Household fuel pollution from the use of low quality biomass fuels is considered as a risk factor for respiratory tract infections (RTI) in women and children. Inhalation of fuel-derived pulmonary toxins (e.g. particulate matter (PM2.5μm) , and carbon monoxide (CO) can harm the lungs of young children, due to their under-developed immune defences. In Bangladesh acute respiratory infections (ARI) are the leading cause of child mortality (< 5 years of age). This thesis aimed to examine the relationship between RTI and household fuel pollution exposure using measured pollution data and medical diagnoses. During an 18-month longitudinal health intervention in northern Bangladesh households (n=408) were interviewed (3 times) on cooking/fuel-use practices and child health. Anthropometric data (height/weight) and finger-prick blood samples for analysis of immune status (c-reactive protein, alpha-1-acidglycoprotein (AGP) and albumin) were collected (n=321 < 5 years of age). All unwell children (62.4%) were medically examined. Household pollution levels (particulate matter (PM2.5μm) and carbon monoxide (CO) were monitored for a 24-hour period (n=61). Moderate/ severe RTI was common (24.8%) (youngest child only n=213). Poor child growth (stunted: 43.8%, underweight=66.7%, wasted: 38.4%) and immunity were detected. 98% of the households used inefficient chimneyless mud stoves and low quality biomass fuels (wood, golden, dung). The measured indoor pollution levels exceeded the WHO safety thresholds (PM2.5 μm range: 85 to 3020 μg/m³ CO range: 0-16 ppm) (PM2.5 μm>25 μm/m³, CO>9ppm). Longitudinal multivariate GLM showed that cooking practices were associated with child immune status: haemoglobin levels (F= 1.555, p=NS) were significantly associated with Bihari ethnicity and a fixed stove use (F=3.718 and F=3.716, p<0.05 respectively). Elevated log₁₀-AGP levels were found (F=4.371, p<0.05) in Saidpur in households using a fixed stove (F=4.123, F=3.780, p<0.05). The patterns in child growth z-scores were due to age only (stunting: F=7.413, p<0.01, underweight F=5.787, p<0.05). Interestingly, poorer change score for weight-for-age (F=34.893, p<0.01) was associated with low age and more frequent cooking (F=6.441 and, F=6.553, p<0.05 respectively). Logistic regression (healthy vs. RTI) identified the presence of child by the stove during cooking as the sole risk factor for RTI (absent OR= 0.257, 95% CI: 0.097 - 0.676, p<0.01). Indoor cooking and the use of a fixed stove were associated with low SES. Education may help to reduce behaviours associated with high household fuel pollution exposure via the introduction of simple healthy cooking practices.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:540813 |
| Date | January 2009 |
| Creators | Näsänen-Gilmore, S. P. K. |
| Publisher | Loughborough University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | https://dspace.lboro.ac.uk/2134/16692 |
Page generated in 0.0021 seconds