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Short-term Effects of Wood Smoke Exposure on the Respiratory System Among Charcoal Production Workers^*

^* From the Department of Thoracic Medicine (Drs. Tzanakis, Bouros, Samiou, and Siafakas), Medical School, University of Crete, Heraklion, Crete; and General Hospital of Rethymnon (Dr. Kallergis), Crete, Greece.

Correspondence to: Nikolaos Tzanakis, MD, Senior Registrar in Respiratory Medicine, Department of Thoracic Medicine, University Hospital of Heraklion, PO Box 1352, 71110 Heraklion, Crete, Greece; e-mail: tzanakis{at}med.uoc.gr

Study objectives: We aimed to investigate the short-term respiratory effects of heavy, occupational wood smoke exposure among traditional charcoal production workers.

Patients and setting: A total of 22 charcoal workers (mean age, 41 years; 9 current smokers, 5 ex-smokers, and 8 nonsmokers) were studied and compared with a control group of 35 farmers residing in Perama, Rethymnon, Crete.

Results: The charcoal workers were exposed to wood smoke for an average of 14 h/d during a mean of 23.7 days required for the burning of kilns. The workers under study were found to have significantly more cough (odds ratio [OR], 4.8; 95% confidence interval [CI], 1.2 to 19.7), sputum production (OR, 6; 95% CI, 1.4 to 26.5), wheezing (OR, 7.7; 95% CI, 1.4 to 41.5), dyspnea (OR, 28.7; 95% CI, 5.4 to 153), and hemoptysis (OR, 2.7; 95% CI, 0.7 to 55) than the control group. The prevalence of respiratory symptoms such as cough, sputum production, wheezing, and dyspnea in the charcoal workers was significantly elevated during the exposure period (OR, 5.4; 95% CI, 1.1 to 17.7; OR, 5.7; 95% CI, 1 to 31; OR, 9.8; 95% CI, 1 to 88; and OR, 36.7; 95% CI, 1 to 327, respectively). The mean ± SD percent of predicted values of FVC, FEV₁, FEV₁/FVC ratio, and forced expiratory flow at 25 to 75% of FVC during the exposure period were significantly lower than those before exposure: 106 ± 10.8 vs 101 ± 11.9, p < 0.01; 104 ± 16 vs 97 ± 15, p < 0.001; 81 ± 9 vs 78 ± 8, p < 0.001; and 95 ± 27 vs 80 ± 25, p < 0.01, respectively. The mean ± SD value of peak expiratory flow at midday and in the evening during the exposure were significantly lower than before: 524 ± 131 L/min vs 548 ± 108 L/min, p = 0.03; and 521 ± 135 L/min vs 547 ± 131 L/min, p = 0.02, respectively.

Conclusions: Our results suggest that wood smoke exposure in charcoal workers is associated with increased respiratory symptoms and decreased pulmonary function. Longitudinal studies are needed to determine potential long-term adverse respiratory effects.

Key Words: charcoal production • occupational exposure • wood smoke

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