1. More targeted smoke control measures should be taken to reduce exposure, specifically for exposed workers.
2. Information on adverse respiratory health effects related to smoke fumes exposure should be provided to workers.
3. Workers should be provided access to efficient personal respiratory protective equipment.
4. Periodic risk assessment and regular medical examinations should be performed for early identification of workers at high risk of developing chronic respiratory diseases amongst ‗Mai Suya‘ workers.
5. Mai Suya workers are to be encouraged to form association to facilitate access to the group by government agencies, non-governmental agencies and community
physicians to address and facilitate the practicability of issues raised above.
72
REFERENCES
1. Anyonge CH, Rugalema G, Kayambazinthu D, Sitoe A, Barany M. Fuelwood, food and medicine: The role of forests in the response to HIV and AIDS in rural areas of southern Africa. Unasylva. 2006;57:20–3.
2. Naeher LP, Brauer M, Lipsett M, Zelikoff JT, Simpson CD, Koenig JQ, et al.
Woodsmoke health effects: a review. Inhal Toxicol. 2007;19(1):67–106.
3. Swiston JR, Davidson W, Attridge S, Li GT, Brauer M, van Eeden SF. Wood smoke exposure induces a pulmonary and systemic inflammatory response in firefighters. Eur Respir J [Internet]. 2008;32(1):129–38.
4. American Lung Association. State of Lung Disease in Diverse Communities 2010 [Internet].
2010 [cited 2013 Feb 17]. p. 100–8. Available from:
httpwww.lungusa.org/asset/documents/publications/lung-disease-data/solddc-2010.pdf 5. Desalu OO, Adekoya a. O, Ampitan B a. Increased risk of respiratory symptoms and chronic
bronchitis in women using biomass fuels in Nigeria. J Bras Pneumol [Internet].
2010;36(4):441–6. Available from: http://www.scielo.br/pdf/jbpneu/v36n4/en_v36n4a08.pdf 6. Akanbi, M O Ukoli , CO Erhabor, G E Akanbi, F O Gordon SB. The Burden of Respiratory
Disease in Nigeria. African J Respir Med. 2009;4(2):10–7.
7. Tzanakis N, Kallergis K, Bouros DE, Samiou MF, Siafakas NM. Short-term effects of wood smoke exposure on the respiratory system among charcoal production workers.
Chest. 2001;119(4):1260–5.
8. Balmes JR. Occupational respiratory diseases. Vol. 27, Primary Care - Clinics in Office Practice. 2000. p. 1009–37.
9. Ige OM, Awoyemi OB. Respiratory symptoms and ventilatory function of the bakery workers in Ibadan, Nigeria. West Afr J Med. 2002;21(4):316–8.
10. Ige OM, Onadeko OB. Respiratory symptoms and ventilatory function of the sawmillers in Ibadan, Nigeria. Afr J Med Med Sci. 2000;29(2):101–4.
11. Akanbi, A B Alexander , B Dienye POOIB. Respiratory Symptoms among Females in a FishingSettlement in the Niger Delta. Africa J Prim Heal Care Fam Med.
2011;3(1):5.
12. Serra A, Mocci F, Sanna Randaccio F. Pulmonary function in Sardinian fire fighters.
Am J Ind Med. 1996;30(1):78–82.
13. Peters EJ, Esin RA, Immananagha KK, Siziya S, Osim EE. Lung function status of some Nigerian men and women chronically exposed to fish drying using burning firewood. Cent Afr J Med. 1999;45(5):119–24.
14. Liou SH, Cheng SY, Lai FM, Yang JL. Respiratory symptoms and pulmonary function in mill workers exposed to wood dust. Am J Ind Med. 1996;30(3):293–9.
15. Wong TW, Wong AHS, Lee FSC, Qiu H. Respiratory health and lung function in Chinese restaurant kitchen workers. Occup Environ Med. 2011;68(10):746–52.
16. Baran S, Swietlik K, Teul I. Lung function: occupational exposure to wood dust. Eur J Med Res. 2009;14 Suppl 4:14–7.
17. Adetona O, Hall DB, Naeher LP. Lung function changes in wildland firefighters working at prescribed burns. Vol. 23, Inhalation Toxicology. 2011. p. 835–41.
74
18. Kocbach Bølling A, Pagels J, Yttri KE, Barregard L, Sallsten G, Schwarze PE, et al. Health effects of residential wood smoke particles: the importance of combustion conditions and physicochemical particle properties. Part Fibre Toxicol. 2009;6:29.
