Occupational exposure to charcoal smoke and dust is a threat to workers respiratory system. What is the prevalence of chronic obstructive pulmonary disease (COPD) in charcoal workers as compared to farmers in rural areas of Democratic Republic of Congo (DRC)? This cross-sectional, comparative, and multi-site study was performed in the charcoal-producing provinces of South-Western DRC. We randomly included charcoal workers and compared them to farmers (18 to 70 years old). Air quality indexes, anthropometric, physical activity, sociodemographic characteristics, and related medical events data were recorded. A Lung function questionnaire was used to assess respiratory symptoms (RS) and spirometry was performed. COPD was defined as the presence of RS for more than 3 months with a FEV1/FVC ratio below the lower limit of normal. The prevalence of COPD was calculated, and logistic regression was used to identify COPD-associated factors. We included 485 subjects between August 2020 and July 2021. Charcoal Producers (CP, n = 229) were compared with farmers (n = 118), and charcoal saleswomen (CS, n = 72) were compared to vegetable saleswomen (VS, n = 66). Respective groups were similar in age, job seniority, height, and weight. The air was more polluted at charcoal workplaces. The prevalence of COPD was higher in CP than in farmers (39.7% vs 14.4%; P < 0.0001), and in CS compared to VS (40.3% vs 13.6%; P < 0.0001). Being a charcoal worker was independently associated with COPD in the CP and farmers group: adjusted OR, 3.54 (95% CI, 1.94-6.46), and, in the saleswomen group: 7.85 (95% CI, 2.85-21.5), where it was also independently associated with young age: 0.85 (0.80-0.93) and monthly income: 0.88 (0.83-0.96). In rural areas of DRC, producing or selling charcoal is associated with a higher risk of COPD.

Background: Occupational biomass pollutant exposure as observed in charcoal workers may have significant cardiovascular effects. This study aims to ascertain the prevalence and risk factors of hypertension and high pulse pressure (HPP), a marker of arterial stiffness, in charcoal workers compared with a control group of agricultural workers from the Democratic Republic of Congo. Methods and Results: The charcoal worker and agricultural worker groups (n=485; median age, 35–40 years) were composed of male charcoal producers (n=229), charcoal saleswomen (n=72), male farmers (n=118), and vegetable saleswomen (n=66). We assessed workplace air pollution, sociodemographic parameters, self‐reported physical activity, body composition, exhaled air carbon monoxide, and blood pressure. Hypertension and HPP prevalences were determined. Logistic regression, adjusted for confounding variables was used to identify the risk factors. Charcoal workplaces were more polluted than agricultural workplaces ( P <0.01). Charcoal producers performed higher levels of physical activity ( P =0.018) and demonstrated higher levels of exhaled air carbon monoxide ( P <0.0001) and pulse pressure ( P =0.006), and higher prevalence of grade 1 hypertension ( P =0.007), isolated systolic hypertension ( P =0.04), and HPP ( P =0.02) than farmers. Overall, hypertension (adjusted odds ratio [aOR], 11.76 [95% CI, 6.26–22.13]), level of particulate matter <10 μm pollutants (aOR, 1.001 [95% CI, 1.0002–1.0017]), smoking (aOR, 2.21 [95% CI, 1.15–4.24]) and low education (aOR, 2.14 [95% CI, 1.10–4.17]) were independently associated with HPP. The level of particulate matter <1.0 μm pollutants (aOR, 1.0009 [95% CI, 1.0002–1.0015]), male sex (aOR, 2.09 [95% CI, 1.21–3.64]), and job seniority (aOR, 1.022 [95% CI, 1.004–1.044]) were independently associated with isolated systolic hypertension. Conclusions: Charcoal producers appear to develop isolated systolic hypertension and HPP more, both indices of cardiovascular events in which occupational biomass particles seem to play an early significant role.

Exposure to charcoal biomass (CB) pollutants affects the cardiorespiratory system. We assessed cardiopulmonary responses (CPR) to exercise in charcoal producers (CPs) compared to farmers and evaluated the prevalence of exercise‐induced bronchoconstriction (EIB). Forty‐five CPs and 36 farmers, healthy males aged 23–39, completed a 15‐m Incremental Shuttle Walk and Run Test (15‐m ISWRT). Air quality index (AQI) and CO intoxication were measured, CPR was assessed through heart rate (HR), blood pressures (SBP, DBP), and spirometry at rest, peak exercise, and during recovery at 5 and 15 min. Aerobic capacity (VO₂ max) was estimated from the distance covered during the 15‐m ISWRT, and EIB was defined as a >10% decrease in FEV1 from baseline values. AQI was worse in charcoal workplaces, and CPs had higher CO intoxication than farmers (p < 0.0001). Both groups reached maximal exercise %HRmax: 84 (82–89) versus 84 (80–89), p = 0.37 and showed similar predicted VO₂ max 36.2 (31.1–43.1) versus 38.9 (32.2–43.7) mL/kg/min, p = 0.60. However, after ISWRT, CPs had lower FEV1 than farmers (2.9 ± 0.6 vs. 3.3 ± 0.6 L, p < 0.003) and slower recovery. EIB prevalence was higher in CPs (60.0% vs. 27.8%, p = 0.006). Chronic exposure to CB increases EIB in healthy CPs, suggesting heightened airway hyperreactivity.