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Hussein H, Shamsipour M, Yunesian M, Hasanvand MS, Mahamudu T, Fotouhi A. Fuel type use and risk of respiratory symptoms: A cohort study of infants in the Northern region of Ghana. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:142501. [PMID: 33038841 DOI: 10.1016/j.scitotenv.2020.142501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 09/13/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
Little evidence exists about the association between fuel type use and risk of respiratory symptoms among infants; we aimed to evaluate this hypothesis through a cohort study in the Northern Region of Ghana. The study was carried out from April 2018 to May 2019. We recruited 28 weeks old pregnant women at selected hospitals and prospectively followed them at birth in the hospital ward to register their newborns and at homes when the baby had attained 3 to 7 months to collect data on respiratory symptoms of infants. A logistic regression model was used to investigate the odds of respiratory symptoms in infants. Exactly 1270 infants completed the study; the average age of women was 27.1 years and standard deviation of 5.1. The study found that infants of mothers who cooked with charcoal and those with firewood had increased odds of having cough with cold 4.10 (95% CI, 2.21-7.61) and 3.95 (95% CI, 2.06-7.58), increased odds of congestion, phlegm with cold by 3.89 (95% CI, 1.73-8.79) and 3.45 (95% CI, 1.44-8.26), increased odds of wheezing 4-14 days or nights by 1.68 (95% CI, 0.72-3.91) and 3.37 (95% CI, 1.41-8.04) and increased odds of seeking medical treatments in a health facility for chest illness by 3.97 (95% CI, 1.31-12.02) and 6.67 (95% CI, 2.14-20.77) in comparison with liquid petroleum gas respectively. Some significant predictors of respiratory infections were maternal malaria, hospitalisations of an infant after birth, residence, cooking location, composite breastfeeding, sharing of a bedroom with infant and air-conditioner or fan in the living room. Our findings indicate increased odds of infant respiratory symptoms in households using solid fuel in Ghana. Although our observational design precludes ascribing any causal relationships, our results are consistent with other studies suggesting clean fuel use during pregnancy and infancy may benefit this vulnerable age group.
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Affiliation(s)
- Hawawu Hussein
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; African Union Scientific Technical and Research Commission, Abuja, Nigeria; Tamale Teaching Hospital, Research Department, Tamale, Ghana
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Masud Yunesian
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad S Hasanvand
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Odo DB, Yang IA, Knibbs LD. A Systematic Review and Appraisal of Epidemiological Studies on Household Fuel Use and Its Health Effects Using Demographic and Health Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1411. [PMID: 33546363 PMCID: PMC7913474 DOI: 10.3390/ijerph18041411] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/12/2022]
Abstract
The domestic combustion of polluting fuels is associated with an estimated 3 million premature deaths each year and contributes to climate change. In many low- and middle-income countries (LMICs), valid and representative estimates of people exposed to household air pollution (HAP) are scarce. The Demographic and Health Survey (DHS) is an important and consistent source of data on household fuel use for cooking and has facilitated studies of health effects. However, the body of research based on DHS data has not been systematically identified, nor its strengths and limitations critically assessed as a whole. We aimed to systematically review epidemiological studies using DHS data that considered cooking fuel type as the main exposure, including the assessment of the extent and key drivers of bias. Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus and the DHS publication portal. We assessed the quality and risk of bias (RoB) of studies using a novel tool. Of 2748 records remaining after removing duplicates, 63 were read in full. A total of 45 out of 63 studies were included in our review, spanning 11 different health outcomes and representing 50 unique analyses. In total, 41 of 45 (91%) studies analysed health outcomes in children <5 years of age, including respiratory infections (n = 17), death (all-cause) (n = 14), low birthweight (n = 5), stunting and anaemia (n = 5). Inconsistencies were observed between studies in how cooking fuels were classified into relatively high- and low-polluting. Overall, 36/50 (80%) studies reported statistically significant adverse associations between polluting fuels and health outcomes. In total, 18/50 (36%) of the analyses were scored as having moderate RoB, while 16/50 (32%) analyses were scored as having serious or critical RoB. Although HAP exposure assessment is not the main focus of the DHS, it is the main, often only, source of information in many LMICs. An appreciable proportion of studies using it to analyse the association between cooking fuel use and health have potential for high RoB, mostly related to confounder control, exposure assessment and misclassification, and outcome ascertainment. Based on our findings, we provide some suggestions for ways in which revising the information collected by the DHS could make it even more amenable to studies of household fuel use and health, and reduce the RoB, without being onerous to collect and analyse.
