Sources of Indoor Air Pollution and Respiratory Health in Preschool Children
Table 3
Studies analyzing the relationship between the use of solid fuels, biomass, fuel oil, and kerosene in the home and the respiratory health of children under the age of 5.
Location Year Author
Design
Sample population: Age Number of cases
Disease studied
Exposure
Control variables
Results: adjusted OR/RR (IC 95%)
Definition of the case
Information source
Source, chemical products
Evaluation
Levels (% exposure)
Studies conducted in Africa and Asia
2 suburbs of Delhi: Kusumpur Pahari and Kathpulty 1998 Sharma et al. [17]
Case-control prospective
633 children (320 1year of age) - 316 Kathapulty - 317 Kusumpur
Acute lower respiratory tract infection (ALRTI)
Q
wood kerosene
Kathapulty: 45% W 55% K Kusumpur: 55% W 45% K
- Job, parents’ educational level - Homes with 1bedroom, location of kitchen, - Family size - Siblings
There were 3 children with three episodes of acute lower respiratory tract infections in the wood group as compared to the kerosene group, but in the latter, there was a tendency to cook inside the home in the presence of the children.
Severe acute lower respiratory tract infection. Cases (201): admitted to hospital Controls (311): healthy children attended to in the same hospital’s pediatric outpatient clinic.
Survey (parents)
Use of fuel other than liquid petroleum gas for cooking: biomass, wood, harvest waste, dung
Questionnaire (parents)
36.8% of the cases and 20.6% of the controls used a cooking fuel other than liquid petroleum gas.
- Parents: age, education - Smoking - Type of house: semi-attached with foundation - Children: breastfed, vaccinated
OR for ALRTI associated with the use of cooking fuel other than liquid petroleum gas. 2.51 (1.51–4.16)
Acute respiratory infection (ARI) (coughing with tachypnea in the two weeks prior to the survey)
Children selected in a national health survey (National Family Health Survey NFHS-2)
(ídem)
Q
Highly pollutant
Covariables added: status of the head of family, type of house, separate kitchen or not, agglomeration of people (3 people per room or >3).
- Highly pollutant fuels: 1.82 (1.58–2.09) - After adjusting for various covariables: 1.58 (1.28–1.95) - In homes where both biomass and cleaner fuels were used 1.41 (1.17–1.70) - Boys/girls: 1.12 (1.01–1.23)
Suburbs of Bangladesh (Dhaka) 2007 Khalequzzaman et al. [20]
Case-control
116 Children under the age of 5 65 biomass 51 solid fuel
During the previous month Prevalence of symptoms and signs: Reddening and itching of eyes, itchy skin, nasal congestion, cough, shortness of breath, intercostal muscle retraction, wheezing, sore throat Prevalence of illness: Respiratory problems, bronchiolitis, asthma, pneumonia Eczema, diarrhea, viral fever
Q and examination of symptoms
Indoor air concentrations of VOCs, CO, CO2, NO2 and dust particles.
Biomass 53% Fossil fuel 47%
- Mother’s age, educational level and job - Smoking in the house by care-taker - Family income, cost of fuel -Ventilation
Use of biomass versus fossil fuels - Cough 1.9 (0.6–6.3) - Shortness of breath 6.3 (1.6–29.1) - Intercostal muscle retraction 5.5 (1.3–29.4); wheezing 4 (1.1–16.2) - Respiratory illness 2.5 (0.5–16.3)
Studies conducted in South America
Guatemala (indigenous group) 2004 Schei et al. [21]
Transversal
1058 children between 4–6 years of age
- Asthma diagnosed - Occasional wheezing in the last 12 months, induced by exercise in the last year, no. of episodes in the last year (4) - Night cough in the last year - Alterations in sleeping habits - Speech limitations - All severe criteria.
Q (ISAAC)
Use of wood for cooking fuel
() cooker with exhaust chimney () mix of gas and open fire cooking () open fire cooking
() 51.5% () 10.4% () 38.1%
OR for open fire cooking wheezing: - Occasional: 2.0 (1.1–3.7) - Last 12 m: 3.4 (1.3–8.5) - Induced by exercise in the past year: 3.5 (1.4–8.6) - Speech limitations: 3.4 (1.1–11.3)
Children hospitalized with acute lower respiratory tract infections. Controls: children with health record at the same hospital matched on date of birth and gender.
Energy sources for heating and cooking
Gas/electric: Mean = 22.2 MG = 18,8 + wood heating: M = 100.9 MG = 57.4 Only wood: M = 85.6 GM = 62.8
Running water, type of house, no. of rooms, no. of children, distance from clinic/hospital, passive exposure to tobacco smoke.
A risk 5 times greater was found for children who lived in houses in which wood was used for cooking, albeit with an ample interval of confidence due to the low number of subjects in this group (8.9% of the cases). The magnitude of correlation decreased less than 20% after adjusting for the potentially confounding variables.
- Survey administered to 10,667 university students (18–25years) about their first 6 years of life - (children born in the mid-70s)
Q
Gas heaters
Q
51.7% Farm 19.4% Rural, not farm 28.9% Urban
- Parents: history of asthma or atopy - No. of children, pets with hair or feathers, family member who smoked indoors daily, daycare outside the home for children under 2, sex of child
- A correlation was found between living on a farm between the ages of 0-6 and allergic rhinoconjunctivitis 0.61 (0.5–0.75; ). Living on a farm was frequent for subjects whose homes were heated with wood.
- Registers from pediatric practices, emergency rooms, and hospitals. - Q (mothers)
Heating fuels (natural gas, electricity, coal, or wood) and cooking fuels (gas, propane, electricity, coal, or wood)
Q
?
- Parents: age, education, ethnic background of mother. Father’s education and smoking - Home: temperature and humidity - Family density, other children 14 years of age - Child: Sex, breastfed
