Effect of reducing indoor air pollution on women's respiratory symptoms and lung function: the RESPIRE Randomized Trial, Guatemala

Am J Epidemiol. 2009 Jul 15;170(2):211-20. doi: 10.1093/aje/kwp100. Epub 2009 May 14.


Exposure to household wood smoke from cooking is a risk factor for chronic obstructive lung disease among women in developing countries. The Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) is a randomized intervention trial evaluating the respiratory health effects of reducing indoor air pollution from open cooking fires. A total of 504 rural Mayan women in highland Guatemala aged 15-50 years, all using traditional indoor open fires, were randomized to either receive a chimney woodstove (plancha) or continue using the open fire. Assessments of chronic respiratory symptoms and lung function and individual measurements of carbon monoxide exposure were performed at baseline and every 6 months up to 18 months. Use of a plancha significantly reduced carbon monoxide exposure by 61.6%. For all respiratory symptoms, reductions in risk were observed in the plancha group during follow-up; the reduction was statistically significant for wheeze (relative risk = 0.42, 95% confidence interval: 0.25, 0.70). The number of respiratory symptoms reported by the women at each follow-up point was also significantly reduced by the plancha (odds ratio = 0.7, 95% confidence interval: 0.50, 0.97). However, no significant effects on lung function were found after 12-18 months. Reducing indoor air pollution from household biomass burning may relieve symptoms consistent with chronic respiratory tract irritation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Air Pollution, Indoor / adverse effects
  • Air Pollution, Indoor / prevention & control*
  • Carbon Monoxide / toxicity
  • Confidence Intervals
  • Cooking / methods
  • Cooking and Eating Utensils
  • Developing Countries
  • Environmental Exposure / adverse effects
  • Female
  • Fires*
  • Guatemala / epidemiology
  • Humans
  • Longitudinal Studies
  • Lung Injury / epidemiology
  • Lung Injury / etiology*
  • Lung Injury / physiopathology
  • Odds Ratio
  • Prevalence
  • Respiratory Function Tests
  • Respiratory System / injuries*
  • Respiratory System / physiopathology
  • Respiratory Tract Diseases / epidemiology
  • Respiratory Tract Diseases / etiology*
  • Respiratory Tract Diseases / physiopathology
  • Risk Factors
  • Smoke / adverse effects*
  • Wood / adverse effects
  • Young Adult


  • Smoke
  • Carbon Monoxide