室内固体燃料使用与中国的结核病：一项匹配病例对照研究。

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

机构信息

Anhui Provincial Tuberculosis Institute, Jixi Road, Hefei. 230022, Anhui, China.

出版信息

BMC Public Health. 2011 Jun 25;11:498. doi: 10.1186/1471-2458-11-498.

DOI:10.1186/1471-2458-11-498

PMID:21702987

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3141461/

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.

摘要

背景

中国在 22 个结核病高负担国家中排名第二。一项建模研究表明，减少室内空气污染有助于推进中国的结核病控制。然而，室内空气污染与结核病之间的关联尚未得到充分证实。本项病例对照研究在中国安徽开展，旨在调查固体燃料的使用是否与结核病有关。

方法

病例为新痰涂片阳性的肺结核患者。每个病例按照预先确定的程序，通过年龄和性别与 2 名对照相匹配。通过问卷调查收集人口统计学信息、吸烟习惯以及用于烹饪和取暖的固体燃料使用情况。固体燃料（煤和生物质）包括煤/褐煤、木炭、木材、秸秆/灌木/草、动物粪便和农业作物残余物。家庭如果使用固体燃料用于烹饪和/或取暖，则被归类为接触固体燃料燃烧（室内空气污染）。通过 Mantel-Haenszel 估计和多变量条件逻辑回归确定分类变量的比值比及其 95%置信区间。

结果

本研究共纳入 202 例新涂阳肺结核病例和 404 名邻居对照。参与研究的人群中，有 73.8%的病例和 72.5%的对照使用固体燃料烹饪，大多数人使用格栅炉（病例 85.2%，对照 86.7%），使用抽油烟机或烟囱排烟（病例 92.0%，对照 92.8%），在单独的房间（病例 24.8%，对照 28.0%）或单独的建筑（病例 67.8%，对照 67.6%）做饭。使用固体燃料烹饪（比值比（OR）1.08，95%置信区间（CI）0.62-1.87）或固体燃料取暖（OR 1.04，95%CI 0.54-2.02）均与结核病无显著关联。与结核病显著相关的因素包括家庭结核病接触者（调整比值比，27.23，95%CI 8.19-90.58）和曾吸烟（调整比值比，1.64，96%CI 1.01-2.66）。