Biofuel pollution: a risk factor for COPD and bronchogenic carcinoma

The WHO has acknowledged the role of biofuel pollution as a risk factor for COPD, particularly in non-smoking women living in rural areas. The aim of our study is to assess the impact of biofuel exposure on the development of COPD and bronchogenic carcinoma. We conducted a retrospective study of 68 non-smoking patients exposed to biofuel smoke admitted for COPD and/or bronchogenic carcinoma between January 2021 and December 2023. The average age was 59. Women predominated in 89% of cases. All the women lived in rural areas and were exposed to wood smoke (wood-fired cooking in 96% of cases, wood-fired heating in 17% of cases), while the men were exposed in a professional context (traditional griller and Moorish bath boiler driver in three cases each, and charcoal burner in two cases). The average duration of exposure was 28 years. Symptoms included chronic dry cough in 61% of cases, hemoptysis in 20%, and exertional dyspnea in 40%. Spirometry in 50% of patients revealed small airway syndrome in 13.5%, irreversible obstructive ventilatory disorder in 34%, moderate in 24%, and severe in 9%. CT scans revealed a tumor-like tissue process in 74.8% of patients. Primary pulmonary adenocarcinoma was found in 47% of cases, and squamous cell carcinoma in 29%. In the other cases, the histological diagnosis was not made because of the patient's general state of health. In this study, we emphasize the causal relationship between exposure to biofuel fumes and the presence of COPD and bronchogenic carcinoma in exposed individuals, particularly women living in rural or semi-urban areas.