Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC).
Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC).
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DOI：
10.1016/s2213-2600(13)70073-0
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发表时间：
2013-07
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通讯作者：
G. Wong;Bert Brunekreef;P. Ellwood;Ross Anderson;Innes Asher;J. Crane;C. Lai;I. EllwoodMPHProfM;Asher MBChB;Prof Gary;WK Wong
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作者：
G. Wong;Bert Brunekreef;P. Ellwood;Ross Anderson;Innes Asher;J. Crane;C. Lai;I. EllwoodMPHProfM;Asher MBChB;Prof Gary;WK Wong
一系列家庭烹饪燃料造成的室内空气污染与呼吸道疾病的发生和恶化有关。在富国和穷国，烹饪燃料对儿童哮喘和过敏的影响尚不清楚。我们调查了哮喘与世界各地使用一系列烹饪燃料之间的关系。方法在国际儿童哮喘和过敏研究（ISAAC）的第三阶段，对13-14岁的中学生进行书面问卷调查，其中247434人（78%）在学校自行填写喘息症状的视频问卷。6-7岁儿童的家长在家完成书面问卷。我们使用逻辑回归研究了烹饪燃料类型与哮喘症状之间的关系。对性别、世界地区、语言、国民总收入、母亲教育、父母吸烟和其他6个特定主题的协变量进行了调整。艾萨克的研究现在已经结束，但研究人员可以继续使用这些仪器进行进一步的研究。研究结果数据收集于1999年至2004年。来自47个国家108个中心的512 707名中小学生被纳入分析。在6-7岁儿童和13-14岁儿童中，使用明火做饭与哮喘症状和报告哮喘的风险增加相关（过去一年喘息的比值比[OR]为1.78,95% CI为1.51 - 1·10）（OR为1.20,95% CI 1.06 - 1·37）。在最后的多变量分析中，6-7岁儿童过去一年的喘息和单纯使用明火做饭的or值为2.17 (95% CI为1.64 - 2.87)，13-14岁儿童的or值为1.35（1.11 - 1.64）。6-7岁儿童过去一年喘息和使用明火与其他燃料混合烹饪的比值比为1.51(1.25 - 1.81)，13-14岁儿童为1.35（1.15 - 1.58）。在这两个年龄组中，我们没有发现使用燃气作为烹饪燃料与哮喘症状或哮喘诊断之间存在关联的证据。使用明火烹饪与儿童哮喘症状和哮喘诊断风险增加有关。由于世界上很大一部分人口使用明火做饭，如果这种联系被证明是因果关系，这种烹饪方法可能是一个重要的可改变的风险因素。资助：保柏基金会、奥克兰医学研究基金会、新西兰健康研究理事会、新西兰哮喘和呼吸基金会、儿童健康研究基金会、霍克湾医学研究基金会、怀卡托医学研究基金会、新西兰葛兰素史克惠康公司、新西兰彩票委员会、新西兰阿斯利康公司、香港研究资助局、葛兰素史克惠康国际医疗事务。
BackgroundIndoor air pollution from a range of household cooking fuels has been implicated in the development and exacerbation of respiratory diseases. In both rich and poor countries, the effects of cooking fuels on asthma and allergies in childhood are unclear. We investigated the association between asthma and the use of a range of cooking fuels around the world.MethodsFor phase three of the International Study of Asthma and Allergies in Childhood (ISAAC), written questionnaires were self-completed at school by secondary school students aged 13–14 years, 244 734 (78%) of whom were then shown a video questionnaire on wheezing symptoms. Parents of children aged 6–7 years completed the written questionnaire at home. We investigated the association between types of cooking fuels and symptoms of asthma using logistic regression. Adjustments were made for sex, region of the world, language, gross national income, maternal education, parental smoking, and six other subject-specific covariates. The ISAAC study is now closed, but researchers can continue to use the instruments for further research.FindingsData were collected between 1999 and 2004. 512 707 primary and secondary school children from 108 centres in 47 countries were included in the analysis. The use of an open fire for cooking was associated with an increased risk of symptoms of asthma and reported asthma in both children aged 6–7 years (odds ratio [OR] for wheeze in the past year, 1·78, 95% CI 1·51–2·10) and those aged 13–14 years (OR 1·20, 95% CI 1·06–1·37). In the final multivariate analyses, ORs for wheeze in the past year and the use of solely an open fire for cooking were 2·17 (95% CI 1·64–2·87) for children aged 6–7 years and 1·35 (1·11–1·64) for children aged 13–14 years. Odds ratios for wheeze in the past year and the use of open fire in combination with other fuels for cooking were 1·51 (1·25–1·81 for children aged 6–7 years and 1·35 (1·15–1·58) for those aged 13–14 years. In both age groups, we detected no evidence of an association between the use of gas as a cooking fuel and either asthma symptoms or asthma diagnosis.InterpretationThe use of open fires for cooking is associated with an increased risk of symptoms of asthma and of asthma diagnosis in children. Because a large percentage of the world population uses open fires for cooking, this method of cooking might be an important modifiable risk factor if the association is proven to be causal.FundingBUPA Foundation, the Auckland Medical Research Foundation, the Health Research Council of New Zealand, the Asthma and Respiratory Foundation of New Zealand, the Child Health Research Foundation, the Hawke's Bay Medical Research Foundation, the Waikato Medical Research Foundation, Glaxo Wellcome New Zealand, the NZ Lottery Board, Astra Zeneca New Zealand, Hong Kong Research Grant Council, Glaxo Wellcome International Medical Affairs.