The effect of exposure to biomass smoke on respiratory symptoms in adult rural and urban Nepalese populations

Om P Kurmi, Sean Semple, Graham S Devereux, Santosh Gaihre, Kin Bong Hubert Lam, Steven Sadhra, Markus F C Steiner, Padam Simkhada, William C S Smith, Jon G Ayres

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)
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BACKGROUND: Half of the world's population is exposed to household air pollution from biomass burning. This study aimed to assess the relationship between respiratory symptoms and biomass smoke exposure in rural and urban Nepal.

METHODS: A cross-sectional study of adults (16+ years) in a rural population (n = 846) exposed to biomass smoke and a non-exposed urban population (n = 802) in Nepal. A validated questionnaire was used along with measures of indoor air quality (PM2.5 and CO) and outdoor PM2.5.

RESULTS: Both men and women exposed to biomass smoke reported more respiratory symptoms compared to those exposed to clean fuel. Women exposed to biomass were more likely to complain of ever wheeze (32.0 % vs. 23.5%; p = 0.004) and breathlessness (17.8% vs. 12.0%, p = 0.017) compared to males with tobacco smoking being a major risk factor. Chronic cough was similar in both the biomass and non-biomass smoke exposed groups whereas chronic phlegm was reported less frequently by participants exposed to biomass smoke. Higher PM2.5 levels (≥2 SDs of the 24-hour mean) were associated with breathlessness (OR = 2.10, 95% CI 1.47, 2.99) and wheeze (1.76, 1.37, 2.26).

CONCLUSIONS: The study suggests that while those exposed to biomass smoke had higher prevalence of respiratory symptoms, urban dwellers (who were exposed to higher ambient air pollution) were more at risk of having productive cough.

Original languageEnglish
Article number92
Number of pages8
JournalEnvironmental health : a global access science source
Publication statusPublished - 6 Nov 2014
Externally publishedYes

Bibliographical note

© 2014 Kurmi et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


  • Adolescent
  • Adult
  • Air Pollutants/toxicity
  • Air Pollution, Indoor/adverse effects
  • Biomass
  • Cough/chemically induced
  • Cross-Sectional Studies
  • Dyspnea/chemically induced
  • Environmental Exposure
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nepal/epidemiology
  • Prevalence
  • Respiratory Sounds/etiology
  • Risk Factors
  • Rural Population
  • Smoke/adverse effects
  • Urban Population
  • Young Adult
  • Breathlessness
  • Phlegm
  • Solid fuel
  • Household air pollution


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