1. Biomass and chronic lung disease: Is the evidence good enough, and does it matter?
Peter Burney
National Heart and Lung Institute
Imperial College, London

2. Burden of disease attributable to 20 leading risk factors in 2010, expressed as a percentage of global disability-adjusted life-years
From Lim et al. Lancet 2012; 380: 2224–60

3. Biomass smoke exposure and the risk of chronic obstructive pulmonary disease (COPD). [redrawn]
Redrawn from: Eisner et al. Am J Respir Crit Care Med 2010;
182:

4. Biomass smoke exposure and the risk of chronic obstructive pulmonary disease (COPD). [redrawn]
Strong evidence of publication bias
Highly variable results (I2>80%)
Redrawn from: Eisner et al. Am J Respir Crit Care Med 2010;
182:

5. Millions Dead: How Do We Know and What Does It Mean?
Methods Used in the
Comparative Risk Assessment
of Household Air Pollution
“….strong evidence of publication bias (Egger’s test: p = 0.007); the pooled OR was 1.94 (1.62, 2.33) with substantial heterogeneity (I2 =85%)……
…….Causal inference is supported by these findings……”
Smith et al. and the HAP CRA Risk Expert Group. Annu. Rev. Public Health :185–206

6. Burden of Obstructive Lung Disease (BOLD) sites

7. Ala Muala, et al. Acute exposure to wood smoke from incomplete combustion - indications of cytotoxicity. Particle and Fibre Toxicology (2015) 12:33

8. The evidence relating to biomass and COPD is not good enough and it does matter:
Deflects attention from more important issues
Leads to sub-optimal prioritisation
Distorts the research agenda
Leads to ineffective policies
Wastes resources