Biomass smoke induced bronchial anthracofibrosis: Presenting features and clinical course

Abstract

Background: The presenting features and clinical course of biomass smoke induced bronchial anthracofibrosis (BAF) are not well known. Patients and methods: 333 patients who had a history of long-term exposure to biomass smoke, having BAF confirmed by a bronchoscopy from January 1998 to December 2004, were included in this study. The clinical features, associated diseases, and clinical outcomes were investigated through the analysis of medical records. Results: There were 51 males (15.3%) and 282 females (84.7%), having a mean age of 72.3 years, ranging from 47 to 90. 33% of patients had a past history of pulmonary tuberculosis. Dyspnea (38.4%) and cough (29.8%) were most common presenting symptoms, followed by hemoptysis (8.9%). Baseline pulmonary function showed mild airflow obstruction. Among patients with forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)<0.7, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I and II were most common. Associated diseases were active tuberculosis in 33.9% of patients, pneumonia in 29.5%, acute exacerbation of chronic airways disease in 22.5%, and malignancy in 4.8%. Among the 18 patients who died at a hospital during the follow-up period, acute infection and malignancy were common causes of death. Conclusions: These findings suggest that biomass smoke induced BAF usually appears clinically as a form of obstructive airways disease. Since various pulmonary diseases, including tuberculosis, pneumonia, and malignancy, can be associated with BAF, thorough clinical evaluation and close follow-up of these patients are required.