Skip to main content
SpringerLink
Log in

Increased cardiovascular risk in association with chronic airflow obstruction among premenopausal rural women of India who cook exclusively with biomass

  • Published:
Air Quality, Atmosphere & Health Aims and scope Submit manuscript

Abstract

We aimed to compare the cardiovascular risk in biomass-using women with or without chronic obstructive pulmonary disease (COPD). A total of 22 biomass-using married women with COPD and 24 matched controls with normal lung function were enrolled for this purpose. Platelet P-selectin (P-sel) expression and platelet–leukocyte aggregation were determined using flow cytometry. Platelet aggregation by collagen was measured by aggregometer. Soluble P-selectin (sP-sel), tumor necrosis factor-alpha (TNF-α), interleukin-8, -6, -10 (IL-8, IL-6, IL-10), neutrophil-activating protein-2 (NAP-2), C-reactive protein (CRP), oxidized low density lipoprotein (oxLDL) in plasma were measured by enzyme-linked immunosorbent assay. Generation of reactive oxygen species (ROS) by leukocytes was measured by flow cytometry, and erythrocyte content of superoxide dismutase (SOD) was measured by spectrophotometry. Particulate matter with a diameter of less than 2.5 μm (PM2.5) in indoor air was measured by real-time aerosol monitor. Compared with control, biomass users with COPD had increased expression of platelet P-selectin, elevated levels of sP-sel, oxLDL, TNF-α, IL-8, IL-6, NAP-2, CRP, lowered IL-10 and more circulating platelet-neutrophil (p < 0.0001) and platelet–monocyte (p < 0.0001) aggregates. ROS generation was increased by 19.5% while SOD was depleted by 32% in women with COPD. Biomass smoke-induced COPD is associated with excess cardiovascular risk via oxidative stress, platelet activation, and inflammation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Abelsohn A (2011) Health effects of outdoor air pollution. Can Fam Physician 57:881–887

    Google Scholar 

  • American Thoracic Society (ATS) (1995) Standardization of spirometry, 1994 Update. Am J Respir Crit Care Med 152:1107–1136

    Google Scholar 

  • Barregard L, Sällsten G, Andersson L, Almstrand AC, Gustafson P, Andersson M, Olin AC (2008) Experimental exposure to wood smoke: effects on airway inflammation and oxidative stress. Occup Env Med 65:319–324

    Article  CAS  Google Scholar 

  • Blanc PD, Iribarren C, Trupin L, Earnest G, Katz PP, Balmes J, Sidney S, Eisner MD (2009) Occupational exposures and the risk of COPD: dusty trades revisited. Thorax 64:6–12

    Article  CAS  Google Scholar 

  • Brook RD, Brook JR, Urch B, Vincent R, Rajagopalan S, Silverman F (2002) Inhalation of fine particulate air pollution and ozone causes acute arterial vasoconstriction in healthy adults. Circulation 105:1534–1536

    Article  CAS  Google Scholar 

  • Bruce N, Perez-Padilla R, Albalak R (2000) Indoor air pollution in developing countries: a major environmental and public health challenge. Bull World Health Organ 78:1078–1092

    CAS  Google Scholar 

  • Castelli WP (1984) Epidemiology of coronary heart disease. The Framinghan Study. Am J Med 76:4–12

    Article  CAS  Google Scholar 

  • Chapman RS, He X, Blair AE, Lan Q (2005) Improvement in household stoves and risk of chronic obstructive pulmonary disease in Xuanwei, China: retrospective cohort study. BMJ 331:1050–1055

    Article  Google Scholar 

  • Curkendall SM, DeLuise C, Jones JK, Lanes S, Stang MR, Goehring E Jr, She D (2006) Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients. Ann Epidemiol 16:63–70

    Article  Google Scholar 

  • Desai MA, Mehta S, Smith KR (2004) Indoor smoke from solid fuels. Assessing the environmental burden of disease at national and local levels, World Health Organization, Geneva

    Google Scholar 

  • Dutta A, Mukherjee B, Das D, Banerjee A, Ray MR (2011) Hypertension with elevated levels of oxidized low-density lipoprotein and anticardiolipin antibody in the circulation of premenopausal Indian women chronically exposed to biomass smoke during cooking. Indoor Air 21:165–176

    Article  CAS  Google Scholar 

  • Ehlert JE, Ludwig A, Grimm TA, Lindner B, Flad HD, Brandt E (2000) Down-regulation of neutrophil functions by the ELR(+) CXC chemokine platelet basic protein. Blood 96:2965–2972

    CAS  Google Scholar 

  • Ekici A, Ekici M, Kurtipek E, Akin A, Arslan M, Kara T, Apaydin Z, Demir S (2005) Obstructive airway diseases in women exposed to biomass smoke. Environ Res 99:93–98

