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慢性阻塞性肺病2016:室内空气污染和COPD_D Behera_Postgraduate研究所的医学教育和研究,印度

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全球超过4亿人患有慢性阻塞性肺病。估计在印度负担约1500万例(~ 900万男性和~ 600万女性)。除了吸烟造成的空气污染,室内空气污染特别是COPD是一个主要的风险因素在印度和其他发展中国家。妇女烹饪与固体燃料增加了呼吸道症状,包括慢性咳嗽和痰。肺功能下降和慢性阻塞性肺病)存在于7%的生物量不吸烟的女性在他们的生活中。相比之下,只有1.8%的患有慢性阻塞性肺病,从不吸烟液化石油气用户。大量的研究表明,在印度慢性肺心脏类似的发病率在男性和女性尽管只75%的男性和10%的女性吸烟。在女性,慢性肺心脏被发现在最年轻的更常见。这归因于国内空气污染由于固体生物质燃料的燃烧导致慢性支气管炎和肺气肿,慢性肺心。许多对我们来说的研究表明暴露于生物质燃料生产各种各样的呼吸道症状,包括慢性阻塞性肺病、肺功能受损(肺功能,尤其是FVC受到空气污染的影响)。 indoor air due to domestic cooking more with biomass fuel), high blood levels carboxyhemoglobin levels and respiratory symptoms in children (mixed fuel and kerosene had the worst effects on the respiratory system children whose households used these fuels).The influence on the choice of fuel used is multifactorial, but cost and socio-economic status seem to be the main drivers. Less affluent households spend most of their income on food, clothing and medical expenses. Depending on the availability of biomass fuels and the distance to travel to acquire them, the inhabitants of the least developed countries can devote on average 2 to 3 hours per week to collect biomass, which leaves little or no enough time for education and work, which makes it very difficult for these families to improve their socio-economic status. Poor families in rural areas of developing countries often receive subsidies for clean fuels. However, many return to biomass when they cannot even afford the subsidized fuel, making them dependent on cheaper but dirtier alternatives. The other important factor is the unavailability of clean fuels in rural areas, due to the lack of a sustainable supply chain mechanism and / or the infrastructure necessary to provide clean fuels. As a result, clean fuel is not available at all or the demand for clean fuel cannot be met in a consistent manner, forcing rural residents to continue to depend on biomass fuels. Traditional stoves that burn solid fuels have a very low energy conversion efficiency ranging from 12% to 25% depending on the type of fuel. About 8-10% of solid fuels undergo partial combustion, often due to insufficient oxygen supply. As a result, one of the main components of biomass smoke is carbon (5-20% of wood smoke as particulate mass), which is found in the particulate fraction of the smoke and is present in a range particle sizes. Biomass smoke also contains> 250 organic compounds, varying mainly depending on the type of fuel burned and the combustion conditions. Partial oxidation of organic matter generates high levels of carbon monoxide, as well as hydrogen cyanide, ammonia and nitrogen oxides. In addition, a large number of other toxic and carcinogenic compounds, such as polycyclic aromatic hydrocarbons (PAH) (for example benzo [a] pyrene (BaP)), aldehydes and free radicals have been highlighted in the biomass smoke. Although fuels from biomass tend to have low levels of halogenated compounds, they can be contaminated with chemicals such as pesticides or mixed with plastics. Certain varieties of coal, notably in China, have a particularly high content of fluorine or silica. Therefore, the combustion of these specific fuels can result in the production of toxic halogen compounds, such as hydrogen chloride, phosgene, dioxin, chloromethane, bromomethane and other halocarbons. D Behera

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