title: Increased risk of respiratory illness associated with kerosene fuel use among women and children in urban Bangalore, India.
abstract: BACKGROUND
  Kerosene is a widely used cooking and lighting fuel in developing countries. The potential respiratory health effects of cooking with kerosene relative to cooking with cleaner fuels such as liquefied petroleum gas (LPG) have not been well characterised.
  
  
  METHODS
  We sampled 600 households from six urban neighbourhoods in Bangalore, India. Each household's primary cook, usually the woman of the house, was interviewed to collect information on current domestic fuel use and whether there was any presence of respiratory symptoms or illness in her or in the children in the household. Our analysis was limited to 547 adult females (ages 18-85) and 845 children (ages 0-17) in households exclusively cooking with either kerosene or LPG. We investigated the associations between kerosene use and the likelihood of having respiratory symptoms or illness using multivariate logistic regression models.
  
  
  RESULTS
  Among adult women, cooking with kerosene was associated with cough (OR=1.88; 95% CI 1.19 to 2.99), bronchitis (OR=1.54; 95% CI 1.00 to 2.37), phlegm (OR=1.51; 95% CI 0.98 to 2.33) and chest illness (OR=1.61; 95% CI 1.02 to 2.53), relative to cooking with LPG in the multivariate models. Among children, living in a household cooking with kerosene was associated with bronchitis (OR=1.91; 95% CI 1.17 to 3.13), phlegm (OR=2.020; 95% CI 1.29 to 3.74) and chest illness (OR=1.70; 95% CI 0.99 to 2.90) after adjusting for other covariates. We also found associations between kerosene use and wheezing, difficulty breathing and asthma in adults and cough and wheezing in children, though these associations were not statistically significant.
  
  
  CONCLUSIONS
  Women and children in households cooking with kerosene were more likely to have respiratory symptoms and illnesses compared with those in households cooking with LPG. Transitioning from kerosene to LPG for cooking may improve respiratory health among adult women and children in this population.
authors.affiliation: Division of Business, Hallym University, Chuncheon, Gangwon-do, South Korea.
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Institute on the Environment, University of Minnesota, St. Paul, Minnesota, USA Department of Epidemiology, Biostatistics and Occupational Health, Institute for Health and Social Policy, McGill University, Montréal, Quebec, Canada.
authors.forename: Jill
authors.initials: J
authors.lastname: Baumgartner
authors.affiliation: Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Harnden
authors.affiliation: Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Alexander
authors.affiliation: Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA National Bureau of Economic Research, Cambridge, Massachusetts, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Town
authors.affiliation: Department of Chest Diseases, St John's Medical College Hospital, Bangalore, Karnataka, India.
authors.forename: George
authors.initials: G
authors.lastname: D'Souza
authors.affiliation: Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Gurumurthy
authors.initials: G
authors.lastname: Ramachandran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003296:Cooking; D004781:Environmental Exposure / Q000009:adverse effects*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007648:Kerosene; D008297:Male; D008875:Middle Aged; D010578:Petroleum; D015995:Prevalence; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*; D012306:Risk; D014505:Urban Population; D055815:Young Adult
chemical_list: D007648:Kerosene; D010578:Petroleum
keywords: India; household air pollution; kerosene; liquefied petroleum gas; respiratory illness