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Affiliation(s)
- Daniel B. Odo
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;
- College of Health Sciences, Arsi University, Oromia, Asella P.O. Box 193, Ethiopia
| | - Ian A. Yang
- Thoracic Program, The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, QLD 4032, Australia;
- UQ Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Brisbane QLD 4032, Australia
| | - Luke D. Knibbs
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia;
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Household air pollution in India and respiratory diseases: current status and future directions. Curr Opin Pulm Med 2020; 26:128-134. [PMID: 31724964 DOI: 10.1097/mcp.0000000000000642] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Combustion of solid cooking fuels employed by more than 3 billion people globally, contributes to approximately one third of ambient air pollution. In the recent past, the issue has drawn global attention because of its threat to the health of rural communities, particularly women and children. This review is focused on the evidence from India on effects of household air pollution (HAP) on respiratory health and interventions to replace the solid fuels. RECENT FINDINGS HAP exposure is a major risk factor for increased respiratory symptoms, respiratory infections, and chronic obstructive pulmonary disease. In most studies, the odds ratio for the risk of development of respiratory disorders is more than one in HAP exposed individuals. HAP is also associated with increased risk of tuberculosis, asthma, mortality from cardio-respiratory illnesses, and nonrespiratory problems such as adverse pregnancy outcomes, prematurity, and low birth weight. SUMMARY Household air pollution is a common but preventable risk factor for respiratory diseases. Replacement of solid cooking fuels with clean fuels such as LPG gas as exemplified by the 'Ujjwala' program of India is likely to be most effective intervention to reduce the HAP related disease burden.
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Simkovich SM, Goodman D, Roa C, Crocker ME, Gianella GE, Kirenga BJ, Wise RA, Checkley W. The health and social implications of household air pollution and respiratory diseases. NPJ Prim Care Respir Med 2019; 29:12. [PMID: 31028270 PMCID: PMC6486605 DOI: 10.1038/s41533-019-0126-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/05/2019] [Indexed: 12/29/2022] Open
Abstract
Approximately three billion individuals are exposed to household air pollution (HAP) from the burning of biomass fuels worldwide. Household air pollution is responsible for 2.9 million annual deaths and causes significant health, economic and social consequences, particularly in low- and middle-income countries. Although there is biological plausibility to draw an association between HAP exposure and respiratory diseases, existing evidence is either lacking or conflicting. We abstracted systematic reviews and meta-analyses for summaries available for common respiratory diseases in any age group and performed a literature search to complement these reviews with newly published studies. Based on the literature summarized in this review, HAP exposure has been associated with acute respiratory infections, tuberculosis, asthma, chronic obstructive pulmonary disease, pneumoconiosis, head and neck cancers, and lung cancer. No study, however, has established a causal link between HAP exposure and respiratory disease. Furthermore, few studies have controlled for tobacco smoke exposure and outdoor air pollution. More studies with consistent diagnostic criteria and exposure monitoring are needed to accurately document the association between household air pollution exposure and respiratory disease. Better environmental exposure monitoring is critical to better separate the contributions of household air pollution from that of other exposures, including ambient air pollution and tobacco smoking. Clinicians should be aware that patients with current or past HAP exposure are at increased risk for respiratory diseases or malignancies and may want to consider earlier screening in this population.
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Affiliation(s)
- Suzanne M Simkovich
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Dina Goodman
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Christian Roa
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Mary E Crocker
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Division of Pulmonary and Sleep Medicine, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - Gonzalo E Gianella
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
- Servicio de Neumología, Unidad de Cuidados Intensivos, Clinica Ricardo Palma, Lima, Peru
| | - Bruce J Kirenga
- Makerere Lung Institute, Makerere University, Kampala, Uganda
- Pulmonology Unit, Department of Medicine, Makerere University, Mulago Hospital, Kampala, Uganda
| | - Robert A Wise
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
- Center for Global Non-Communicable Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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North CM, Rice MB, Ferkol T, Gozal D, Hui C, Jung SH, Kuribayashi K, McCormack MC, Mishima M, Morimoto Y, Song Y, Wilson KC, Kim WJ, Fong KM. Air pollution in the Asia-Pacific Region: A Joint Asian Pacific Society of Respirology/American Thoracic Society perspective (Republication). Respirology 2019; 24:484-491. [PMID: 30920029 DOI: 10.1111/resp.13531] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Crystal M North
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary B Rice
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Thomas Ferkol
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - David Gozal
- Department of Child Health, The University of Missouri School of Medicine, Columbia, MO, USA
| | | | - Soon-Hee Jung
- Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, South Korea
| | - Kozo Kuribayashi
- Department of Respiratory Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Meredith C McCormack
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, John Hopkins School of Medicine, Baltimore, MD, USA
| | - Michiaki Mishima
- Department of Physical Therapeutics, Kyoto University Hospital of Medicine, Kyoto, Japan
| | - Yasuo Morimoto
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yuanlin Song
- Department of Pulmonary Medicine, Zhongshan Hospital, Shanghai, China.,Fudan University, Shanghai, China
