Abstract
TAB3-PD-07 Introduction: Indoor air pollution due to cooking or heating with gas, wood, or coal has been reported to be associated with asthma in children. Overall, however, the evidence as to the role of these pollutants remains conflicting. We investigated the relation to asthma by studying 21 centers worldwide that are characterized by various cooking and heating regimens. Methods: A cross-sectional study was carried out in 21 centers in 15 countries. Random samples (n ≥ 1000) of schoolchildren (age, 9–11 years) were drawn and studied by standardized questionnaires with detailed questions on the occurrence and severity of asthma symptoms, and on heating and cooking fuels (gas, wood, coal/coke, or oil) as well as on other potential risk factors. In addition, standardized protocols were applied for skin prick testing to assess atopic sensitization. Crude and adjusted odds ratios (OR) were calculated for each center. Combined estimates were calculated with meta-analysis random effects models. Results: In affluent countries (gross national income ≥$9200 per year per capita), there was no relation between indoor pollutants from cooking or heating with wheeze in the past year with combined ORs of 1.01 (95% CI, 0.90–1.14) and 0.91 (95% CI, 0.80–1.04), respectively. In the remaining non-affluent countries there was a tendency for an increased OR for indoor pollutants from cooking (OR = 1.25; 95% CI, 0.81–1.92). Subanalyses revealed a statistically significant OR (1.93; 95% CI, 1.50–2.48) with cooking pollutants among children with a positive skin prick test in nonaffluent centers. Girls showed a significant OR (1.33; 95% CI, 1.04–1.69) for heating pollutants in nonaffluent countries. For exposures in the first year of life, again, no association was found among affluent centers. Among nonaffluent centers, the estimated ORs were increased for cooking (1.16; 95% CI, 0.78–1.71) and for heating (1.20; 95% CI, 1.02–1.41). In these countries, ORs tended to be higher among girls for cooking (1.32, 95% CI, 0.87–1.98) and heating pollutants (1.42; 95% CI, 0.96–2.08) than among boys where no association was found. Adjustment for age, sex, ETS, and bedroom sharing, as an indicator for socioeconomic status, did not change any of the above results Conclusions: These results suggest an association with indoor air pollutants only in nonaffluent countries where exposures to indoor pollutants due to cooking and heating are likely to be higher.
Published Version
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