Lung Damage among Individuals with Biomass Smoke Exposure Characterized by CT Features and Changes in Pulmonary Function

Abstract BackgroundBiomass smoke exposure (BSE) is an important etiological factor in chronic obstructive pulmonary disease (COPD). However, few studies have focused on the effects of BSE in the respiratory muscles or lungs.MethodsUsing a cohort, we selected 98 participants in underdeveloped rural areas: 16 healthy individuals with BSE (“BSE normal”), 19 patients with BSE and COPD (“BSE+COPD”), 13 healthy individuals with cigarette smoke exposure (“CSE normal”), 25 patients with cigarette smoke exposure and COPD (“CSE+COPD”), and 25 healthy controls. Patients with GOLD stage I and II COPD were included. Baseline data (demographic data, BSE or CSE, lung function, and CT findings) and follow-up lung function data were collected. CT parameters of emphysema, pulmonary small vessels, airway remodeling, pectoralis muscles, and erector spinae muscle were measured.ResultsIndividuals with BSE were mainly women (32/35, 91.43%). Compared with the CSE+COPD group, the BSE+COPD group demonstrated slow lung function decline, increased lower lung emphysema, and narrower airway lumen and airway wall thickening in moderate and small airways (all P<.05). Compared with healthy controls, the CSE normal and BSE normal groups exhibited significant reduction of pulmonary small vessel area and obvious airway remodeling in small airways (P<.05). Compared with the BSE normal group, the BSE+COPD group showed significantly more severe emphysema and airway remodeling, as well as reduced left pectoralis major muscle area (all P<.05).ConclusionsHealthy individuals with BSE had reduced pulmonary small vessel area and obvious airway remodeling; patients with BSE and COPD showed more severe emphysema, airway remodeling, and pectoralis major muscle change. More investigations are needed regarding interventions for BSE.Trial registration: ChiCTR, ChiCTR-OO-14004264 . Registered 12 February 2014, http://www.chictr.org.cn/showproj.aspx?proj=5304