Indoor solid fuel use and tuberculosis in China: A matched case-control study

Xiaohong Kan, Chen Yuan Chiang, Donald A. Enarson, Wenhua Chen, Jianan Yang, Genwang Chen

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Abstract. Background: China ranks second among the 22 high burden countries for tuberculosis. A modeling exercise showed that reduction of indoor air pollution could help advance tuberculosis control in China. However, the association between indoor air pollution and tuberculosis is not yet well established. A case control study was conducted in Anhui, China to investigate whether use of solid fuel is associated with tuberculosis. Methods. Cases were new sputum smear positive tuberculosis patients. Two controls were selected from the neighborhood of each case matched by age and sex using a pre-determined procedure. A questionnaire containing demographic information, smoking habits and use of solid fuel for cooking or heating was used for interview. Solid fuel (coal and biomass) included coal/lignite, charcoal, wood, straw/shrubs/grass, animal dung, and agricultural crop residue. A household that used solid fuel either for cooking and (/or) heating was classified as exposure to combustion of solid fuel (indoor air pollution). Odds ratios and their corresponding 95% confidence limits for categorical variables were determined by Mantel-Haenszel estimate and multivariate conditional logistic regression. Results: There were 202 new smear positive tuberculosis cases and 404 neighborhood controls enrolled in this study. The proportion of participants who used solid fuels for cooking was high (73.8% among cases and 72.5% among controls). The majority reported using a griddle stove (85.2% among cases and 86.7% among controls), had smoke removed by a hood or chimney (92.0% among cases and 92.8% among controls), and cooked in a separate room (24.8% among cases and 28.0% among controls) or a separate building (67.8% among cases and 67.6% among controls). Neither using solid fuel for cooking (odds ratio (OR) 1.08, 95% CI 0.62-1.87) nor using solid fuel for heating (OR 1.04, 95% CI 0.54-2.02) was significantly associated with tuberculosis. Determinants significantly associated with tuberculosis were household tuberculosis contact (adjusted OR, 27.23, 95% CI 8.19-90.58) and ever smoking tobacco (adjusted OR 1.64, 96% CI 1.01-2.66). Conclusion: In a population where the majority had proper ventilation in cooking places, the association between use of solid fuel for cooking or for heating and tuberculosis was not statistically significant.

Original languageEnglish
Article number498
JournalBMC Public Health
Volume11
DOIs
Publication statusPublished - 2011

Fingerprint

Case-Control Studies
China
Tuberculosis
Cooking
Indoor Air Pollution
Heating
Odds Ratio
Coal
Smoking
Agricultural Crops
Charcoal
Poaceae
Sputum
Smoke
Biomass
Habits
Ventilation
Logistic Models
Demography
Interviews

Keywords

  • biomass
  • fossil fuels
  • indoor air pollution
  • risk factors
  • tuberculosis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Indoor solid fuel use and tuberculosis in China : A matched case-control study. / Kan, Xiaohong; Chiang, Chen Yuan; Enarson, Donald A.; Chen, Wenhua; Yang, Jianan; Chen, Genwang.

In: BMC Public Health, Vol. 11, 498, 2011.

Research output: Contribution to journalArticle

Kan, Xiaohong ; Chiang, Chen Yuan ; Enarson, Donald A. ; Chen, Wenhua ; Yang, Jianan ; Chen, Genwang. / Indoor solid fuel use and tuberculosis in China : A matched case-control study. In: BMC Public Health. 2011 ; Vol. 11.
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title = "Indoor solid fuel use and tuberculosis in China: A matched case-control study",
abstract = "Abstract. Background: China ranks second among the 22 high burden countries for tuberculosis. A modeling exercise showed that reduction of indoor air pollution could help advance tuberculosis control in China. However, the association between indoor air pollution and tuberculosis is not yet well established. A case control study was conducted in Anhui, China to investigate whether use of solid fuel is associated with tuberculosis. Methods. Cases were new sputum smear positive tuberculosis patients. Two controls were selected from the neighborhood of each case matched by age and sex using a pre-determined procedure. A questionnaire containing demographic information, smoking habits and use of solid fuel for cooking or heating was used for interview. Solid fuel (coal and biomass) included coal/lignite, charcoal, wood, straw/shrubs/grass, animal dung, and agricultural crop residue. A household that used solid fuel either for cooking and (/or) heating was classified as exposure to combustion of solid fuel (indoor air pollution). Odds ratios and their corresponding 95{\%} confidence limits for categorical variables were determined by Mantel-Haenszel estimate and multivariate conditional logistic regression. Results: There were 202 new smear positive tuberculosis cases and 404 neighborhood controls enrolled in this study. The proportion of participants who used solid fuels for cooking was high (73.8{\%} among cases and 72.5{\%} among controls). The majority reported using a griddle stove (85.2{\%} among cases and 86.7{\%} among controls), had smoke removed by a hood or chimney (92.0{\%} among cases and 92.8{\%} among controls), and cooked in a separate room (24.8{\%} among cases and 28.0{\%} among controls) or a separate building (67.8{\%} among cases and 67.6{\%} among controls). Neither using solid fuel for cooking (odds ratio (OR) 1.08, 95{\%} CI 0.62-1.87) nor using solid fuel for heating (OR 1.04, 95{\%} CI 0.54-2.02) was significantly associated with tuberculosis. Determinants significantly associated with tuberculosis were household tuberculosis contact (adjusted OR, 27.23, 95{\%} CI 8.19-90.58) and ever smoking tobacco (adjusted OR 1.64, 96{\%} CI 1.01-2.66). Conclusion: In a population where the majority had proper ventilation in cooking places, the association between use of solid fuel for cooking or for heating and tuberculosis was not statistically significant.",
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author = "Xiaohong Kan and Chiang, {Chen Yuan} and Enarson, {Donald A.} and Wenhua Chen and Jianan Yang and Genwang Chen",
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T1 - Indoor solid fuel use and tuberculosis in China

