Chronic Obstructive Pulmonary Disease in Non-Smokers

In COPD, tobacco smoking is established as a major risk factor. However, especially in the last 15 years, there are studies have shown that long-term exposure to biomass fuel smoke to cook and heat homes, also carries a high risk for the development of COPD. This occurs particularly in developing countries, and women and children have the highest exposure rates and are therefore more likely to develop the disease. It is estimated that 25-45% of patients with COPD have never smoked, and the burden of COPD not associated with smoking is possibly higher than previously believed. Although exposure to biomass is the major risk factor for COPD not associated with smoking, there are other associated factors such as occupational exposure to dust and gases, HIV/AIDS, lower respiratory tract infection (particularly in the childhood), chronic asthma, external pollution, and poverty. This chapter exposes the evidence of this association, and some clinical, functional, anatomopathological and therapeutic aspects and particularly the need for preventive interventions to face this other side of the entity that seems to be increasing.