    Article  CAS  Google Scholar 

  • Ezzati M (2005) Indoor air pollution and health in developing countries. Lancet 366:104–106

    Article  Google Scholar 

  • Ferroni P, Basili S, Martini F, Vieri M, Labbadia G, Cordova C, Alessandri C, Gazzaniga PP (2000) Soluble P-selectin as a marker of platelet hyperactivity in patients with chronic obstructive pulmonary disease. J Investig Med 48:21–27

    CAS  Google Scholar 

  • Fimognari FL, Scarlata S, Conte ME, Incalzi RA (2008) Mechanisms of atherothrombosis in chronic obstructive pulmonary disease. Int J COPD 3:89–96

    Google Scholar 

  • Frampton MW (2006) Inflammation and airborne particles. Clin Occup Env Med 5:797–815

    Google Scholar 

  • Gan WQ, Man SF, Senthilselvan A, Sin DD (2004) Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 59:574–580

    Article  CAS  Google Scholar 

  • Halonen JI, Lanki T, Yli-Tuomi T, Kulmala M, Tiittanen P, Pekkanen J (2008) Urban air pollution, and asthma and COPD hospital emergency room visits. Thorax 63:635–641

    Article  CAS  Google Scholar 

  • Hogg JC (2004) Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet 364:709–721

    Article  Google Scholar 

  • Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, Cherniack RM, Rogers RM, Sciurba FC, Coxson HO, Paré PD (2004) The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 350:2645–2653

    Article  CAS  Google Scholar 

  • Hsia J, Margolis KL, Eaton CB, Wenger NK, Allison M, Wu L, LaCroix AZ, Black HR; Women’s Health Initiative Investigators (2007) Prehypertension and cardiovascular disease risk in the Women’s Health Initiative. Circulation 115:855–860

    Article  Google Scholar 

  • Hu G, Zhou Y, Tian J, Yao W, Li J, Li B, Ran P (2010) Risk of COPD from exposure to biomass smoke: a metaanalysis. Chest 138:20–31

    Article  Google Scholar 

  • Hunninghake DB (2005) Cardiovascular disease in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2:44–49

    Article  CAS  Google Scholar 

  • Iwamoto H, Yokoyama A (2009) COPD in smokers with atherosclerosis: are we missing the trail? Am J Respir Crit Care Med 180:103–104

    Google Scholar 

  • JNC-7 (2003) Seventh Report of the Joint Committee on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Bethesda, MD, National Heart, Lung, Blood Institute, National High Blood Pressure Education Program, May 2003. Available at http://www.nhbli.nih. gov/guidelines/hypertension/. Accessed 9 June 2010

  • Kurmi OP, Semple S, Simkhada P, Smith WC, Ayres JG (2010) COPD and chronic bronchitis risk of indoor air pollution from solid fuel: a systematic review and meta-analysis. Thorax 65:221–228

    Article  Google Scholar 

  • Kusche-Vihrog K, Urbanova K, Blanqué A, Wilhelmi M, Schillers H, Kliche K, Pavenstädt H, Brand E, Oberleithner H (2011) C-reactive protein makes human endothelium stiff and tight. Hypertension 57:231–237

    Article  CAS  Google Scholar 

  • Lassègue B, Griendling KK (2004) Reactive oxygen species in hypertension: an update. Am J Hypertens 17:852–860

    Article  Google Scholar 

  • Li N, Goodall AH, Hjemdahl P (1997) A sensitive flow cytometric assay for circulating platelet-leucocyte aggregates. Br J Haematol 99:808–816

    Article  CAS  Google Scholar 

  • Lindgren A, Stroh E, Montnémery P, Nihlén U, Jakobsson K, Axmon A (2009) Traffic-related air pollution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern Sweden. Int J Health Geogr 8:2

    Article  Google Scholar 

  • Lipton R, Banerjee A, Dowling KC, Treno AJ (2005) The geography of COPD hospitalization in California. COPD 2:435–444

    Article  Google Scholar 

  • Liu SM, Wang XP, Wang DL, Zhou YM, Lü JC, Zheng JP, Zhong NS, Ran PX (2005) Epidemiologic analysis of COPD in Guangdong province. Zhonghua Yi Xue Za Zhi 85:747–752

    Google Scholar 

  • Liu S, Zhou Y, Wang X, Wang D, Lu J, Zheng J, Zhong N, Ran P (2007) Biomass fuels are the probable risk factor for chronic obstructive pulmonary disease in rural South China. Thorax 62:889–897

    Article  Google Scholar 

  • Maclay JD, McAllister DA, Johnston S, Raftis J, McGuinnes C, Deans A, Newby DE, Mills NL, Macnee W (2011) Increased platelet activation in patients with stable and acute exacerbation of COPD. Thorax 66:769–774