19. Austin C. Wildland firefighter health risks and respiratory protection Research Projects REPORT R-572 Studies and Research Projects. Québec (CA);2008 50-56.
20. Kennedy IM. The health effects of combustion-generated aerosols. Proc Combust Inst.
2007;31 II:2757–70.
21. Austin C. Chemical Substances and Biological Agents Studies and Research Projects.
Quebec; 2008.
22. Fujii T, Hayashi S, Hogg JC, Mukae H, Suwa T, Goto Y, et al. Interaction of alveolar macrophages and airway epithelial cells following exposure to particulate matter produces mediators that stimulate the bone marrow. Am J Respir Cell Mol Biol.
2002;27(1):34–41.
23. Gaga M, Vignola AM, Chanez P. Upper and lower airways: similarities and differences. In:
Spiro S, editor. European Respiratory Monograph. European Respiratory Society; 2001. p.
1–15.
24. Hernández-Garduño E, Brauer M, Pérez-Neria J, Vedal S. Wood smoke exposure and lung adenocarcinoma in non-smoking Mexican women. Int J Tuberc Lung Dis.
2004;8(3):377–83.
25. Lopata AL, Lehrer SB. New insights into seafood allergy. Curr Opin Allergy Clin Immunol.
2009;9:270–7.
26. Nielsen E. Health effects assessment of exposure to particles from wood smoke.
Toxicol Lett. 2007;172(1235):S120.
27. Kogevinas M, Zock J-PP, Jarvis D, Kromhout H, Lillienberg L, Plana E, et al. Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II). Lancet. 2007;370(9584):336–41.
28. Pierson WE, Koenig JQ, Bardana Jr EJ. Potential adverse health effects of wood smoke. West J Med. 1989;151(390070664):339–42.
29. Fine PM, Cass GR, Bernd R. T. Simoneit. Organic compounds in biomass smoke from residential wood combustion: Emissions characterization at a continental scale. J Geophys Res. 2002;107(D21):1–9.
30. Holian A, Stock A, Migliaccio C, Noonan C, Ward T. Conference summary:
International Biomass Smoke Health Effects (IBSHE). Inhal Toxicol.
2010;22(April):91–3.
31. Maestrelli P, Boschetto P, Fabbri LM, Mapp CE. Mechanisms of occupational asthma.
J Allergy Clin Immunol. 2009;123(3):531–42.
32. Larsson BM, Palmberg L, Malmberg PO, Larsson K. Effect of exposure to swine dust on levels of IL-8 in airway lavage fluid. Thorax. 1997;52(7):638–42.
33. Lemiere C, Ameille J, Boschetto P, Labrecque M, Pralong JA. Occupational Asthma. New Deleterious Agents at the Workplace. Clin Chest Med. 2012;33(3):519–30.
34. Samuelsen M, Nygaard UC, Løvik M. Allergy adjuvant effect of particles from wood smoke and road traffic. Toxicology. 2008;246(2–3):124–31.
35. Nielsen GD, Olsen O, Larsen ST, Løvik M, Poulsen LK, Glue C, et al. IgE-mediated sensitisation, rhinitis and asthma from occupational exposures. Smoking as a model for airborne adjuvants? Toxicology. 2005;216(2–3):87–105.
36. Siracusa A, Marabini A, Folletti I, Moscato G. Smoking and occupational asthma. Clin Exp ALLERGY. 2006;36(5):577–84.
37. Rongo LMB, Besselink A, Douwes J, Barten F, Msamanga GI, Dolmans WM V, et al.
Respiratory symptoms and dust exposure among male workers in small-scale wood industries in Tanzania. J Occup Environ Med. 2002;44(12):1153–60.
38. Guggisberg M, Hessel PA, Michaelchuk D, Ahmed I. Respiratory symptoms and exposure to wood smoke in an isolated Northern community. Can J Public Heal.
2003;94(5):372–6.
39. Greven FE, Rooyackers JM, Kerstjens HAM, Heederik DJ. Respiratory symptoms in firefighters. Am J Ind Med. 2011;54(5):350–5.
76
40. Mastrangelo G, Tartari M, Fedeli U, Fadda E, Saia B. Ascertaining the risk of chronic obstructive pulmonary disease in relation to occupation using a case-control design.
Occup Med (Chic Ill). 2003;53(3):165–72.
41. Fullerton DG, Suseno A, Semple S, Kalambo F, Malamba R, White S, et al. Wood smoke exposure, poverty and impaired lung function in Malawian adults. Int J Tuberc Lung Dis.
