論文No4020
Occupational Exposure to Charcoal Smoke and Dust, a Major Risk Factor for COPD
A Multiregional Cross-Sectional Study in the Democratic Republic of Congo
Pierre Olenga Vuvu Lofuta,Malgorzata Klass,Nathalie Pauwen,...Alain Van Muylem,Silvia Perez-Bogerd,Gaël Deboeck
CHEST, Volume 166, Issue 6, p1334-1346, December 2024.
要約
この研究は、コンゴ民主共和国（DRC）の農村部において、炭焼き労働者が農民に比べて慢性閉塞性肺疾患（COPD）を発症するリスクが高いことを示しました。
DRC南西部の木炭生産地域において、炭焼き労働者と農民、炭を販売する女性と野菜を販売する女性を比較対象とし、呼吸器症状や肺機能を調査しました。
その結果、炭焼き労働者や炭を販売する女性は、農民や野菜を販売する女性に比べて、COPDの有病率が有意に高いことがわかりました。
これは、炭の煙や粉塵を日常的に吸い込むことで、肺が慢性的に炎症を起こし、COPDの発症リスクが高まることを示唆しています。
Take Home Message
炭焼き労働者の健康リスク: DRCの炭焼き労働者は、職業病としてのCOPDのリスクが非常に高いことが明らかになりました。
大気汚染の影響: 炭の煙や粉塵といった大気汚染物質が、肺の健康に深刻な影響を与えることを示唆しています。
予防の重要性: 炭焼き労働者に対する呼吸器保護具の着用や、作業環境の改善といった予防対策が急務です。
グローバルな健康問題: この研究結果は、開発途上国における伝統的な燃料利用と健康問題の関係を示すものであり、グローバルな健康問題として捉える必要があります。
Background
Occupational exposure to charcoal smoke and dust is a threat to workers’ respiratory systems.
Research Question
What is the prevalence of COPD in charcoal workers compared with that of farmers in rural areas of Democratic Republic of Congo (DRC)?
Study Design and Methods
This cross-sectional, comparative, and multisite study was performed in the charcoal-producing provinces of southwestern DRC. We randomly included charcoal workers and compared them with farmers (age range, 18-70 years). Air quality indexes, anthropometric features, physical activity, sociodemographic characteristics, and related medical events data were recorded. A lung function questionnaire was used to assess respiratory symptoms and spirometry was performed. COPD was defined as the presence of respiratory symptoms for > 3 months with an FEV1 to FVC ratio less than the lower limit of normal. The prevalence of COPD was calculated, and logistic regression was used to identify COPD-associated factors.
Results
We included 485 participants between August 2020 and July 2021. Charcoal producers (CPs; n = 229) were compared with farmers (n = 118), and charcoal saleswomen (n = 72) were compared with vegetable saleswomen (n = 66). Respective groups were similar in age, job seniority, height, and weight. The air was more polluted at charcoal workplaces. The prevalence of COPD was higher in CPs than in farmers (39.7% vs 14.4%; P < .0001) and higher in charcoal saleswomens compared with vegetable saleswomen (40.3% vs 13.6%; P < .0001). Being a charcoal worker was associated independently with COPD in the CP and farmers groups (adjusted OR, 3.54; 95% CI, 1.94-6.46) and in the saleswomen group (adjusted OR, 7.85; 95% CI, 2.85-21.5), where it was also associated independently with young age (adjusted OR, 0.85; 95% CI, 0.80-0.93) and monthly income (adjusted OR, 0.88; 95% CI, 0.83-0.96).
Interpretation
In rural areas of DRC, producing or selling charcoal is associated with a higher risk of COPD.