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American Journal of Epidemiology Advance Access published online on May 14, 2009
American Journal of Epidemiology, doi:10.1093/aje/kwp100
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Effect of Reducing Indoor Air Pollution on Women's Respiratory Symptoms and Lung Function: The RESPIRE Randomized Trial, Guatemala

Tone Smith-Sivertsen, Esperanza Díaz, Dan Pope, Rolv T. Lie, Anaite Díaz, John McCracken, Per Bakke, Byron Arana, Kirk R. Smith and Nigel Bruce

Correspondence to Dr. Esperanza Díaz, Section for General Practice, Department of Public Health and Primary Health Care, Faculty of Medicine and Dentistry, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway (e-mail: esperanza.diaz{at}isf.uib.no).

Received for publication June 10, 2008. Accepted for publication April 1, 2009.

Exposure to household wood smoke from cooking is a risk factor for chronic obstructive lung disease among women in developing countries. The Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) is a randomized intervention trial evaluating the respiratory health effects of reducing indoor air pollution from open cooking fires. A total of 504 rural Mayan women in highland Guatemala aged 15–50 years, all using traditional indoor open fires, were randomized to either receive a chimney woodstove (plancha) or continue using the open fire. Assessments of chronic respiratory symptoms and lung function and individual measurements of carbon monoxide exposure were performed at baseline and every 6 months up to 18 months. Use of a plancha significantly reduced carbon monoxide exposure by 61.6%. For all respiratory symptoms, reductions in risk were observed in the plancha group during follow-up; the reduction was statistically significant for wheeze (relative risk = 0.42, 95% confidence interval: 0.25, 0.70). The number of respiratory symptoms reported by the women at each follow-up point was also significantly reduced by the plancha (odds ratio = 0.7, 95% confidence interval: 0.50, 0.97). However, no significant effects on lung function were found after 12–18 months. Reducing indoor air pollution from household biomass burning may relieve symptoms consistent with chronic respiratory tract irritation.

biomass; bronchitis, chronic; carbon monoxide; developing countries; pulmonary disease, chronic obstructive; smoke; spirometry; wood

Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; RESPIRE, Randomized Exposure Study of Pollution Indoors and Respiratory Effects


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