2011;15(3):391–8.
42. Pierson WE, Koenig JQ, Bardana EJ. Potential adverse health effects of wood smoke.
West J Med. 1989;151(3):339–42.
43. Koterba AP, Saltoun CA. Asthma classification. Vol. 33, Allergy and Asthma Proceedings.
2012.
44. Tarlo SM, Broder I. Irritant-induced occupational asthma. Chest. 1989;96(2):297–300.
45. Bardana EJ. 8. Occupational asthma and allergies. J Allergy Clin Immunol [Internet].
2003;111(2 Suppl):S530-9. Available from: papers://a7e5d1ab-af1a-42c6-a673c67654742ae0/Paper/p366
46. Beckett WS. The epidemiology of occupational asthma. Vol. 7, European Respiratory Journal. 1994. p. 161–4.
47. Celli BR, MacNee W, Agusti A, Anzueto A, Berg B, Buist AS, et al. Standards for the diagnosis and treatment of patients with COPD: A summary of the ATS/ERS position paper.
Vol. 23, European Respiratory Journal. 2004. p. 932–46.
48. Eisner MD, Anthonisen N, Coultas D, Kuenzli N, Perez-Padilla R, Postma D, et al. An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Vol. 182, American Journal of Respiratory and Critical Care Medicine. 2010. p. 693–718.
49. Sekido Y, Fong KM, Minna JD. Molecular genetics of lung cancer. Annu Rev Med.
2003;54:73–87.
50. Hecht SS. Tobacco smoke carcinogens and lung cancer. Curr Cancer Res. 2011;6:53–
74.
51. Straif K, Baan R, Grosse Y, Secretan B, El Ghissassi F, Bouvard V, et al.
Carcinogenicity of shift-work, painting, and fire-fighting. Vol. 8, The lancet oncology.
2007. p. 1065–6.
52. Sun S, Schiller JH, Gazdar AF. Lung cancer in never smokers — a different disease.
Nat Rev Cancer. 2007;7(10):778–90.
53. International Energy Agency. World Energy Investment Outlook. Int Energy Agency, Paris, Fr. 2003;23:329.
54. Kurmi OP, Arya PH, Lam KBH, Sorahan T, Ayres JG. Lung cancer risk and solid fuel smoke exposure: A systematic review and meta-analysis. Eur Respir J.
2012;40(5):1228–37.
55. Xu X, Christiani DC, Dockery DW, Wang L. Exposure-response relationships between occupational exposures and chronic respiratory illness: a community-based study. Am Rev Respir Dis. 1992;146(2):413–8.
56. Health effects of breathing woodsmok.Alaska Department of Environmental Protection :1–5.
[Internet] Available from
https://dec.alaska.gov/air/anpms/comm/docs/woodsmoke_health_effects_jan07.pdf 57. Larson T V, Koenig JQ. Wood smoke: emissions and noncancer respiratory effects.
Annu Rev Public Health. 1994;15:133–56.
58. Interpretation_of_Pulmonary_Function_Tests_A_Practical_Guide_3rd_Ed_2009.
59. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J [Internet]. 2005;26(1):153–61.
Available from: http://www.ncbi.nlm.nih.gov/pubmed/15994402
60. Barreiro TJ, Perillo I. An Approach to Interpreting Spirometry. Vol. 69, American Family Physician. 2004. p. 1107–14.
61. Glady CA, Aaron SD, Lunau M, Clinch J, Dales RE. A spirometry-based algorithm to direct lung function testing in the pulmonary function laboratory. Chest.
2003;123(6):1939–46.
62. Hankinson JL, Kawut SM, Shahar E, Smith LJ, Stukovsky KH, Graham Barr R. Performance of american thoracic society-recommended spirometry reference values in a multiethnic sample of adults the multi-ethnic study of atherosclerosis (MESA) lung study. Chest.
2010;137(1):138–45.
78
63. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. The role of reference values in interpreting lung function tests. De Sa JMAC, Santos AD, editors.
Eur Respir J Off J Eur Soc Clin Respir Physiol [Internet]. 2007;24(3):948–68. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16264058
64. Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:
GOLD executive summary. Am J Respir Crit Care Med [Internet].
2013;187(4):347–65. Available from: http://www.atsjournals.org/doi/pdf/10.1164/rccm.201204-0596PP
65. Brusasco V, Pellegrino R, Rodarte JR. Vital capacities in acute and chronic airway obstruction: Dependence on flow and volume histories. Eur Respir J.
