**9. COPD from exposure to biomass smoke**

It is considered that the population at risk of inhaling smoke from biomass could reach 3000 million people worldwide, mostly female. Anatopatology, COPD from inhalation of smoke from biomass has been becoming well known, has important similarities with COPD from smoking, but also significant differences.

Although its natural evolution is not well known yet, COPD from exposure to biomass smoke has some features in common with COPD from smoking. Romieu et al designed a study with methodology of trial in a group of Mexican women was divided into two groups: the control group cooking with the traditional open fire and the treatment group cooking with Patsari stove. After 6 years, confirmed a dramatic difference in the evolution of FEV1: the control group decline 62 ml FEV1 per year, while the intervention group only lost half. Orozco et al demonstrated that COPD in Spain by exposure to biomass smoke should be considered especially in older women from rural areas.

The impact of this disease is usually not epidemiologically relevant in developed countries, although some cases have been identified in countries as the United States, for example, in New Mexico, USA reported that 26% of subjects had been exposed to smoke from biomass fuel.
