Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom.
Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom.
Sci Total Environ. 2021 Feb 10;755(Pt 1):142187. doi: 10.1016/j.scitotenv.2020.142187. Epub 2020 Sep 12.
Epidemiological studies have shown a positive association between exposure to outdoor and indoor solid fuel combustion and adverse health effects. We reviewed the epidemiological evidence from Europe, North America, Australia and New Zealand on the association between outdoor and indoor exposure to solid fuel combustion and respiratory outcomes in children. We performed a systematic review and meta-analysis. Pooled relative risks (RRs) and 95% confidence intervals (CI) were calculated using random-effects models. We identified 74 articles. Due to limited evidence on other exposures and outcomes, we performed meta-analyses on the association between indoor wood burning exposure and respiratory outcomes. The RR for the highest vs the lowest category of indoor wood exposure was 0.90 (95% CI 0.77-1.05) considering asthma as an outcome. The corresponding pooled RRs for lower respiratory infection (LRI) and upper respiratory infection (URI) were 1.11 (95% CI 0.88, 1.41) and 1.11 (95% CI 0.85, 1.44) respectively. No association was found between indoor wood burning exposure and risk of wheeze and cough. Inconsistent and limited results were found considering the relationship between indoor wood burning exposure and other respiratory outcomes (rhinitis and hay fever, influenza) as well as indoor coal burning exposure and respiratory outcomes in children. Results from epidemiological studies that evaluated the relationship between the exposure to outdoor emissions derived from indoor combustion of solid fuels are too limited to allow firm conclusions. We found no association between indoor wood burning exposure and risk of asthma. A slight, but not significant, increased risk of LRI and URI was identified, although the available evidence is limited. Epidemiological studies evaluating the relationship between indoor coal burning exposure and respiratory outcomes, as well as, studies considering exposure to outdoor solid fuels, are too limited to draw any firm conclusions.
流行病学研究表明，暴露于室外和室内固体燃料燃烧与不良健康影响之间存在正相关关系。我们回顾了欧洲、北美、澳大利亚和新西兰的流行病学证据，研究了室外和室内接触固体燃料燃烧与儿童呼吸结果之间的关系。我们进行了系统评价和荟萃分析。使用随机效应模型计算了 pooled relative risks (RRs) 和 95% confidence intervals (CI)。我们确定了 74 篇文章。由于其他暴露和结果的证据有限，我们对室内木材燃烧暴露与呼吸结果之间的关系进行了荟萃分析。考虑到哮喘作为一个结果，最高与最低室内木材暴露类别之间的相对风险（RR）为 0.90（95%置信区间 0.77-1.05）。下呼吸道感染（LRI）和上呼吸道感染（URI）的相应 pooled RRs 分别为 1.11（95%置信区间 0.88,1.41）和 1.11（95%置信区间 0.85,1.44）。未发现室内木材燃烧暴露与喘息和咳嗽的风险之间存在关联。考虑到室内木材燃烧暴露与其他呼吸结果（鼻炎和花粉热、流感）以及室内燃煤暴露与儿童呼吸结果之间的关系，结果不一致且有限。评估暴露于室内燃烧固体燃料产生的室外排放物与风险之间关系的流行病学研究结果非常有限，无法得出明确的结论。我们没有发现室内木材燃烧暴露与哮喘风险之间存在关联。尽管可用证据有限，但确定了 LRI 和 URI 风险略有增加但无统计学意义。评估室内燃煤暴露与呼吸结果之间关系的流行病学研究以及考虑暴露于室外固体燃料的研究非常有限，无法得出任何明确的结论。
