Large EU subsidy for research into lung disease in poorer countries

22 September 2015• NEWSITEM

The Leiden University Medical Centre (LUMC) is to receive a subsidy of 3 million euros from the European Commission (the Horizon 2020 subsidy programme) to help find solutions for chronic pulmonary disorders in relatively poor countries.

The Leiden University Medical Centre (LUMC) is to receive a subsidy of 3 million euros from the European Commission (the Horizon 2020 subsidy programme) to help find solutions for chronic pulmonary disorders in relatively poor countries. These disorders are common in those countries because a large proportion of the population smokes or cooks under primitive conditions. “The great thing about this project is that we’re involving the local population,” explains Professor Niels Chavannes, principal investigator of the Fresh Air Study, an international consortium of fourteen partner institutes.

Prof. Niels ChavannesTwo sources of smoke pose a threat to the lungs of billions of people around the world: cigarette smoke and the smoke produced when cooking under primitive conditions. Every day, around three billion people (usually women) cook inside the home with fuel such as wood, cow dung or coal, generating a great deal of smoke that can damage the lung function. In addition, the poorer countries are home to approximately three-quarters of the world’s tobacco smokers. “Chronic lung diseases are now the third leading cause of death around the world, after cardiovascular disease and cancer,” says Niels Chavannes, Professor of General Medicine at the Department of Public Health and Primary Healthcare (PHEG) at the LUMC.

Now that infectious diseases are being effectively combated in countries with low incomes, the chronic lung disease COPD has been found to be a major problem. Little is known about the disease, even though pilot studies have been carried out in a number of countries, such as Uganda, Vietnam, Kyrgyzstan and Greece. “In those countries, we’ve built up a network of committed local researchers who are now taking part in this large project. We plan to map out the problem of lung diseases in detail, but also to look for specific solutions. And if they work, we also want to be able to implement them straight away.”

Clean cooking stoves

Research has shown that those solutions can differ for each country so it is important to ask the population to contribute ideas and to give them a greater say in the matter. A project implemented by a different research group in India almost failed because the large pots that people use there to cook for the whole family were too big for the clean cooking stoves originally supplied by the project. In Ethiopia, another project failed because the fuel used by the very efficient cooking stoves was too expensive. In the end, all the stoves ended up as scrap on the black market.


Chavannes has had a similar experience. “In Vietnam, we wanted the people to build chimneys in their homes, something that had earlier been done very successfully in China. In the end, however, it turned out that people didn’t want the chimneys because they believed ghosts would use them to enter the house. Cooking under canopies outside the house turned out to be a much more viable solution.” The researchers hope to develop a matrix in which a number of variables, such as local cooking habits, cultural practices and the available fuel, determine which solution is the most suitable for a particular country.


“One thing we discovered in earlier research is that it’s important to demonstrate the link between smoke and children’s health. People everywhere want their children to be healthy, yet children’s health is often seriously affected by smoke because they often sit on their mother’s lap while she is cooking. In some cases, children’s lungs are even damaged in the uterus.” Many children under the age of five have already been prescribed an average of two courses of antibiotics for respiratory disorders. The Fresh Air Study will examine whether this can be reduced, because some of these ‘respiratory disorders’ are actually caused by smoke poisoning rather than infections.

“We want to focus on education, using resources such as information films, animation and texting via mobile phones. We also want to test an app that people can use to measure their own lung function by blowing into the speaker of their smartphones. It’s vitally important that people are given accurate information because healthcare workers in rural areas in poor countries are often badly trained and don’t even realise that smoking and kitchen smoke are unhealthy,” says Chavannes.

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