1997;10(6):1316–20.
66. Celli BR, Halbert RJ, Isonaka S, Schau B. Population impact of different definitions of airway obstruction. Eur Respir J. 2003;22(2):268–73.
67. Hardie JA, Buist AS, Vollmer WM, Ellingsen I, Bakke PS, Mørkve O. Risk of overdiagnosis of COPD in asymptomatic elderly never-smokers. Eur Respir J.
2002;20(5):1117–22.
68. Webb WR. Radiology of obstructive pulmonary disease. AJR Am J Roentgenol.
1997;169(3):637–47.
69. Staggenborg A. Restrictive Pulmonary Disorders: an Overview. Educ Consult Serv [Internet]. 2009;5798(800). Available from: www.RCECS.com
70. Hanning CD, Alexander-Williams, Jm. Pulse oximetry: a practical review. Bmj.
1995;311(August):367–70.
71. Pretto JJ, Roebuck T, Beckert L, Hamilton G. Clinical use of pulse oximetry: official guidelines from the Thoracic Society of Australia and New Zealand. Respirology [Internet].
2014;19(1):38–46. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24251722 72. Kamat V. Pulse Oximetry. Int J Anaesth. 2002;46(4):261.
73. Petterson MT, Begnoche VL, Graybeal JM. The effect of motion on pulse oximetry and its clinical significance. Anesth Analg [Internet]. 2007;105(6 Suppl):S78-84. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/18048903
74. Milner QJ, Mathews GR. An assessment of the accuracy of pulse oximeters.
Anaesthesia [Internet]. 2012;67(4):396–401. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/22324874%5Cnhttp://onlinelibrary.wiley.com/st ore/10.1111/j.1365-2044.2011.07021.x/asset/j.1365-
2044.2011.07021 .x.pdf?v=1&t=h53ok9k9&s=7758f2e6c6943fc4069a65794ac47aff2f 933868
75. Adewole OO, Desalu OO, Nwogu KC, Adewole TO, Erhabor GE. Respiratory symptoms and lung function patterns in workers exposed to wood smoke and cooking oil fumes (mai suya) in Nigeria. Ann Med Health Sci Res. 2013;3(1):38–42.
76. Muhib FB, Lin LS, Stueve A, Miller RL, Ford WL, Johnson WD, et al. A venue-based method for sampling hard-to-reach populations. Public Health Rep. 2001;116(SUPPL.
1):216–22.
77. Cotes JECJE. Medical Research Council Questionnaire (MRCQ) on Respiratory Symptoms.
Occup Med (Chic Ill). 2007;57(5):388.
78. Roca J, Burgos F, Sunyer J, Saez M, Chinn S, Antó JM, et al. References values for forced spirometry. Eur Respir J. 1998;11(6):1354–62.
79. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Vol. 26, European Respiratory Journal. 2005. p. 319–
38.
80. V Umoh, E Peters, G Erhabor, E Ekpe and AI. Indoor air pollution and respiratory symptoms among fishermen in the Niger delta of Nigeria. africanjournalofrespiratorymedicine. 9(1):17–
21.
81. National Population Commission[Nigeria] (NPC). Nigeria Demographic and Health Survey 2013. Abuja, Nigeria; 2013.
80
82. Ibhafidon LI, Obaseki DO, Erhabor GE, Akor AA, Irabor I, Obioh I. Respiratory symptoms, lung function and particulate matter pollution in residential indoor environment in Ile-Ife, Nigeria. Niger Med J. 2014;55(1):48–53.
83. Patel MMMM, Chillrud SNSN, Correa JCJC, Hazi Y, Feinberg M, KC D, et al. Traffic-Related Particulate Matter and Acute Respiratory Symptoms among New York City Area Adolescents. Environ Health Perspect . 2010;118(9):1338–43.
84. Fell AKM, Thomassen TR, Kristensen P, Egeland T, Kongerud J. Respiratory symptoms and ventilatory function in workers exposed to portland cement dust. J Occup Environ Med.
2003;45(9):1008–14.
85. Umoh VA, Peters E. The relationship between lung function and indoor air pollution among rural women in the Niger Delta region of Nigeria. Lung India. 2014;31(0970– 2113 (Print)):110–5.
86. Peters, EJ. Esin, RA. Immananagha, KK. Siziya, S. Osim E. Lung function status of some Nigerian men and women chronically exposed to fish drying using burning wood. Cen Afr J Med. 1999;45:118–26.
