Investigation of Ocular Disease and Household Fuel Use in Kaski District, Nepal

尼泊尔卡斯基地区眼部疾病和家庭燃料使用情况调查

• 批准号: 8965013
• 负责人: MICHAEL N BATES
• 金额: $ 49.07万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-30 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8965013
• 关键词: Affect; Age; Age related macular degeneration; Air Pollution; Animals; Biomass; Blindness; Burn injury; Carbon Monoxide; Cardiovascular Diseases; Case-Control Studies; Cataract; Charcoal; Child; Chronic; Chronic Obstructive Airway Disease; Coal; Confidence Intervals; Cornea; Cost-Benefit Analysis; Cross-Sectional Studies; Crystalline Lens; Data; Data Collection; Developing Countries; Diagnosis; Disease; Ensure; Epidemiologic Studies; Exposure to; Eye; Eye diseases; Female; Fire - disasters; Formaldehyde; Funding; Health; Health Policy; Heating; High Prevalence; Hospitals; Household; Household Air Pollution; Infection; International Agencies; Intervention; Investigation; Keratoconjunctivitis Sicca; Kerosene; Life; Lighting; Link; Liquid substance; Macular degeneration; Malignant neoplasm of lung; Monitor; Naphthalene; National Institute of Environmental Health Sciences; Nepal; Odds Ratio; Ophthalmic examination and evaluation; Outcome Measure; Pain; Particulate Matter; Pneumonia; Policies; Public Health; Reactive Oxygen Species; Recording of previous events; Research Infrastructure; Research Personnel; Rest; Risk Factors; Source; Surgeon; Teaching Hospitals; Testing; Tissues; Tobacco smoking; Trachoma; Training; United States National Institutes of Health; Visual impairment; Visually Impaired Persons; Woman; Wood material; World Health Organization; aged; ambient air pollution; base; biomass fuel; blind; cigarette smoking; clay; combustion product; cooking; eye dryness; high risk; lens; ocular pain; policy implication; pollutant; public health relevance; solid fuel

 DESCRIPTION (provided by applicant): Solid fuels (coal and biomass) are used for cooking and heating by approximately 3 billion people worldwide-- almost all in the developing world. Kerosene is also widely used for cooking and lighting. These fuels emit into the kitchen high concentrations of pollutants, including particulate matter, carbon monoxide and other organic compounds known to affect the eye, such as formaldehyde and naphthalene. Usually, women doing the cooking are the most exposed. There is evidence linking solid fuels to a wide range of health effects, but the impact on eye diseases has not been extensively investigated. Virtually no studies have investigated kerosene use and eye disease. In every part of the world, females are at higher risk of eye disease at all ages. About 90% of visually impaired and blind people lived in developing countries. These two closely related ocular disease studies, which focus on cataract of the lens and age-related macular degeneration (AMD), the first and third most common causes of blindness in the world, and dry eye disease, a major cause of pain and discomfort, take advantage of the established infrastructure, including offices, vehicles and trained field staff, and prior data collection-household cooking, heating and lighting appliance use, and air pollution monitoring data--of an earlier NIH-funded epidemiologic study of TB and indoor fuel use, in Pokhara, Nepal. The ocular disease studies are a cross-sectional study investigating cataract and dry eye disease, and a case-control study investigating AMD. In the cross-sectional study, women, aged 40-70 years, from TB study households, chosen on the basis of their cooking, heating and lighting appliance use, will be transported to the Manipal Teaching Hospital in Pokhara, where they will receive a free and comprehensive eye examination. Slit-lamp photos of the crystalline lens will be taken and tests done for dry eye disease. Separately, a case-control study of AMD diagnosed in women attending the hospital will be carried out. Statistical analysis in both studies will focus on examining associations between household fuel uses, for cooking, heating and lighting, and the ocular outcome measures. Together, these will comprise the most comprehensive investigation ever of these potentially causal relationships. Results will have implications for policy and for health interventions. In particular, if evidence is produced that kerosene is a risk factor for eye diseas, then this will strengthen arguments for not treating kerosene as a clean fuel alternative to biomass, as is currently the policy of some international agencies, including WHO. The studies will provide data for reworking cost-benefit analyses of replacing biomass stoves and fuel-based lighting sources with alternatives, such as LPG stoves or electric lighting.

 描述（由申请人提供）：全世界大约有 30 亿人使用固体燃料（煤炭和生物质）做饭和取暖——几乎全部在发展中国家。煤油还广泛用于烹饪和照明。这些燃料向厨房排放高浓度的污染物，包括颗粒物、一氧化碳和其他已知会影响眼睛的有机化合物，例如甲醛和萘。通常，做饭的女性是暴露程度最高的。有证据表明固体燃料与多种健康影响有关，但其对眼部疾病的影响尚未得到广泛研究。实际上没有研究调查煤油的使用和眼部疾病。在世界各地，各个年龄段的女性患眼病的风险都较高。大约 90% 的视障者和盲人生活在发展中国家。这两项密切相关的眼部疾病研究重点关注晶状体白内障和年龄相关性黄斑变性（AMD）（世界上第一和第三大常见致盲原因）以及干眼病（疼痛和不适的主要原因），利用现有的基础设施，包括办公室、车辆和训练有素的现场工作人员，以及先前的数据收集（家庭烹饪、取暖和照明设备的使用以及空气污染监测数据）。 美国国立卫生研究院 (NIH) 资助在尼泊尔博卡拉开展的结核病和室内燃料使用流行病学研究。眼部疾病研究是一项调查白内障和干眼病的横断面研究，以及一项调查 AMD 的病例对照研究。 在这项横断面研究中，来自结核病研究家庭的 40 至 70 岁女性，根据她们的烹饪、取暖和照明器具的使用情况进行选择，将被送往博卡拉的马尼帕尔教学医院，在那里她们将接受免费的全面眼科检查。将拍摄晶状体的裂隙灯照片并进行干眼病测试。 另外，还将对在医院就诊的女性中诊断出的 AMD 进行病例对照研究。这两项研究的统计分析将侧重于检查家庭烹饪、取暖和照明燃料使用与眼部结果测量之间的关联。这些将共同构成对这些潜在因果关系的最全面的调查。结果将对政策和健康干预措施产生影响。特别是，如果有证据表明煤油是眼部疾病的危险因素，那么这将强化不将煤油视为生物质的清洁燃料替代品的论点，正如包括世界卫生组织在内的一些国际机构目前的政策那样。这些研究将为用液化石油气炉或电照明等替代品取代生物质炉和燃料照明源的改造成本效益分析提供数据。