School of Public Health, University of California-Berkeley, Berkeley, California 94720-7360, USA.
Environ Health Perspect. 2010 Apr;118(4):558-64. doi: 10.1289/ehp.0901032.
In Nepal, tuberculosis (TB) is a major problem. Worldwide, six previous epidemiologic studies have investigated whether indoor cooking with biomass fuel such as wood or agricultural wastes is associated with TB with inconsistent results.
Using detailed information on potential confounders, we investigated the associations between TB and the use of biomass and kerosene fuels.
A hospital-based case-control study was conducted in Pokhara, Nepal. Cases (n = 125) were women, 20-65 years old, with a confirmed diagnosis of TB. Age-matched controls (n = 250) were female patients without TB. Detailed exposure histories were collected with a standardized questionnaire.
Compared with using a clean-burning fuel stove (liquefied petroleum gas, biogas), the adjusted odds ratio (OR) for using a biomass-fuel stove was 1.21 [95% confidence interval (CI), 0.48-3.05], whereas use of a kerosene-fuel stove had an OR of 3.36 (95% CI, 1.01-11.22). The OR for use of biomass fuel for heating was 3.45 (95% CI, 1.44-8.27) and for use of kerosene lamps for lighting was 9.43 (95% CI, 1.45-61.32).
This study provides evidence that the use of indoor biomass fuel, particularly as a source of heating, is associated with TB in women. It also provides the first evidence that using kerosene stoves and wick lamps is associated with TB. These associations require confirmation in other studies. If using kerosene lamps is a risk factor for TB, it would provide strong justification for promoting clean lighting sources, such as solar lamps.
在尼泊尔，结核病（TB）是一个主要问题。在全球范围内，已有六项先前的流行病学研究调查了室内使用生物质燃料（如木材或农业废弃物）烹饪是否与结核病有关，但结果不一致。
利用有关潜在混杂因素的详细信息，我们调查了结核病与使用生物质和煤油燃料之间的关联。
在尼泊尔博克拉进行了一项基于医院的病例对照研究。病例组（n=125）为年龄在 20-65 岁之间、确诊结核病的女性。年龄匹配的对照组（n=250）为无结核病的女性患者。使用标准化问卷收集详细的暴露史。
与使用清洁燃烧燃料炉（液化石油气、沼气）相比，使用生物质燃料炉的调整后比值比（OR）为 1.21（95%置信区间[CI]，0.48-3.05），而使用煤油燃料炉的 OR 为 3.36（95%CI，1.01-11.22）。使用生物质燃料取暖的 OR 为 3.45（95%CI，1.44-8.27），使用煤油灯照明的 OR 为 9.43（95%CI，1.45-61.32）。
本研究提供了证据表明，室内使用生物质燃料，特别是作为取暖来源，与女性结核病有关。它还首次提供了使用煤油炉和灯芯灯与结核病有关的证据。这些关联需要在其他研究中得到证实。如果使用煤油灯是结核病的危险因素，那么推广清洁照明来源（如太阳能灯）将提供强有力的理由。
