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Biomass smoke exposure as an occupational risk: cross-sectional study of respiratory health of women working as street cooks in Nigeria
  1. Olayemi Fehintola Awopeju1,
  2. Benoit Nemery2,
  3. Olusegun Tope Afolabi3,
  4. Katrien Poels2,
  5. Jeroen Vanoirbeek2,
  6. Daniel Osagbemworhue Obaseki1,
  7. Olufemi Olanisun Adewole1,
  8. Hervé Anicet Lawin4,
  9. William Vollmer5,
  10. Gregory Efosa Erhabor1
  1. 1 Department of Medicine, Obafemi Awolowo University, Ile Ife, Nigeria
  2. 2 Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
  3. 3 Department of Community Health, Obafemi Awolowo University, Ile Ife, Nigeria
  4. 4 Department of Public Health, Unit of Teaching and Research in Occupational and Environmental Health, University of Abomey-Calavi, Cotonou, Benin
  5. 5 Centre for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
  1. Correspondence to Dr Olayemi Fehintola Awopeju, Department of Medicine, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun 220005, Nigeria; yemijide{at}


Objective Little is known about respiratory health of women who are occupationally exposed to biomass smoke outside their homes. This study reports the exposure and respiratory health of street cooks in Ile-Ife, Nigeria.

Methods We assessed exposure to biomass smoke by questionnaire in 188 street cooks and 197 control women and by personal diffusive samplers to quantify volatile organic compounds (VOCs) in a subsample of the women. Respiratory symptoms were assessed by a standardised questionnaire, and pulmonary function was assessed by spirometry before and after bronchodilation. Regression analysis was conducted to compare the outcome between the two groups.

Results The study included 188 women (median age 40, IQR 30–50 years) who had worked as street cooks for a median of 7 years (IQR 3–15 years) and 197 control women with similar demographics. Benzene concentration in passive samplers worn by the street cooks was significantly higher compared with controls (median (IQR) 119.3 (82.7–343.7) µg/m3 vs 0.0 (0.0–51.2) µg/m3, p<0.001). The odds of reported respiratory symptoms were significantly higher among the street cooks than controls: cough (adjusted OR 4.4, 95% CI 2.2 to 8.5) and phlegm (adjusted OR 3.9, 95% CI 1.5 to 7.3). The street cooks also had higher odd of airway obstruction as measured by forced expiratory volume in 1 s/forced vital capacity <0.7: 11% 3% (adjusted OR of 3.3 (95% CI 1.3 to 8.7)).

Conclusions This study provides evidence of adverse respiratory effects among street cooks using biomass fuels.

  • volatile organic compounds (vocs)
  • airway obstruction
  • diffuse sampling
  • benzene
  • spirometry

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  • Contributors AOF, BN, OTA and DOO contributed in the conception and design of the study. OFA, BN, MV, OTA, JV, DOO, OOA, HAL, KP and GEE contributed in analysis, interpretation and drafting of the manuscript. BN, KP and JV contributed in analysis of VOCs. All authors read and approved the final manuscript.

  • Funding This study was funded by the ATS Foundation Grant Research Grant Award for 2012.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Health Research Ethic Committee, Institute of Public Health, Obafemi Awolowo University, Ile-Ife (IPHOAU/12/22).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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