title: Indoor charcoal smoke and acute respiratory infections in young children in the Dominican Republic.
abstract: The authors investigated the effect of charcoal smoke exposure on risks of acute upper and lower respiratory infection (AURI and ALRI) among children under age 18 months in Santo Domingo, Dominican Republic (1991-1992). Children living in households using charcoal for cooking (exposed, n = 201) were age-matched to children living in households using propane gas (nonexposed, n = 214) and were followed for 1 year or until 2 years of age. Fuel use and new episodes of AURI and ALRI were ascertained biweekly through interviews and medical examinations. Household indoor-air concentration of respirable particulate matter (RPM) was measured in a sample of follow-up visits. Incidences of AURI and ALRI were 4.4 and 1.4 episodes/child-year, respectively. After adjustment for other risk factors, exposed children had no significant increase in risk of AURI but were 1.56 times (95% confidence interval: 1.23, 1.97) more likely to develop ALRI. RPM concentrations were higher in charcoal-using households (27.9 microg/m(3) vs. 17.6 microg/m(3)), and ALRI risk increased with RPM exposure (10-microg/m(3) increment: odds ratio = 1.17, 95% confidence interval: 1.02, 1.34). Exposure to charcoal smoke increases the risk of ALRI in young children, an effect that is probably mediated by RPM. Reducing charcoal smoke exposure may lower the burden of ALRI among children in this population.
authors.affiliation: Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA. lebautista@wisc.edu
authors.forename: Leonelo E
authors.initials: LE
authors.lastname: Bautista
authors.forename: Adolfo
authors.initials: A
authors.lastname: Correa
authors.forename: Jill
authors.initials: J
authors.lastname: Baumgartner
authors.forename: Patrick
authors.initials: P
authors.lastname: Breysse
authors.forename: Genevieve M
authors.initials: GM
authors.lastname: Matanoski
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis; D002606:Charcoal / Q000009:adverse effects*; D002675:Child, Preschool; D003296:Cooking; D004293:Dominican Republic / Q000453:epidemiology; D004784:Environmental Monitoring / Q000379:methods; D062665:Epidemiological Monitoring; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis; D011407:Propane / Q000009:adverse effects / Q000032:analysis; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects* / Q000032:analysis
chemical_list: D052638:Particulate Matter; D012906:Smoke; D002606:Charcoal; D011407:Propane