87. Omland O, Würtz ET, Aasen TB, Blanc P, Brisman JB, Miller MR, et al. Occupational chronic obstructive pulmonary disease: a systematic literature review. Scand J Work Environ Health . 2014;40(1):19–35.
88. Diaz-Guzman E, McCarthy K, Siu A, Stoller JK. Frequency and causes of combined obstruction and restriction identified in pulmonary function tests in adults. Respir Care.
2010;55(3):310–6.
89. Swanney MP, Ruppel G, Enright PL, Pedersen OF, Crapo RO, Miller MR, et al. Using the lower limit of normal for the FEV1/FVC ratio reduces the misclassification of airway obstruction. Thorax. 2008;63:1046–51.
90. Vollmer WM, Gíslason P, Burney P, Enrigh PL, Gulsvik a., Kocabas a., et al. Comparison of spirometry criteria for the diagnosis of COPD: Results from the BOLD study. Eur Respir J. 2009;34(3):588–97.
91. Larsson K, Tornling G, Gavhed D, Müller-Suur C, Palmberg L. Inhalation of cold air increases the number of inflammatory cells in the lungs in healthy subjects. Eur Respir J.
1998;12(4):825–30.
92. Giesbrecht GG. The respiratory system in a cold environment. Aviat Space Environ Med.
1995;66(9):890–902.
93. Maekinen TM, Hassi J. Health Problems in Cold Work. Ind Health. 2009;47(3):207–
20.
94. Koskela HO. Cold air-provoked respiratory symptoms: the mechanisms and management. Int J Circumpolar Health. 2007;66(2):91–100.
95. Shirinde J, Wichmann J, Voyi K. Association between wheeze and selected air pollution sources in an air pollution priority area in South Africa: a cross-sectional study. Environ Health. 2014;13(1):32.
96. Sparrow D, Bosse R, Rosner B, Weiss R. The effect of occupational exposure on pulmonary function: a longitudinal evaluation of fire fighters and nonfire fighters. Am Rev Respir Dis.
1982;125(3):319–22.
97. Sherman CB, Barnhart S, Miller MF, Segal MR, Aitken M, Schoene R, et al.
Firefighting acutely increases airway responsiveness. Am Rev Respir Dis.
1989;140(1):185–90.
98. Zuskin E, Mustajbegovic J, Schachter EN. Respiratory symptoms and lung function in bus drivers and mechanics. Am J Ind Med. 1994;26(6):771–83.
99. Austin CC, Dussault G, Ecobichon DJ. Municipal firefighter exposure groups, time spent at fires and use of self-contained-breathing-apparatus. Am J Ind Med .
2001;40(6):683–92.
100. Zock JP, Sunyer J, Kogevinas M, Kromhout H, Burney P, Antó JM. Occupation, chronic bronchitis, and lung function in young adults. An international study. Am J Respir Crit Care Med . 2001;163(7):1572–27.
82
101. Orozco-Levi M, Garcia-Aymerich J, Villar J, Ramírez-Sarmiento a, Antó JM, Gea J. Wood smoke exposure and risk of chronic obstructive pulmonary disease. Eur Respir J . 2006;27(3):542–6.
102. Salvi SS, Barnes PJ. Chronic obstructive pulmonary disease in non-smokers. Lancet.
2009;374(9691):733–43.
103. Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease.
Lancet. 2012;379(9823):1341–51.
104. Moreira MA, Moraes MR, Silva DG, Pinheiro TF, Vasconcelos Junior HM, Maia LF, et al.
Comparative study of respiratory symptoms and lung function alterations in patients with chronic obstructive pulmonary disease related to the exposure to wood and tobacco smoke. J Bras Pneumol . 2008;34(9):667–74.
105. Fullerton DG, Suseno A, Semple S, Kalambo F, Malamba R, White S, et al. Wood smoke exposure, poverty and impaired lung function in Malawian adults. Int J Tuberc Lung Dis.
2011;15(3):391–8.
106. Marchetti N, Garshick E, Kinney GL, Mckenzie A, Stinson D, Lutz SM, et al.
Association between Occupational Exposure and Lung Function , Respiratory Symptoms , and High-Resolution Computed Tomography Imaging in COPDGene.
2014;190(7):756–62.
107. Huuskonen O, Kivisaari L, Zitting A, Kaleva S, Vehmas T. Emphysema findings associated with heavy asbestos-exposure in high resolution computed tomography of finnish construction workers. J Occup Health. 2004;46:266–71.
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