SPIROMETRIC AND CLINICAL PROFILE OF NON-SMOKING WOMEN WITH BIOMASS-FUEL-RELATED COPD COMPARED WITH TOBACCO-SMOKING MEN: A CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL

Abstract

Background: In non-smoking women of South Asia, a prominent risk factor for COPD is biomass fuel combustion, which leads to a specific COPD phenotype, defined by less emphysema and more small-airway disease. Systematic comparison of this phenotype with tobacco-smoking COPD has implications for clinical management and public health policy.

Methods: A cross-sectional study compared 120 non-smoking women with biomass-fuel-related COPD (≥200 hour-years cumulative cooking exposure) with 120 tobacco-smoking men with COPD at a tertiary care hospital. Spirometry, HRCT chest, GOLD staging, CAT/mMRC scores, and BODE index were assessed.

Results: Biomass-COPD patients showed predominantly small-airway phenotype on HRCT (86.7% vs 54.2%), more frequent productive cough (72.5% vs 48.3%), less radiological emphysema (18.3% vs 52.5%), similar GOLD stage distribution (both predominantly II/III), lower BMI (21.4±3.8 vs 23.8±4.2 kg/m²), and higher mMRC ≥2 (61.7% vs 50.8%). Cumulative biomass exposure >200 hour-years, poor kitchen ventilation and more than two children were independent risk factors for moderate-severe disease in the biomass group.

Conclusion: Biomass-fuel COPD represents a distinct COPD phenotype in Indian women, with small-airway predominance and greater symptomatic burden despite similar spirometric severity. Improved cookstoves, kitchen ventilation, and LPG access are key priorities for household air pollution interventions.