title: Atopic dermatitis and indoor use of energy sources in cooking and heating appliances.
abstract: BACKGROUND
  Atopic dermatitis (AD) prevalence has considerably increased worldwide in recent years. Studying indoor environments is particularly relevant, especially in industrialised countries where many people spend 80% of their time at home, particularly children. This study is aimed to identify the potential association between AD and the energy source (biomass, gas and electricity) used for cooking and domestic heating in a Spanish schoolchildren population.
  
  
  METHODS
  As part of the ISAAC (International Study of Asthma and Allergies in Childhood) phase III study, a cross-sectional population-based survey was conducted with 21,355 6-to-7-year-old children from 8 Spanish ISAAC centres. AD prevalence, environmental risk factors and the use of domestic heating/cooking devices were assessed using the validated ISAAC questionnaire. Crude and adjusted odds ratios (cOR, aOR) and 95% confidence intervals (CIs) were obtained. A logistic regression analysis was performed (Chi-square test, p-value < 0.05).
  
  
  RESULTS
  It was found that the use of biomass systems gave the highest cORs, but only electric cookers showed a significant cOR of 1.14 (95% CI: 1.01-1.27). When the geographical area and the mother's educational level were included in the logistic model, the obtained aOR values differed moderately from the initial cORs. Electric heating was the only type which obtained a significant aOR (1.13; 95% CI: 1.00-1.27). Finally, the model with all selected confounding variables (sex, BMI, number of siblings, mother's educational level, smoking habits of parents, truck traffic and geographical area), showed aOR values which were very similar to those obtained in the previous adjusted logistic analysis. None of the results was statistically significant, but the use of electric heating showed an aOR close to significance (1.14; 95% CI: 0.99-1.31).
  
  
  CONCLUSIONS
  In our study population, no statistically significant associations were found between the type of indoor energy sources used and the presence of AD.
authors.affiliation: Unit of Public Health, Hygiene and Environmental care, Department of Preventive Medicine, University of Valencia, Valencia, Spain. ana.maria.vicedo@uv.es
authors.forename: Ana M
authors.initials: AM
authors.lastname: Vicedo-Cabrera
authors.forename: Luís
authors.initials: L
authors.lastname: García-Marcos
authors.forename: Agustín
authors.initials: A
authors.lastname: Llopis-González
authors.forename: Ángel
authors.initials: Á
authors.lastname: López-Silvarrey-Varela
authors.forename: Izaskun
authors.initials: I
authors.lastname: Miner-Canflanca
authors.forename: José
authors.initials: J
authors.lastname: Batlles-Garrido
authors.forename: Alfredo
authors.initials: A
authors.lastname: Blanco-Quiros
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Busquets-Monge
authors.forename: Carlos
authors.initials: C
authors.lastname: Díaz-Vazquez
authors.forename: Carlos
authors.initials: C
authors.lastname: González-Díaz
authors.forename: Antonio
authors.initials: A
authors.lastname: Martínez-Gimeno
authors.forename: Francisco
authors.initials: F
authors.lastname: Guillén-Grima
authors.forename: Alberto
authors.initials: A
authors.lastname: Arnedo-Pena
authors.forename: María
authors.initials: M
authors.lastname: Morales-Suárez-Varela
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects; D000886:Anthropometry; D001674:Bioelectric Energy Sources / Q000706:statistics & numerical data*; D002648:Child; D003296:Cooking / Q000295:instrumentation*; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006361:Heating / Q000295:instrumentation*; D006801:Humans; D008019:Life Style; D008297:Male; D016017:Odds Ratio; D010287:Parent-Child Relations; D010290:Parents / Q000193:education; D012907:Smoking / Q000453:epidemiology; D012931:Social Environment; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires