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      Effect of exposure to biomass smoke from cooking fuel types and eye disorders in women from hilly and plain regions of Nepal

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          Abstract

          Background/Aim

          To study the association between exposure to biomass smoke from cooking fuels andi cataract, visual acuity and ocular symptoms in women.

          Methods

          We conducted a community-based cross-sectional study among women (≥20 years and without a previous diagnosis of cataract, ocular trauma or diabetes or those taking steroids) from hilly and plain regions of Nepal. Eligible participants received an interview and a comprehensive eye assessment (cataract development, visual acuity test and ocular symptoms). Participants’ data on demographics, cooking fuel type and duration of use, and cooking habits were collected. We addressed potential confounders using the propensity score and other risk factors for ocular diseases through regression analysis.

          Results

          Of 784 participants, 30.6% used clean fuel (liquefied petroleum gas, methane, electricity) as their primary current fuel, and the remaining 69.4% used biomass fuels. Thirty-nine per cent of the total participants had cataracts—about twofold higher in those who currently used biomass fuel compared with those who used clean fuel (OR=2.27; 95% CI 1.09 to 4.77) and over threefold higher in those who always used biomass. Similarly, the nuclear cataract was twofold higher in the current biomass user group compared with the clean fuel user group (OR=2.53; 95% CI 1.18–5.42) and over threefold higher among those who always used biomass. A higher proportion of women using biomass had impaired vision, reported more ocular symptoms compared with those using clean fuel. Severe impaired vision and blindness were only present in biomass fuel users. However, the differences were only statistically significant for symptoms such as redness, burning sensation, a complaint of pain in the eye and tear in the eyes.

          Conclusions

          Cataract was more prevalent in women using biomass for cooking compared with those using clean fuel.

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          Most cited references26

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          Is Open Access

          Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015

          Summary Background Exposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country levels. Methods We estimated global population-weighted mean concentrations of particle mass with aerodynamic diameter less than 2·5 μm (PM2·5) and ozone at an approximate 11 km × 11 km resolution with satellite-based estimates, chemical transport models, and ground-level measurements. Using integrated exposure–response functions for each cause of death, we estimated the relative risk of mortality from ischaemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, lung cancer, and lower respiratory infections from epidemiological studies using non-linear exposure–response functions spanning the global range of exposure. Findings Ambient PM2·5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7 million to 4·8 million) deaths and 103·1 million (90·8 million 115·1 million) disability-adjusted life-years (DALYs) in 2015, representing 7·6% of total global deaths and 4·2% of global DALYs, 59% of these in east and south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95% UI 97 000–422 000) deaths and a loss of 4·1 million (1·6 million to 6·8 million) DALYs from chronic obstructive pulmonary disease in 2015. Interpretation Ambient air pollution contributed substantially to the global burden of disease in 2015, which increased over the past 25 years, due to population ageing, changes in non-communicable disease rates, and increasing air pollution in low-income and middle-income countries. Modest reductions in burden will occur in the most polluted countries unless PM2·5 values are decreased substantially, but there is potential for substantial health benefits from exposure reduction. Funding Bill & Melinda Gates Foundation and Health Effects Institute.
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            Genetics of human cataract.

            The pathogenesis of inherited cataracts of all kinds recapitulates the developmental and cell biology of the lens. Just as each novel mutation provides additional information about the structural or functional biology of the affected gene, each newly identified gene provides insight into the developmental and cellular biology of the lens. The set of genes currently known to be associated with cataract is far from complete, especially for age-related cataract, and there is much additional information to be discovered through further genetic studies. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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              Risk of COPD from exposure to biomass smoke: a metaanalysis.

              Although many studies have suggested that biomass smoke is a risk factor for COPD, the relationship between the two has not been firmly established. In particular, the extent of the association between exposure of biomass smoke and COPD in different populations, as well as the relationship between biomass smoke and cigarette smoke, is not clear. To ascertain the relationship between biomass smoke and COPD, we performed a metaanalysis. We searched MEDLINE, EMBASE, and the Latin American and Caribbean Literature in Health Sciences Database and analyzed 15 epidemiologic (11 cross-sectional and four case-control) studies that met our criteria. Data were extracted and analyzed independently by two investigators using a standardized protocol. Overall, people exposed to biomass smoke have an odds ratio (OR) of 2.44 (95% CI, 1.9-3.33) for developing COPD, relative to those not exposed to biomass smoke. Biomass smoke exposure was clearly identified as a risk factor for developing COPD in both women (OR, 2.73; 95% CI, 2.28-3.28) and men (OR, 4.30; 95% CI, 1.85-10.01), and in both the Asian population (OR, 2.31; 95% CI, 1.41-3.78) and the non-Asian population (OR, 2.56; 95% CI, 1.71-3.83). This risk factor has also been revealed in patients with chronic bronchitis (OR, 2.56; 95% CI, 1.77-3.70) and COPD (OR, 2.65; 95% CI, 1.75-4.03), and in cigarette smokers (OR, 4.39; 95% CI, 1.40-4.66) and non-cigarette smokers (OR, 2.55; 95% CI, 2.06-3.15). Exposure to biomass smoke is a risk factor for COPD.
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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                British Journal of Ophthalmology
                Br J Ophthalmol
                BMJ
                0007-1161
                1468-2079
                December 16 2021
                January 2022
                January 2022
                September 12 2020
                : 106
                : 1
                : 141-148
                Article
                10.1136/bjophthalmol-2020-316766
                32920527
                3cc29944-6100-4d04-9a9e-d89c3ecb378b
                © 2020
                History

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