| | - Kevin C Wilson
- Division of Allergy, Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, South Korea
| | - Kwun M Fong
- The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia.,The University of Queensland Thoracic Research Centre at The Prince Charles Hospital, Brisbane, QLD, Australia
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North CM, Rice MB, Ferkol T, Gozal D, Hui C, Jung SH, Kuribayashi K, McCormack MC, Mishima M, Morimoto Y, Song Y, Wilson KC, Kim WJ, Fong KM. Air Pollution in the Asia-Pacific Region. A Joint Asian Pacific Society of Respirology/American Thoracic Society Perspective. Am J Respir Crit Care Med 2019; 199:693-700. [DOI: 10.1164/rccm.201804-0673pp] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Crystal M. North
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Massachusetts
| | - Mary B. Rice
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Thomas Ferkol
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - David Gozal
- Department of Child Health, The University of Missouri School of Medicine, Columbia, Missouri
| | | | - Soon-Hee Jung
- Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, South Korea
| | - Kozo Kuribayashi
- Department of Respiratory Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Meredith C. McCormack
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, John Hopkins School of Medicine, Baltimore, Maryland
| | - Michiaki Mishima
- Department of Physical Therapeutics, Kyoto University Hospital of Medicine, Kyoto, Japan
| | - Yasuo Morimoto
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yuanlin Song
- Department of Pulmonary Medicine, Zhongshan Hospital, Shanghai, China
- Fudan University, Shanghai, China
| | - Kevin C. Wilson
- Division of Allergy, Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Woo Jin Kim
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, South Korea
| | - Kwun M. Fong
- The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Australia; and
- The University of Queensland Thoracic Research Centre at The Prince Charles Hospital, Brisbane, Australia
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Lamichhane P, Sharma A, Mahal A. Impact of cleaner fuel use and improved stoves on acute respiratory infections: evidence from India. Int Health 2018; 9:349-366. [PMID: 29206926 DOI: 10.1093/inthealth/ihx041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 10/18/2017] [Indexed: 11/13/2022] Open
Abstract
Background The use of cleaner fuel and improved stoves has been promoted as a means to lower harmful emissions from solid fuels. However, little is known about how exclusive use of cleaner fuels, mixed fuel use and improved stoves influences children's health. Methods We compared the impact of using liquefied petroleum gas (LPG) exclusively with mixed fuel use (LPG plus polluting fuels) and with exclusive use of polluting fuels on acute respiratory infections (ARI) among 16 157 children 0-4 years of age from households in the 2012 Indian Human Development Survey. Inverse probability weighting (IPW) procedures for multiple treatments were used for this evaluation. Results Children from households using LPG had a 5.0% lower probability of reporting ARI relative to exclusive users of polluting fuels, with larger effects (10.7%) in rural households. The probability of ARI in households using improved stoves and mixed fuel use was also lower in rural households, by 2.9% and 2.8%, respectively. The magnitude of effect varied across population subgroups, with the highest effects for children living in households living in kachha (low quality material) houses households identified as poor. Conclusion Use of LPG and improved stoves lowered the probability of ARI among children younger than 5 years.
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Affiliation(s)
- Prabhat Lamichhane
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, Victoria 3004, Australia.,School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Anurag Sharma
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia
| | - Ajay Mahal
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, Victoria 3004, Australia.,Nossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Page CM, Patel A, Hibberd PL. Does smoke from biomass fuel contribute to anemia in pregnant women in Nagpur, India? A cross-sectional study. PLoS One 2015; 10:e0127890. [PMID: 26024473 PMCID: PMC4449186 DOI: 10.1371/journal.pone.0127890] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/20/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Anemia affects upwards of 50% of pregnant women in developing countries and is associated with adverse outcomes for mother and child. We hypothesized that exposure to smoke from biomass fuel--which is widely used for household energy needs in resource-limited settings--could exacerbate anemia in pregnancy, possibly as a result of systemic inflammation. OBJECTIVE To evaluate whether exposure to smoke from biomass fuel (wood, straw, crop residues, or dung) as opposed to clean fuel (electricity, liquefied petroleum gas, natural gas, or biogas) is an independent risk factor for anemia in pregnancy, classified by severity. METHODS A secondary analysis was performed using data collected from a rural pregnancy cohort (N = 12,782) in Nagpur, India in 2011-2013 as part of the NIH-funded Maternal and Newborn Health Registry Study. Multinomial logistic regression was used to estimate the effect of biomass fuel vs. clean fuel use on anemia in pregnancy, controlling for maternal age, body mass index, education level, exposure to household tobacco smoke, parity, trimester when hemoglobin was measured, and receipt of prenatal iron and folate supplements. RESULTS The prevalence of any anemia (hemoglobin < 11 g/dl) was 93% in biomass fuel users and 88% in clean fuel users. Moderate-to-severe anemia (hemoglobin < 10 g/dl) occurred in 53% and 40% of the women, respectively. Multinomial logistic regression showed higher relative risks of mild anemia in pregnancy (hemoglobin 10-11 g/dl; RRR = 1.38, 95% CI = 1.19-1.61) and of moderate-to-severe anemia in pregnancy (RRR = 1.79, 95% CI = 1.53-2.09) in biomass fuel vs. clean fuel users, after adjusting for covariates. CONCLUSION In our study population, exposure to biomass smoke was associated with higher risks of mild and moderate-to-severe anemia in pregnancy, independent of covariates. TRIAL REGISTRATION ClinicalTrials.gov NCT 01073475.