T2 - A matched case-control study

AU - Kan, Xiaohong

AU - Chiang, Chen Yuan

AU - Enarson, Donald A.

AU - Chen, Wenhua

AU - Yang, Jianan

AU - Chen, Genwang

PY - 2011

Y1 - 2011

N2 - Abstract. Background: China ranks second among the 22 high burden countries for tuberculosis. A modeling exercise showed that reduction of indoor air pollution could help advance tuberculosis control in China. However, the association between indoor air pollution and tuberculosis is not yet well established. A case control study was conducted in Anhui, China to investigate whether use of solid fuel is associated with tuberculosis. Methods. Cases were new sputum smear positive tuberculosis patients. Two controls were selected from the neighborhood of each case matched by age and sex using a pre-determined procedure. A questionnaire containing demographic information, smoking habits and use of solid fuel for cooking or heating was used for interview. Solid fuel (coal and biomass) included coal/lignite, charcoal, wood, straw/shrubs/grass, animal dung, and agricultural crop residue. A household that used solid fuel either for cooking and (/or) heating was classified as exposure to combustion of solid fuel (indoor air pollution). Odds ratios and their corresponding 95% confidence limits for categorical variables were determined by Mantel-Haenszel estimate and multivariate conditional logistic regression. Results: There were 202 new smear positive tuberculosis cases and 404 neighborhood controls enrolled in this study. The proportion of participants who used solid fuels for cooking was high (73.8% among cases and 72.5% among controls). The majority reported using a griddle stove (85.2% among cases and 86.7% among controls), had smoke removed by a hood or chimney (92.0% among cases and 92.8% among controls), and cooked in a separate room (24.8% among cases and 28.0% among controls) or a separate building (67.8% among cases and 67.6% among controls). Neither using solid fuel for cooking (odds ratio (OR) 1.08, 95% CI 0.62-1.87) nor using solid fuel for heating (OR 1.04, 95% CI 0.54-2.02) was significantly associated with tuberculosis. Determinants significantly associated with tuberculosis were household tuberculosis contact (adjusted OR, 27.23, 95% CI 8.19-90.58) and ever smoking tobacco (adjusted OR 1.64, 96% CI 1.01-2.66). Conclusion: In a population where the majority had proper ventilation in cooking places, the association between use of solid fuel for cooking or for heating and tuberculosis was not statistically significant.

AB - Abstract. Background: China ranks second among the 22 high burden countries for tuberculosis. A modeling exercise showed that reduction of indoor air pollution could help advance tuberculosis control in China. However, the association between indoor air pollution and tuberculosis is not yet well established. A case control study was conducted in Anhui, China to investigate whether use of solid fuel is associated with tuberculosis. Methods. Cases were new sputum smear positive tuberculosis patients. Two controls were selected from the neighborhood of each case matched by age and sex using a pre-determined procedure. A questionnaire containing demographic information, smoking habits and use of solid fuel for cooking or heating was used for interview. Solid fuel (coal and biomass) included coal/lignite, charcoal, wood, straw/shrubs/grass, animal dung, and agricultural crop residue. A household that used solid fuel either for cooking and (/or) heating was classified as exposure to combustion of solid fuel (indoor air pollution). Odds ratios and their corresponding 95% confidence limits for categorical variables were determined by Mantel-Haenszel estimate and multivariate conditional logistic regression. Results: There were 202 new smear positive tuberculosis cases and 404 neighborhood controls enrolled in this study. The proportion of participants who used solid fuels for cooking was high (73.8% among cases and 72.5% among controls). The majority reported using a griddle stove (85.2% among cases and 86.7% among controls), had smoke removed by a hood or chimney (92.0% among cases and 92.8% among controls), and cooked in a separate room (24.8% among cases and 28.0% among controls) or a separate building (67.8% among cases and 67.6% among controls). Neither using solid fuel for cooking (odds ratio (OR) 1.08, 95% CI 0.62-1.87) nor using solid fuel for heating (OR 1.04, 95% CI 0.54-2.02) was significantly associated with tuberculosis. Determinants significantly associated with tuberculosis were household tuberculosis contact (adjusted OR, 27.23, 95% CI 8.19-90.58) and ever smoking tobacco (adjusted OR 1.64, 96% CI 1.01-2.66). Conclusion: In a population where the majority had proper ventilation in cooking places, the association between use of solid fuel for cooking or for heating and tuberculosis was not statistically significant.

KW - biomass

KW - fossil fuels

KW - indoor air pollution

KW - risk factors

KW - tuberculosis

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