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Selected trace metals of importance in different incense before and after the smoldering process were assessed based on the recent respiratory ailments. Marketed perfumed and non-perfumed incense from different countries was separately analyzed using an Inductive coupled Plasma-Mass Spectroscopy (ICP-MS). A particulate analyzer measured the dispersed particulates (PM 2.5 ) in the indoor environment. The analysis revealed higher mean metals concentrations in the smoldered perfumed incense (1.98 µg g -1 ) than in the non-smoldered and non-perfumed incense (0.59 µg g -1 ). Pilot-scale experiments included the smoke dispersed in different sized-rooms, and the distance between the inhaler and the smoldering incense. Simultaneously, a questionnaire distributed to 300 residents from six sampling areas revealed the exposure of incense to human health. This study indicated significant attributes on (a) the room size and incense volume, (b) the permissible inmate's number in a room, (c) the distance between the inmate vicinity and the point of smoldering incense, (d) selectivity of incense, besides the outdoor environmental influence. Furthermore, this study revealed the various categories of respiratory ailments in residents in relation to the frequency of burning incense, prolonged smoke exposure, and the impact of burners although, earlier beneficial effects of incenses were evidenced. This study recommends preventive measures to human respiratory ailments from smoldering incense.

While there is strong evidence for the association between household air pollution and lung cancer among non-smoking women, the association between domestic incense use and lung cancer risk has been inconsistent. We conducted a systematic review of PubMed articles authored between 1969 and August 25, 2015 before performing a manual review of each study, and found a total of seven published studies on this topic. Most of the studies are case-control in design and did not further stratify by sex and smoking status. Of the seven studies, three reported positive associations, three reported null associations and one study found a negative association between incense use and lung cancer. Only one study reported estimates for non-smoking women. Future studies should be larger in sample size, stratify by both sex and smoking status in their analyses, and collect more detailed information on incense use in order to facilitate the understanding of the association between domestic incense use and lung cancer risk among non-smoking women in Asia.

The health impact of indoor air pollution is a growing area of interest for public health professionals. People typically spend up to 90 per cent of their time indoors, particularly women, young children and elders. Although the adverse health effects of second-hand tobacco smoke are well recognised, the impact of burning incense in the home has received little attention in Western literature. Incense burning in the home is common in a number of cultures (particularly Asian, North African or Arabic). Many health visitors (HVs) work with communities who use incense regularly for religious/cultural reasons and it is a neglected area of study and research.The literature suggests that home incense use can have significant adverse health effects, particularly on cardiopulmonary morbidity and mortality. Further research is needed to identify which individuals are most susceptible, which types of incense are most harmful, and whether any actions can be taken to minimise exposure.