PT - JOURNAL ARTICLE AU - Peter Moschovis AU - Lauren Kleimola AU - Nicolas Oreskovic AU - David Christiani AU - Patricia Hibberd TI - Household air pollution, smoking, and chronic respiratory disease in low and middle-income countries DP - 2014 Sep 01 TA - European Respiratory Journal PG - P1943 VI - 44 IP - Suppl 58 4099 - http://erj.ersjournals.com/content/44/Suppl_58/P1943.short 4100 - http://erj.ersjournals.com/content/44/Suppl_58/P1943.full SO - Eur Respir J2014 Sep 01; 44 AB - IntroductionHousehold air pollution (HAP) and smoking are important risk factors for chronic respiratory disease in low and middle-income countries (LMIC). We assessed the relative contributions of HAP and smoking to chronic respiratory disease in adults across 44 LMIC.MethodsWe used data from the World Health Survey, conducted by the WHO in 2002-2004. The survey measured exposure to HAP (use of high-polluting cooking fuel), current tobacco smoking, and respiratory symptoms in the past year (wheezing, exercise-induced wheezing, chest tightness, nocturnal chest tightness, and shortness of breath). We measured the effect of HAP and smoking on the odds of wheezing or any respiratory symptom.ResultsA total of 197,295 adults across 44 countries were included in the analysis, representing a weighted population of 1.69 billion; 58.2% were exposed to HAP and 26.8% were currently smoking. Among respondents, 8.9% reported wheezing and 17.2% reported any respiratory symptom. After adjusting for age, sex, income, and urban setting, the combination of HAP and smoking was associated with a greater odds of wheezing or any respiratory symptom than either risk factor alone.ConclusionsThe combination of HAP and tobacco smoking significantly increases the risk of wheezing and chronic respiratory symptoms. Both risk factors must be addressed in order to reduce the global burden of chronic respiratory disease.