Effect of cooking fuels on respiratory diseases in preschool children in Lucknow, India

The association between cooking fuels and the risk of respiratory disease in preschool children in Lucknow, India was studied. We interviewed mothers of 650 study children, randomly selected from among 28 urban poor neighborhoods. Children were eligible if they were less than five years of age, free of congenital heart disease, malignancy, and compromised immune status. Respiratory disease (defined as one or more of the following: runny nose, cough, sore throat, breathlessness, and noisy respiration) was assessed by observation. Exposures included the types of cooking fuels and duration of their use in the last week and other potential predictors of respiratory disease. Odds ratios (ORs) for disease were adjusted for covariables using multiple logistic regression. The point prevalence of respiratory disease was 14.5%, Cooking fuels used were wood (56.0%), kerosene (24.2%), coal (19.2%), gas (15.4%), and dung cakes (8.6%). Use of dung cakes, a sun-dried mixture of cow or buffalo dung and straw, as cooking fuel was associated with respiratory disease (adjusted OR = 2.69, 95% confidence interval [CI] = 1.37-5.31, P = 0.004), as was overcrowding in the bedroom (adjusted OR = 1.25 for each additional person, 95% CI = 1.11-1.41, P = 0.001). Age, weight, gender, family income, and household structure were not associated with disease. Use of dung cakes as cooking fuel and overcrowding in the bedroom increased the risk of respiratory disease. Interventions to modify oven design or install chimneys and, where feasible, to reduce the number of people sleeping together should be considered.