Indoor Air Pollution as a Risk Factor for Fatal Anthracosis and Copd in Sub-Saharan Africa–The Case of an Unidentified Rwandan Male of About 50 Years

Abstract

Background: The deposition of particles of coal dust into the lung tissue, particularly due to high exhaust pollution levels in large cities, smoking, or in the coal mining sector, is generally considered as less harmful than the deposition of other kinds of dust that lead to unspecified clinical pictures of the lung tissue (e.g. asbestosis, silicosis, silicatosis). However, anthracosis, a more or less intensive deposition of coal dust into the pulmonary interstitium and lymphatic system connected with a blackish pigmentation is a common macroscopic and microscopic finding especially in cities and greatly contributes to the development of chronic obstructive lung disease (COPD). The present case report aims at highlighting the high relevance of indoor pollution to the development of COPD and other lung diseases. Methods: We review a case of a 50-year-old Rwandan male autopsied at the Kacyiru Police Hospital as part of an inter-disciplinary Forensic Summer School with the theme” A holistic approach towards a safer society” in the Conference held in Kigali-Rwanda from 24th -27th August 2015. Results: The autopsy revealed severe chronic anthracosis, COPD, pulmonary firosis, emphysema; and a diagnosis of pulmonary insufficiency was made as the cause of death. Conclusion: Indoor air pollution, particularly through the burning of biomass and coal in closed rooms, is a relevant risk factor for the development of pulmonary diseases such as anthracosis and COPD. Mainly affected are regions in developing and emerging countries, especially in the countryside. Therefore, the reduction of the concentration of pollutants inside closed rooms is the most important aim, either by using more effective technical devices or by improving ventilation in these rooms. These objectives should be pursued by educational and policy measures.