Residential Wood Burning and Pulmonary Function in the Agricultural Lung Health Study

Julie D White; Annah B Wyss; Thanh T Hoang; Mikyeong Lee; Marie Richards; Christine G Parks; Laura E Beane-Freeman; John L Hankinson; David M Umbach; Stephanie J London

doi:10.1289/EHP10734

Residential Wood Burning and Pulmonary Function in the Agricultural Lung Health Study

Environ Health Perspect. 2022 Aug;130(8):87008. doi: 10.1289/EHP10734. Epub 2022 Aug 25.

Authors

Affiliations

¹ Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
² GenOmics, Bioinformatics, and Translational Research Center, Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, North Carolina, USA.
³ Westat, Durham, North Carolina, USA.
⁴ Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
⁵ Hankinson Consulting, Inc., Athens, Georgia, USA.
⁶ Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
⁷ Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.

Abstract

Background: In low- and middle-income countries, burning biomass indoors for cooking or heating has been associated with poorer lung function. In high-income countries, wood, a form of biomass, is commonly used for heating in rural areas with increasing prevalence. However, in these settings the potential impact of chronic indoor woodsmoke exposure on pulmonary function is little studied.

Objective: We evaluated the association of residential wood burning with pulmonary function in case-control study of asthma nested within a U.S. rural cohort.

Methods: Using sample weighted multivariable linear regression, we estimated associations between some and frequent wood burning, both relative to no exposure, in relation to forced expiratory volume in 1 s ( ${FEV}_{1}$ ), forced vital capacity (FVC), their ratio ( ${FEV}_{1} / FVC$ ), and fractional exhaled nitric oxide (FeNO). We examined effect modification by smoking or asthma status.

Results: Among all participants and within smoking groups, wood burning was not appreciably related to pulmonary function. However, in individuals with asthma ( $n = 1,083$ ), frequent wood burning was significantly associated with lower ${FEV}_{1}$ [ $β$ : $- 164 mL$ ; 95% confidence interval (CI): $- 261$ , $- 66 mL$ ], FVC ( $β$ : $- 125 mL$ ; 95% CI: $- 230$ , $- 20 mL$ ), and ${FEV}_{1} / FVC$ ( $β$ : $- 2 %$ ; 95% CI: $- 4$ , $- 0.4 %$ ), whereas no appreciable association was seen in individuals without asthma ( $n = 1,732$ ). These differences in association by asthma were statistically significant for ${FEV}_{1}$ ( $p_{i n t e r a c t i o n} = 0.0044$ ) and ${FEV}_{1} / FVC$ ( $p_{i n t e r a c t i o n} = 0.049$ ). Frequent wood burning was also associated with higher FeNO levels in all individuals ( $n = 2,598$ ; $β$ : $0.1 ln (ppb)$ ; 95% CI: 0.02, 0.2), but associations did not differ by asthma or smoking status.

Discussion: Frequent exposure to residential wood burning was associated with a measure of airway inflammation (FeNO) among all individuals and with lower pulmonary function among individuals with asthma. This group may wish to reduce wood burning or consider using air filtration devices. https://doi.org/10.1289/EHP10734.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Asthma* / epidemiology
Forced Expiratory Volume
Humans
Lung
Vital Capacity
Wood*