Aetiology of Chronic Obstructive Pulmonary Disease (COPD) in non smoking women of Kandy district , Sri Lanka

Aim: COPD is a disease which has high prevalence worldwide and has high morbidity and mortality. Although smoking is a well recognized cause of COPD, most of Sri- Lankan women are non smokers. Therefore females having COPD become an important group to study aetiology of COPD other than smoking.The aim of this study is to identify causes of COPD in females of Kandy, Sri Lanka.

Method: The study consisted of 54 patients who were diagnosed of having COPD on the basis FEV1/ FEC ratio of below 70% and had bronchodilator reversibility of less than 12%. The cohort of patients was selected from patients investigated for cough and dyspnoea presented to the Chest Clinic, Kandy for a period of 9 months from 01 Jul 2008 to 31 Mar 2009 The study group of patients was interviewed using a prepared questionnaire .Their demographic data including social status was recorded . The aetiologies of smoking recurrent chest infections in early childhood and indoor air pollution were recorded

Results:  The age range of the patients was 48y to 82y with a mean age of 69.8y. All the patients were life time nonsmokers. 26% reported to have inhaling secondhand smoke from one or more   household smokers. Only 7% had recurrent chest infections in childhood. 82% of patients had exposure to indoor air pollution in the form of using firewood for cooking in under ventilated kitchens. 88% of the patients  were form suburban and rural areas and 68%  belonged to poorer social classes. In spite of the high literacy ratio of Srilana 5.2% of the study population was illiterate.

Conclusion:  Indoor air pollution is a significant cause of COPD in women of Kandy, Sri Lanka COPD .affects women of poorer social strata. Since around 80% of Sri Lankan households use firewood for cooking, it is very important to improve standards of cooking and ventilation in kitchens,and to empower women with knowledge in  causative factors and prevention of COPD.