Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Public Health Foundation of India, Indian Institute of Public Health-Hyderabad, Bangalore, India.
Thorax. 2018 Nov;73(11):1026-1040. doi: 10.1136/thoraxjnl-2017-210952. Epub 2018 Jun 20.
Improved biomass cookstoves may help reduce the substantial global burden of morbidity and mortality due to household air pollution (HAP) that disproportionately affects women and children in low and middle income countries (LMICs).
Systematic review and meta-analysis of (quasi-)experimental studies identified from 13 electronic databases (last update: 6 April 2018), reference and citation searches and via expert consultation.
LMICs PARTICIPANTS: Women and children INTERVENTIONS: Improved biomass cookstoves MAIN OUTCOME MEASURES: Low birth weight (LBW), preterm birth, perinatal mortality, paediatric acute respiratory infections (ARIs) and COPD among women.
We identified 53 eligible studies, including 24 that met prespecified design criteria. Improved cookstoves had no demonstrable impact on paediatric lower ARIs (three studies; 11 560 children; incidence rate ratio (IRR)=1.02 (95% CI 0.84 to 1.24)), severe pneumonia (two studies; 11 061 children; IRR=0.88 (95% CI 0.39 to 2.01)), LBW (one study; 174 babies; OR=0.74 (95% CI 0.33 to 1.66)) or miscarriages, stillbirths and infant mortality (one study; 1176 babies; risk ratio (RR) change=15% (95% CI -13 to 43)). No (quasi-)experimental studies assessed preterm birth or COPD. In observational studies, improved cookstoves were associated with a significant reduction in COPD among women: two studies, 9757 participants; RR=0.74 (95% CI 0.61 to 0.90). Reductions in cough (four studies, 1779 participants; RR=0.72 (95% CI 0.60 to 0.87)), phlegm (four studies, 1779 participants; RR=0.65 (95% CI 0.52 to 0.80)), wheezing/breathing difficulty (four studies; 1779 participants; RR=0.41 (95% CI 0.29 to 0.59)) and conjunctivitis (three studies, 892 participants; RR=0.58 (95% CI 0.43 to 0.78)) were observed among women.
Improved cookstoves provide respiratory and ocular symptom reduction and may reduce COPD risk among women, but had no demonstrable child health impact.
PROSPERO: CRD42016033075.
改良生物质炊具的使用可能有助于减少全球因室内空气污染（HAP）而导致的大量发病率和死亡率，这种污染对中低收入国家（LMICs）的妇女和儿童的影响不成比例。
从 13 个电子数据库（最后更新日期：2018 年 4 月 6 日）、参考文献和引文搜索以及专家咨询中系统地检索和分析了（准）实验研究。
LMICs
妇女和儿童
改良生物质炊具
低出生体重（LBW）、早产、围产期死亡率、儿科急性呼吸道感染（ARIs）和妇女中的 COPD。
我们确定了 53 项符合条件的研究，其中 24 项符合预先规定的设计标准。改良炉灶对儿科下呼吸道感染（3 项研究；11061 名儿童；发病率比（IRR）=1.02（95%CI 0.84 至 1.24））、严重肺炎（2 项研究；11061 名儿童；IRR=0.88（95%CI 0.39 至 2.01））、LBW（1 项研究；174 名婴儿；OR=0.74（95%CI 0.33 至 1.66））或流产、死产和婴儿死亡率（1 项研究；1176 名婴儿；风险比（RR）变化=15%（95%CI 13%至 43%））没有明显影响。没有（准）实验研究评估早产或 COPD。在观察性研究中，改良炉灶与妇女中 COPD 的显著减少有关：两项研究，9757 名参与者；RR=0.74（95%CI 0.61 至 0.90）。咳嗽（4 项研究，1779 名参与者；RR=0.72（95%CI 0.60 至 0.87））、咳痰（4 项研究，1779 名参与者；RR=0.65（95%CI 0.52 至 0.80））、喘息/呼吸困难（4 项研究；1779 名参与者；RR=0.41（95%CI 0.29 至 0.59））和结膜炎（3 项研究，892 名参与者；RR=0.58（95%CI 0.43 至 0.78））的发生率在妇女中降低。
改良炉灶提供呼吸道和眼部症状减轻，可能降低妇女患 COPD 的风险，但对儿童健康没有明显影响。
PROSPERO：CRD42016033075。
