Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Int J Epidemiol. 2009 Oct;38(5):1351-63. doi: 10.1093/ije/dyp286. Epub 2009 Sep 16.
Exposure to indoor air pollution due to open burning of biomass fuel is common in low- and middle-income countries. Previous studies linked this exposure to an increased risk of respiratory illness, low birth weight (LBW) and other disorders. We assessed the association between exposure to biomass fuel sources and second-hand tobacco smoke (SHTS) in the home and adverse health outcomes in early infancy in a population in rural south India.
A population-based cohort of newborns was followed from birth through 6 months. Household characteristics were assessed during an enrolment interview including the primary type of cooking fuel and smoking behaviour of household residents. Follow-up visits for morbidity were carried out every 2 weeks after delivery. Infants were discharged at 6 months when anthropometric measurements were collected.
11 728 live-born infants were enrolled and followed, of whom 92.3% resided in households that used wood and/or dung as a primary source of fuel. Exposure to biomass fuel was associated with an adjusted 49% increased risk of LBW, a 34% increased incidence of respiratory illness and a 21% increased risk of 6-month infant mortality. Exposed infants also had 45 and 30% increased risks of underweight and stunting at 6 months. SHTS exposure was also associated with these adverse health outcomes except for attained growth.
Open burning of biomass fuel in the home is associated with significant health risks to the newborn child and young infant. Community-based trials are needed to clarify causal connections and identify effective approaches to reduce this burden of illnesses.
在中低收入国家，由于生物质燃料的开放式燃烧，室内空气污染很常见。先前的研究将这种暴露与呼吸道疾病、低出生体重（LBW）和其他疾病的风险增加联系起来。我们评估了在印度南部农村地区的人群中，家庭中生物质燃料来源和二手烟草烟雾（SHTS）暴露与婴儿早期不良健康结果之间的关联。
对新生儿进行了一项基于人群的队列研究，从出生到 6 个月进行随访。在登记访谈期间评估了家庭特征，包括主要的烹饪燃料类型和家庭居民的吸烟行为。分娩后每两周进行一次发病率随访。婴儿在 6 个月时出院，同时收集人体测量学数据。
共纳入并随访了 11728 名活产婴儿，其中 92.3%的婴儿居住在以木材和/或粪便为主要燃料来源的家庭中。与使用生物质燃料相比，暴露于生物质燃料的婴儿发生 LBW 的风险增加了 49%，发生呼吸道疾病的风险增加了 34%，6 个月时婴儿死亡率增加了 21%。暴露于生物质燃料的婴儿还存在体重不足和发育迟缓的风险增加了 45%和 30%。SHTS 暴露也与这些不良健康结果有关，除了生长。
家庭中生物质燃料的开放式燃烧会给新生儿和幼儿带来严重的健康风险。需要进行基于社区的试验，以明确因果关系，并确定减轻这种疾病负担的有效方法。
