IMPACT OF HOUSEHOLD COOKING FUELS ON GENDER-SPECIFIC ADULT TUBERCULOSIS AND DIABETES IN INDIA: A CROSS-SECTIONAL SURVEY

摘要

Background:lndoor air pollution due to solid cooking fuels has been widely reported to be an important risk factor for tuberculosis (TB). A few recent studies implicate its association with diabetes as well. Aims: We aim to investigate the effect of household cooking fuel and other environmental factors on TB and diabetes in Indian population. Additional aim is to explore the gender-specific differences in risk factors of the two diseases. Methods: The data is extracted from the most recent National Family Health Survey (NFHS-3), a nationally representative demographic and health survey of Indian households.Detailed structured interview was conducted covering a total of 124,385 women, aged 15-49 and 74,369 men, aged 15-54 during 2005-2006. Information was collected on TB and diabetes, household characteristics including cooking fuels, socio-economic, lifestyle and other factors. Multivariate logistic regression models are built to assess the impact of household cooking fuels on TB and diabetes. The cooking fuels are re-categorized as clean (as reference), kerosene and solid biomass fuels. Results: Both kerosene and solid biomass cooking fuels were associated with increased risk of TB in women (odds ratios 2.27 (95% CI 1.43, 3.62) and 2.34 (1.86, 2.94) respectively). The risk decreased for kerosene (OR 1.51 (0.93, 2.49)) but disappeared for solid cooking fuels (OR 1.19 (0.86,1.65)) after controlling for age, BMI, socio-economic, diet and lifestyle factors. In contrast, diabetes was negatively associated with solid cooking fuels (OR 0.44 (0.39, 0.49)) but not with kerosene (OR 1.08 (0.85,1.36)). After adjusting for the potential confounders the risk increased slightly for kerosene (OR 1.23 (0.95,1.59)) and solid cooking fuels (OR 0.90 (0.75,1.07)) but no longer remain statistically significant. Separate analysis in men is currently underway. Conclusions: Our first results show kerosene use is associated with increased risk of TB and diabetes in Indian women.