Robin L F, Less P S, Winget M, Steinhoff M, Moulton L H, Santosham M, Correa A
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA.
Pediatr Infect Dis J. 1996 Oct;15(10):859-65. doi: 10.1097/00006454-199610000-00006.
Acute lower respiratory illnesses (ALRI) have been associated with exposure to domestic smoke. To examine further this association, a case-control study was conducted among Navajo children seen at the Public Health Service Indian Hospital at Fort Defiance, AZ.
Cases, children hospitalized with an ALRI (n = 45), were ascertained from the inpatient logs during October, 1992, through March, 1993. Controls, children who had a health record at the same hospital and had never been hospitalized for ALRI, were matched 1:1 to cases on date of birth and gender. Home interviews of parents of subjects during March and April, 1993, elicited information on heating and cooking fuels and other household characteristics. Indoor air samples were collected for determination of time-weighted average concentrations of respirable particles (i.e. < 10 microns in diameter).
Age of cases at the time of admission ranged from 1 to 24 months (median, 7 months); 60% of the cases were male. Matched pair analysis revealed an increased risk of ALRI for children living in households that cooked with any wood (odds ratio (OR), 5.0; 95% confidence interval (CI), 0.6 to 42.8), had indoor air concentrations of respirable particles > or = 65 micrograms/m3 (i.e. 90th percentile) (OR 7.0, 95% CI 0.9 to 56.9), and where the primary caretaker was other than the mother (OR 9, 95% CI 1.1 to 71.4). Individual adjustment for potential confounders resulted in minor change (i.e. < 20%) in these results. Indoor air concentration of respirable particles was positively correlated with cooking and heating with wood (P < 0.02) but not with other sources of combustion emissions.
Cooking with wood-burning stoves was associated with higher indoor air concentrations of respirable particles and with an increased risk of ALRI in Navajo children.
急性下呼吸道疾病（ALRI）与接触家庭烟雾有关。为进一步研究这种关联，在亚利桑那州迪法恩斯堡公共卫生服务印第安医院对纳瓦霍儿童进行了一项病例对照研究。
病例为1992年10月至1993年3月期间因ALRI住院的儿童（n = 45），从住院日志中确定。对照为在同一家医院有健康记录且从未因ALRI住院的儿童，按出生日期和性别与病例1:1匹配。1993年3月和4月对受试者的父母进行家庭访谈，获取有关取暖和烹饪燃料及其他家庭特征的信息。采集室内空气样本以测定可吸入颗粒物（即直径<10微米）的时间加权平均浓度。
入院时病例的年龄范围为1至24个月（中位数为7个月）；60%的病例为男性。配对分析显示，居住在使用任何木材烹饪的家庭中的儿童患ALRI的风险增加（优势比（OR）为5.0；95%置信区间（CI）为0.6至42.8），室内可吸入颗粒物浓度>或 = 65微克/立方米（即第90百分位数）（OR为7.0，95%CI为0.9至56.9），以及主要照顾者不是母亲的家庭（OR为9，95%CI为1.1至71.4）。对潜在混杂因素进行个体调整后，这些结果变化较小（即<20%）。室内可吸入颗粒物浓度与用木材烹饪和取暖呈正相关（P < 0.02），但与其他燃烧排放源无关。
使用燃木炉灶烹饪与纳瓦霍儿童室内可吸入颗粒物浓度升高及患ALRI的风险增加有关。
