Clinico-radiological and functional assessment of respiratory symptomatics with either exposure to biomass fuel smoke or tobacco smoking

Abstract

Background: Biomass fuel smoke exposure and smoking are two major causes of obstructive airway disease.

Aim and objectives: Clinico-radiological and functional assessment in respiratory symptomatics with either exposure tobiomass fuel smoke or tobacco smoking.

Methods: A total of 85 consecutive respiratory symptomatics with either exposure tobiomass fuel smoke (Group 1: 41 never smokers) or tobacco smoking (Group 2: 44) with a clinical diagnosis of COPD were enrolled. Both groups, age matched with no obvious chest radiographic abnormalities, underwent PFT, six minute walk test and HRCT thorax.

Results: The mean age in Groups 1 and 2 were 58.1±9.5 v/s 59.6±7.9 years respectively. In Group 1, all 41 patients were females while in Group 2, there were 39 males and 5 females. Cough was the most common 39/41(95.1%) symptom in Group 1 while dyspnoea was predominant symptom 40/44(90.9%) in Group 2. Post bronchodilator FEV₁ (64±18.8% v/s 54.3±18.9%; P=0.019) and FEV₁/FVC (67.0±20.6 v/s 46.8±11.3; P=0.0001) were significantly lower in Group 2. Six minute walk distance was significantly less in Group 1 (282.9±89.6 v/s 337.9±75.1; P=0.0028) as compared to Group 2. Diffuse fibrotic bands 24/41(58.5%) and bronchial wall thickening 16/41(39%) were commonest imaging finding in Group 1 while emphysematous changes were predominantly 36/44(81.8%) seen in Group 2.

Conclusions: Patients in Group 1 had more of a restrictive pattern on PFT and exercise tolerance was significantly lower. Patients in Group 2 had more emphysematous changes with poorer lung functions but a better functional status.