Positive impact of improved cookstove usage on respiratory health in Congolese refugees: a prospective cohort study

Around 3 billion people worldwide use solid biomass fuels for cooking. Exposure to indoor biomass smoke is an important cause of COPD and therefore a target of many public health interventions, such as usage of improved cookstoves. The aim of our study was to show whether usage of improved cookstoves can lead to relevant improvement in lung function and CAT-score in a well characterized population including a subgroup of this population with preexisting airway obstruction. Interviews and spirometry were performed in Congolese women living in an UNHCR (United Nations High Commissioner for Refugees) refugee camp in Rwanda before (baseline, BL) and 9 months after (follow-up, F9) they received an energy-efficient cookstove (Save80) and were trained how to use it. Two hundred sixty-two women completed both spirometry and interview appropriately at BL and F9 and were included in per protocol (pp) analysis, which showed no change in mean FEV1. The predefined subgroup of this population with airway obstruction at baseline (N = 31) showed a significant FEV1 increase (FEV1_F9 = 1.70 L; p < 0.01 vs FEV1_BL = 1.58 L, p < 0.01). Median CAT-scores were significantly lower in the F9 assessment. Our data indicate that usage of improved cookstoves has a positive impact on respiratory health especially in individuals with preexisting airway obstruction. Further studies to investigate long-term outcome are warranted.