resulted in highest SpCO (median 11.5%). Participants from households where cooking takes place in a separate room had the lowest SpCO as compared to cooking outside or cooking in a shared room inside (6% vs. 9% vs.10.5%, p < 0.01). Sex or the activity of cooking itself was not associated with a difference in SpCO. Multivariate analysis confirmed cooking in a separate room (as compared to cooking outside) and living in a rural vs. urban setting as protective factors against high SpCO. The findings demonstrate a high burden of chronic respiratory symptoms which also cause socioeconomic impact. High levels of SpCO indicate a relevant burden of carbon monoxide poisoning in the local population. The level of CO in the blood is more dependent on shared exposure to sources of CO with the type of housing and type of cooking fuel as most relevant factors, and less on person-individual risk factors or activities.

Sections du résumé

BACKGROUND
The burden of chronic respiratory symptoms and respiratory functional limitations is underestimated in Africa. Few data are available on carbon monoxide (CO) poisoning in sub-Saharan Africa and existing data is derived from CO in ambient air, but not from biomarkers in the blood.
METHODS
Data from the Tanzanian Lung Health study, a cross-sectional study on lung health among outpatients and visitors to an urban as well as a rural hospital in Tanzania, was analyzed to describe respiratory symptoms and functional limitations. Saturation of peripheral blood with carbon monoxide (SpCO) was measured transcutaneously and non-invasively in participants using a modified pulse oxymeter indicative of CO poisoning. Univariate and multivariate analysis was performed.
RESULTS
Nine hundred and ninety-seven participants were included in the analysis, the median age of participants was 46 years (49% male). 38% of participants reported some degree of chronic shortness of breath and 26% felt limited in their daily activities or at work by this symptom. The median SpCO was 7% (IQR 4-13, range 2-31%) among all participants without active smoking status (N = 808). Participants cooking with gas or electricity had the lowest SpCO (median 5%), followed by participants cooking with charcoal (median 7%). Cooking with wood, particularly using a stove, resulted in highest SpCO (median 11.5%). Participants from households where cooking takes place in a separate room had the lowest SpCO as compared to cooking outside or cooking in a shared room inside (6% vs. 9% vs.10.5%, p < 0.01). Sex or the activity of cooking itself was not associated with a difference in SpCO. Multivariate analysis confirmed cooking in a separate room (as compared to cooking outside) and living in a rural vs. urban setting as protective factors against high SpCO.
CONCLUSION
The findings demonstrate a high burden of chronic respiratory symptoms which also cause socioeconomic impact. High levels of SpCO indicate a relevant burden of carbon monoxide poisoning in the local population. The level of CO in the blood is more dependent on shared exposure to sources of CO with the type of housing and type of cooking fuel as most relevant factors, and less on person-individual risk factors or activities.

Identifiants

pubmed: 35365149
doi: 10.1186/s12940-022-00847-x
pii: 10.1186/s12940-022-00847-x
pmc: PMC8976359
doi:

Substances chimiques

Carbon Monoxide 7U1EE4V452

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

38

Informations de copyright

© 2022. The Author(s).

Références

Environ Health Perspect. 2015 Apr;123(4):285-92
pubmed: 25398189
Environ Int. 2018 Oct;119:429-437
pubmed: 30029097
Prim Care Respir J. 2013 Sep;22(3):300-5
pubmed: 23817677
Environ Health. 2019 Aug 20;18(1):73
pubmed: 31429759
Ann Emerg Med. 2006 Oct;48(4):477-8
pubmed: 16997690
BMC Pulm Med. 2019 Oct 17;19(1):181
pubmed: 31623601
Respir Care. 2013 Feb;58(2):232-40
pubmed: 22782305
Am J Respir Crit Care Med. 2017 Mar 1;195(5):596-606
pubmed: 27753502
Int J Environ Health Res. 2020 Feb;30(1):75-88
pubmed: 30754998
Environ Health. 2017 Jul 21;16(1):76
pubmed: 28732501
Am J Respir Crit Care Med. 2019 Mar 1;199(5):613-621
pubmed: 30141966
Hematol Oncol Clin North Am. 2016 Apr;30(2):457-75
pubmed: 27040965
J Emerg Med. 2008 May;34(4):441-50
pubmed: 18226877
PLoS One. 2019 Dec 31;14(12):e0225712
pubmed: 31891576
BMC Pulm Med. 2018 Jan 19;18(1):11
pubmed: 29351754
Am J Emerg Med. 2016 May;34(5):840-4
pubmed: 26947364
Ann Emerg Med. 2011 Jul;58(1):74-9
pubmed: 21459480
Afr Health Sci. 2015 Sep;15(3):972-81
pubmed: 26957989
Eur J Intern Med. 2016 Apr;29:65-70
pubmed: 26703428
Medicine (Baltimore). 2016 Jan;95(3):e2549
pubmed: 26817904
COPD. 2020 Jun;17(3):297-305
pubmed: 32462945
Int J Tuberc Lung Dis. 2019 Oct 1;23(10):1100-1106
pubmed: 31627775
Ann Emerg Med. 2010 Oct;56(4):382-8
pubmed: 20605259
Eur Respir J. 2018 Jan 31;51(2):
pubmed: 29386343
Oncotarget. 2017 Jun 29;8(38):63680-63690
pubmed: 28969020
PLoS One. 2017 Apr 25;12(4):e0176465
pubmed: 28441428
Dtsch Arztebl Int. 2018 Dec 24;115(51-52):863-870
pubmed: 30765023
NPJ Prim Care Respir Med. 2016 Sep 01;26:16050
pubmed: 27597659
Lancet. 2021 Mar 6;397(10277):928-940
pubmed: 33631128
Lancet Glob Health. 2015 Jan;3(1):e44-51
pubmed: 25539969
Int J Environ Res Public Health. 2018 Sep 05;15(9):
pubmed: 30189674
Int J Environ Res Public Health. 2021 Mar 04;18(5):
pubmed: 33806412

Auteurs

Thomas Zoller (T)

Swiss Tropical and Public Health Institute, Socinstr. 57, 4051, Basel, Switzerland.
Ifakara Health Institute, Dar es Salaam, Tanzania.
Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
University of Basel, Basel, Switzerland.

Elirehema H Mfinanga (EH)

Ifakara Health Institute, Dar es Salaam, Tanzania.

Tresphory B Zumba (TB)

Ifakara Health Institute, Dar es Salaam, Tanzania.

Peter J Asilia (PJ)

Ifakara Health Institute, Dar es Salaam, Tanzania.

Edwin M Mutabazi (EM)

Ifakara Health Institute, Dar es Salaam, Tanzania.

David Wimmersberger (D)

Swiss Tropical and Public Health Institute, Socinstr. 57, 4051, Basel, Switzerland.
University of Basel, Basel, Switzerland.

Francis Mhimbira (F)

Ifakara Health Institute, Dar es Salaam, Tanzania.

Frederick Haraka (F)

Swiss Tropical and Public Health Institute, Socinstr. 57, 4051, Basel, Switzerland.
Ifakara Health Institute, Dar es Salaam, Tanzania.
University of Basel, Basel, Switzerland.

Klaus Reither (K)

Swiss Tropical and Public Health Institute, Socinstr. 57, 4051, Basel, Switzerland. klaus.reither@swisstph.ch.
University of Basel, Basel, Switzerland. klaus.reither@swisstph.ch.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH