HEALTH HAZARDS FROM CULTURAL PRACTICES: INCENSE BURNING

Incense, as coils, cones, powders and sticks, is widely used for religious and cultural practices. Usage includes meditations, celebrations, deodorizations, in addition to spiritual and ancestral worship. Health problems from incense burning are numerous. An 87-year-old woman with history of asthma and COPD , on oxygen therapy, presents with unexplained shortness of breath. Detailed history taking disclosed temporal relationship with incense burning. Recommendation to stop burning incense was denied as burning joss stick incense daily allows patient to express homage and veneration for ancestors. Subsequently, advice to use electric incense devices resulted in improvement of patient's symptoms. Burning incense poses health risks including headaches , respiratory dysfunction, dermatologic sensitivity and allergic reactions . Incense fumes contain carbon, sulfur, nitrogen oxides as well as formaldehyde, and other polycyclic aromatic volatile compounds which are carcinogenic. Per gram burned, particulate matter generated from incense is 45 mg versus 10 mg from cigarettes. Studies report family members, including children, exposed to incense burning suffer from secondhand smoke health consequences. Similar to tobacco smoke, thirdhand incense smoke may linger in furniture, clothing, and other articles, dissipating for months afterwards. Besides health implications, incense combustion contributes to air pollution and can be a fire hazard. Understanding the role, cultural sensitivity and sacred significance of incense burning is vital but health risks from burning incense cannot be overlooked. Screening patients for incense use, in addition to replacement with electric or aromatic vapors, simulated visuals, improved ventilation, and limiting burn time can be explored with impacted patients.