COPD in Biomass exposed nonsmokers: a different phenotype

INTRODUCTION: Chronic obstructive pulmonary disease, most commonly caused by tobacco smoking, is increasingly reported in nonsmoking patients exposed to domestic combustion of biomass fuels. This is particularly common among rural women in the low- and middle-income countries. It is highly likely that the disease in these patients is a different clinical phenotype. AREAS COVERED: This manuscript covers epidemiological and clinical aspects of biomass-exposed COPD and also dwells upon its different phenotypic characteristics. EXPERT OPINION: Chronic obstructive pulmonary disease in biomass-exposed, nonsmoker patients which predominantly presents with features of chronic bronchitis is more likely a distinct phenotype with greater likelihood of small airway involvement.