Table 2

Effect size of chronic bronchitis associated with solid fuel smoke exposure

ReferenceType of studyCountryFuel typeExposure measuredSample sizeDiagnosis criteriaSample typeEffect size
Pandey (1984a and b)37,38CS studyNepalBiomassExposure not measured directly748BMRC criteriaNon-smoking adults ≥20 years13.76% (women)7.87 (4.67 to 13.26)
3.0% (men)
2826BMRC criteriaAdults ≥20 years18.30%Could not be calculated
Albalak et al (1999)39CS studyBoliviaBiomassPM10 exposure measured directly in both indoor and outdoor kitchenIndoor=102BMRC criteriaAdults ≥20 years22% (indoor),2.5 (1.25 to 5.00)
Outdoor=13913% (outdoor)
Behera and Jindal (1991)40DSIndiaBiomass, LPG, kerosene, mixedExposure not measured directly3608BMRC criteriaWomen involved in cooking2.9% (biomass)1.18 (0.83 to 1.67)
(biomass user)
1.3 (kerosene),
2.5 (LPG) and
1.2 (mixed)
Qureshi (1994)41CC study defined by fuel(s) usedIndiaBiomass (BM), mixed fuel (MF)Exposure not measured directly286 (BM),BMRC criteriaAdults ≥15 years10.14% (BM),2.10 (1.50 to 2.94) (biomass user)
560 (MF)5.11% (MF)
Akhtar et al (2007)18CC study defined by fuel typesPakistanBiomass mixed (BM),Exposure not measured directly1426 cases and 1131 controlsATS criteriaFemale non-smokers7.01% (cases) and 2.92% (control)2.51 (1.65 to 3.83) (BM)
Wood (W),2.38 (2.12 to 3.01) (W)
Dung (D)2.01 (1.72 to 2.42) (D)
Straw (S)3.32 (1.11 to 9.88) (S)
Menezes (1994)17CS surveyBrazilSolid fuel and clean fuel usedExposure not measured directly but classified as high, moderate and no exposure411 (none)ATS criteriaAdults ≥40 years9.3% (mone)1.0 (none)
385 (moderate)14.0% (moderate)1.49 (0.92 to 2.41)
257 (high)16.0% (high)1.30 (0.75 to 2.27)
Ekici et al (2005)36CC study defined by fuel typesTurkeyBiomass and LPGExposure not measured directly397 (cases) 199 (control)BMRC criteriaNon-smoking women ≥40 years28.5% (cases) 13.6% (controls)2.5 (1.5 to 4.0)
Kiraz et al (2003)21CC study defined by fuel typesTurkeyBiomass and LPGExposure not measured directly242 (cases) 102 (control)BMRC criteriaWomen ≥25 years20.7% (cases) 10.8% (control)1.9 (1.3 to 3.01)
Uzun et al 200342CS studyTurkeyBiomass and non-biomassNo direct measurement90 (biomass)
87 (non-biomass)
BMRC criteriaAdult women58.9% (biomass)
29.4% (non-biomass)
3.36 (1.80 to 6.26)
Cetinkaya et al 200043CS studyTurkeyBiomassNo direct measurement461 (men)
562 (women)
ERS criteriaAdult men vs women17.8% vs 10.0%1.96 (1.36 to 2.82)
Golshan et al 2002b44CS studyIranGas, kerosene and woodPM10 measured470 (gas)
493 (kerosene)
227 (wood)
BMRC criteriaWomen3.4%2.91 (2.08 to 4.4)
for using wood in the past
Dutt et al 199645CS studyIndiaLPG, kerosene, biomassNo direct measurement97 (biomass)
100 (kerosene)
98 (LPG)
BMRC criteriaWomen 15–60 years4.1% (biomass)
2.0% (kerosene)
1.0% (LPG)
4.17 (0.46 to 38.02)
(biomass vs LPG)
Perez-Padilla et al 199646CS study (defined by disease type)MexicoWoodNo direct measurement127 (CB or CAO)
375 controls with other diseases
Hospital diagnosedWomen >40 years76% of individuals with CB were exposed to wood smoke3.9 (2.0 to 7.6)
  • ATS, American Thoracic Society; BMRC, British Medical Research Council; CAO, chronic airway obstruction; CB, chronic bronchitis; CC, case–control; CS, cross-sectional; DS, descriptive study; ERS, European Respiratory Society; LPG, liquefied petroleum gas; PM10, particles of ≤10 μm.