Duration of solid fuel cookstove use is associated with increased risk of acute lower respiratory infection among children under six months in rural central India

Autoři: Lauren Arlington aff001;  Archana B. Patel aff002;  Elizabeth Simmons aff001;  Kunal Kurhe aff002;  Amber Prakash aff002;  Sowmya R. Rao aff001;  Patricia L. Hibberd aff001
Působiště autorů: Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America aff001;  Lata Medical Research Foundation, Nagpur, Maharashtra, India aff002;  Department of Pediatrics, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224374



India has a higher number of deaths due to acute lower respiratory infections (ALRIs) in children <5 years than any other country. The underlying cause of half of ALRI deaths is household air pollution from burning of solid fuels, according to the World Health Organization. If there is a direct association between duration of exposure and increased ALRI risk, a potential strategy might be to limit the child’s exposure to burning solid fuel.

Methods and materials

Children born to pregnant women participating in the Global Network for Women and Children's Health Maternal and Newborn Health Registry near Nagpur, India were followed every two weeks from birth to six months to diagnose ALRI. The number of hours per day that the child’s mother spent in front of a burning solid fuel cookstove was recorded. Children of mothers using only clean cookstoves were classified as having zero hours of exposure. Odds Ratios with 95% confidence intervals were obtained from Generalized Estimating Equations logistic models that assessed the relationship of exposure to solid fuels with risk of ≥1 ALRI, adjusted for sex of the child, household smoking, wealth, maternal age, birth weight and parity.


Between August 2013 and March 2014, 302 of 1,586 children (19%) had ≥1 episode of ALRI. Results from the multivariable analysis indicate that the odds of ALRI significantly increased from 1.2 (95% CI: 0.7–2.2) for <1 hour of exposure to 2.1 (95% CI: 1.4–3.3) for >3 hours of exposure to solid fuel cookstoves compared with no exposure (p<0.01). Additionally, decreasing wealth [middle: 1.2 (0.9, 1.6); poor: 1.4 (1.2–1.7); p<0.001] was associated with ALRIs.


Our study findings indicate that increasing the time mothers spend cooking near solid fuel cookstoves while children are in the house may be associated with development of ≥1 ALRI in children <6 months.

Klíčová slova:

Birth weight – Fuels – Children – India – Infants – Mothers – Pollution – Pregnancy


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