Chronic bronchitis and chronic obstructive
lung disease Women who cook with solid fuels have increased respiratory symptoms, including chronic cough and
phlegm, a decrease in lung function,25 and an increased incidence of COPD ,26,27 which resembles cigarette
smoking-related COPD both clinically and in its prognosis.28,29 However, tobacco smoking tends to give rise to COPD with more emphysema and goblet cell hyperplasia, whereas domestic exposure to wood smoke tends to produce COPD with more small airway fibrosis and anthracosis, and hyperplasia of the pulmonary artery intimal. 30 The typical patient with biomass-smoke-associated COPD is an elderly woman born in a rural area with lifelong exposure to wood
smoke, who has mild to moderate airflow obstruction and normal or nearly normal pulmonary transfer factor of carbon monoxide (TLCO) and whose chest X-ray shows mainly bronchial wall thickening. Hypoxemia can be important, especially in communities at moderate or high altitude, or in elderly or obese women. Treatment should be as for COPD in smokers, insisting on the reduction of exposure.