    Article  Google Scholar 

  • Melville AM, Pless-Mulloli T, Afolabi OA, Stenton SC (2010) COPD prevalence and its association with occupational exposures in a general population. Eur Res J 36:488–493

    Article  CAS  Google Scholar 

  • Menezes AMB, Perez-Padilla R, Jardim JRB, Muiño A, Lopez MV, Valdivia G, de Oca MM, Talamo C, Hallal PC, Victoria CG (2005) Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet 366:1875–1881

    Article  Google Scholar 

  • Michelson AD, Linden MD, Barnard MR, Furman MI, Frelinger AL III (2007) Flow cytometry. In: Michelson AD (ed) Platelets, 2nd edn. Elsevier/Academic Press, San Diego, pp 545–564

    Chapter  Google Scholar 

  • Montecucco F, Steffens S, Burger F, Da Costa A, Bianchi G, Bertolotto M, Mach F, Dallegri F, Ottonello L (2008) Tumor necrosis factor-alpha (TNF-alpha) induces integrin CD11b/CD18 (Mac-1) up-regulation and migration to the CC chemokine CCL3 (MIP 1-alpha) on human neutrophils through defined signaling pathways. Cell Signal 20:557–568

    Article  CAS  Google Scholar 

  • O’Brien E, Petrie J, Littler WA, De Swiet M, Padfield P, Dillon MJ (1997) Blood pressure measurement: recommendations of the British Hypertension Society, 3rd edn. BMJ Publishing Group, London

    Google Scholar 

  • Orozco-Levi M, Garcia-Aymerich J, Villar J, Ramirez-Sarmiento A, Anto JM, Gea J (2006) Wood smoke exposure and risk of chronic obstructive pulmonary disease. Eur Respir J 27:542–546

    Article  CAS  Google Scholar 

  • Paoletti F, Aldinucci D, Mocali A, Caparrini A (1986) A sensitive spectrophotometric method for the determination of superoxide dismutase activity in tissue extracts. Anal Biochem 154:536–541

    Article  CAS  Google Scholar 

  • Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS (2001) GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Resp Crit Care Med 163:1256–1276

    CAS  Google Scholar 

  • Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO III, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith SC Jr, Taubert K, Tracy RP, Vinicor F (2003) Markers of inflammation and cardiovascular disease. Application to clinical and public health practice: a statement for Healthcare Professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 107:499–511

    Article  Google Scholar 

  • Qureshi AI, Suri MFK, Kirmani JF, Divani AA, Mohammad Y (2005) Is Prehypertension a risk factor for cardiovascular diseases? Stroke 36:1859–1863

    Article  Google Scholar 

  • Rahman I, MacNee W (1996) Oxidant antioxidant imbalance in smokers and chronic obstructive pulmonary disease. Thorax 51:348–350

    Article  CAS  Google Scholar 

  • Rahman I, Morrison D, Donaldson K, MacNee W (1996) Systemic oxidative stress in asthma, COPD, and smokers. Am J Respir Crit Care Med 154:1055–1060

    CAS  Google Scholar 

  • Ramírez-Venegas A, Sansores RH, Perez-Padilla R, Regalado J, Velazquez A, Sanchez C, Mayar ME (2006) Survival of patients with chronic obstructive pulmonary disease due to biomass smoke and tobacco. Am J Respir Crit Care Med 173:393–397

    Article  Google Scholar 

  • Rinne ST, Rodas EJ, Bender BS, Rinne ML, Simpson JM, Galer-Unti R, Glickman LT (2006) Relationship of pulmonary function among women and children to indoor air pollution from biomass use in rural Ecuador. Respir Med 100:1208–1215

    Article  Google Scholar 

  • Rosenfeld JB, Silverberg DS, Viskoper R (1985) Hypertension control in the community. Libbey (John) and Company Ltd, London

    Google Scholar 

  • Rothe G, Valet G (1990) Flow cytometric analysis of respiratory burst activity in phagocytes with hydroethidine and 2′,7′-dichlorofluorescein. J Leukoc Biol 47:440–448

    CAS  Google Scholar 

  • Salvi S, Barnes PJ (2010) Is exposure to biomass smoke the biggest risk factor for COPD globally? Chest 138:3–6

    Article  Google Scholar 

  • Schiemann F, Grimm TA, Hoch J, Gross R, Lindner B, Petersen F, Bulfone-Paus S, Brandt E (2006) Mast cells and neutrophils proteolytically activate chemokine precursor CTAP-III and are subject to counterregulation by PF-4 through inhibition of chymase and cathepsin G. Blood 107:2234–2242