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Affiliation(s)
- Charlotte M. Page
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Archana Patel
- Lata Medical Research Foundation, Nagpur, Maharashtra, India
| | - Patricia L. Hibberd
- Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Global Health, Massachusetts General Hospital for Children, Boston, Massachusetts, United States of America
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Upadhyay AK, Singh A, Kumar K, Singh A. Impact of indoor air pollution from the use of solid fuels on the incidence of life threatening respiratory illnesses in children in India. BMC Public Health 2015; 15:300. [PMID: 25884539 PMCID: PMC4397688 DOI: 10.1186/s12889-015-1631-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 03/12/2015] [Indexed: 11/13/2022] Open
Abstract
Background India contributes 24% of the global annual child deaths due to acute respiratory infections (ARIs). According to WHO, nearly 50% of the deaths among children due to ARIs is because of indoor air pollution (IAP). There is insufficient evidence on the relationship between IAP from the use of solid fuels and incidence of life threatening respiratory illnesses (LTRI) in children in India. Methods Panel data of children born during 2001–02, from the Young Lives Study (YLS) conducted in India during 2002 and 2006–07 was used to estimate the impact of household use of solid fuels for cooking on LTRI in children. Multivariable two-stage random effects logistic regression model was used to estimate the odds of suffering from LTRI among children from households using solid fuels relative to children from households using other fuels (Gas/Electricity/Kerosene). Results Bivariate results indicate that the probability of an episode of LTRI was considerably higher among children from households using solid fuels for cooking (18%) than among children from households using other fuels (10%). Moreover, children from households using solid fuels in both the rounds of YLS were more likely to suffer from one or more than one episode of LTRI compared to children from households using solid fuels in only one round. Two-stage random effects logistic regression result shows that children from households using solid fuels were 1.78 (95% CI: 1.05-2.99) times as likely to suffer from LTRI as those from households using other fuels. Conclusion The findings of this paper provide conclusive evidence on the harmful effects of the use of solid fuels for cooking on LTRI in India. The Government of India must make people aware about the health risks associated with the use of solid fuels for cooking and strive to promote the use of cleaner fuels.
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Affiliation(s)
- Ashish Kumar Upadhyay
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400 088, India.
| | - Abhishek Singh
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400 088, India.
| | - Kaushalendra Kumar
- International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400 088, India.
| | - Ashish Singh
- Indian Institute of Technology Bombay, Mumbai, India.
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Accinelli RA, Llanos O, López LM, Pino MI, Bravo YA, Salinas V, Lazo M, Noda JR, Sánchez-Sierra M, Zárate L, da Silva J, Gianella F, Kheirandish-Gozal L, Gozal D. Adherence to reduced-polluting biomass fuel stoves improves respiratory and sleep symptoms in children. BMC Pediatr 2014; 14:12. [PMID: 24433576 PMCID: PMC3898254 DOI: 10.1186/1471-2431-14-12] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 01/14/2014] [Indexed: 11/17/2022] Open
Abstract
Background Symptoms of sleep apnea are markedly increased in children exposed to smoke from biomass fuels and are reduced by kitchen stoves that improve indoor biomass pollution. However, the impact of adherence to the use of improved stoves has not been critically examined. Methods Sleep-related symptom questionnaires were obtained from children <15 years of age in 56 families residing in the communities of Lliupapuquio, Andahuaylas province in Peru before and 2 years after installation of less-polluting Inkawasi cooking stoves. Results 82 children with lifetime exposures to indoor fuel pollution were included. When compared to those alternating between both types of stoves or those using traditional stoves only, those children who exclusively used Inkawasi cooking stoves showed significant improvements in sleep and respiratory related symptoms, but some minor albeit significant improvements occurred when both stoves were concomitantly used. Conclusions Improvements in respiratory and sleep-related symptoms associated with elevated indoor biomass pollution occur only following implementation and exclusive utilization of improved kitchen stoves.
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Affiliation(s)
- Roberto A Accinelli
- Laboratorio de Respiración del Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Perú.
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