Biomass smoke induced bronchial anthracofibrosis: presenting features and clinical course.

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 1s (FEV(1))/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.