    Article  CAS  Google Scholar 

  • Schikowski T, Sugiri D, Ranft U, Gehring U, Heinrich J, Wichmann HE, Krämer U (2005) Long-term air pollution exposure and living close to busy roads are associated with COPD in women. Respir Res 6:152–161

    Article  Google Scholar 

  • Seely AJE, Pascual JL, Christou NV (2003) Science review: cell membrane expression (connectivity) regulates neutrophil delivery, function and clearance. Crit Care 7:291–307

    Article  Google Scholar 

  • Shrestha I, Shresta S (2005) Indoor air pollution from biomass fuels and respiratory health of the exposed population in Nepalese households. Int J Occup Env Health 11:150–160

    CAS  Google Scholar 

  • Singh D, Edwards L, Tal-Singer R, Rennard S (2010) Sputum neutrophils as a biomarker in COPD: findings from the ECLIPSE study. Respir Res 11:77

    Article  Google Scholar 

  • Smith KR, Mehta S, Maeusezahl-Feuz M (2004) Indoor air-pollution from solid fuel use. In: Ezzatti M, Lopez AD, Rodgers A, Murray CJL (eds) Comparative quantification of health risks: Global and regional burden of disease attributable to selected major risk factors. World Health Organization, Geneva, pp 1435–1493

    Google Scholar 

  • Smith-Sivertsen T, Díaz E, Pope D, Lie RT, Díaz A, McCracken J, Bakke P, Arana B, Smith KR, Bruce N (2009) Effect of reducing indoor air pollution on women's respiratory symptoms and lung function: the RESPIRE Randomized Trial, Guatemala. Am J Epidemiol 170:211–220

    Article  Google Scholar 

  • Snoep JD, Roest M, Barendrecht AD, De Groot PG, Rosendaal FR, Van Der Bom JG (2010) High platelet reactivity is associated with myocardial infarction in premenopausal women: a population-based case-control study. J Thromb Hemost 8:906–913

    Article  CAS  Google Scholar 

  • Takanashi S, Hasegawa Y, Kanehira Y, Yamamoto K, Fujimoto K, Satoh K, Okamura K (1999) Interleukin-10 level in sputum is reduced in bronchial asthma, COPD and in smokers. Eur Respir J 14:309–314

    Article  CAS  Google Scholar 

  • Torres-Duque C, Maldonado D, Perez-Padilla R, Ezzati M, Viegi G (2008) Biomass fuels and respiratory diseases: a review of the evidence. Proc Am Thorac Soc 5:577–590

    Article  Google Scholar 

  • Touyz RM, Schiffrin EL (2004) Reactive oxygen species in vascular biology: implications in hypertension. Histochem Cell Biol 122:339–352

    Article  CAS  Google Scholar 

  • Viegi G, Maio S, Pistelli F, Baldacci S, Carrozzi L (2006) Epidemiology of chronic obstructive pulmonary disease: health effects of air pollution. Respirology 11:523–532

    Article  Google Scholar 

  • von Haehling S, Hopkinson NS, Polkey MI, Niethammer M, Anker SD, Genth-Zotz S (2009) Elevated TNF-alpha production in whole blood in patients with severe COPD: the potential link to disease severity. Wien Klin Wochenschr 121:303–308

    Article  Google Scholar 

  • Whitworth JA. World Health Organization, International Society of Hypertension Writing Group (2003) 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 21:1983–1992

    Article  Google Scholar 

  • WHO (2008) World health statistics. World Health Organization, Geneva

  • Yee J, Sadar MD, Sin DD, Kuzyk M, Xing L, Kondra J, McWilliams A, Man SF, Lam S (2009) Connective tissue-activating peptide III: a novel blood biomarker for early lung cancer detection. J Clin Oncol 27:2787–2792

    Article  CAS  Google Scholar 

Download references

Acknowledgement

The study was funded by Council of Scientific and Industrial Research, India, and Central Pollution Control Board under Ministry of Environment and Forests, Government of India.

Conflict of interest

All the authors disclose that there is no potential conflict of interest.

Author information

Authors and Affiliations

  1. Chittaranjan National Cancer Institute, Kolkata, India

    Anindita Dutta, Manas Ranjan Ray, Bidisha Mukherjee & Saswati Chowdhury

Authors
  1. Anindita Dutta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Manas Ranjan Ray
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bidisha Mukherjee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Saswati Chowdhury
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anindita Dutta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dutta, A., Ray, M.R., Mukherjee, B. et al. Increased cardiovascular risk in association with chronic airflow obstruction among premenopausal rural women of India who cook exclusively with biomass. Air Qual Atmos Health 6, 307–315 (2013). https://doi.org/10.1007/s11869-012-0173-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11869-012-0173-8

Keywords

Search

Navigation