|Does biofuel smoke contribute to anaemia and stunting in early childhood?|
||Mishra, V., R.D. Retherford
||International Journal of Epidemiology, Vol 36, Page: 117-129
||Background Reliance on biomass fuels for cooking and heating exposes many women and
young children in developing countries to high levels of air pollution indoors.
Exposure to biomass smoke has been linked to reduced birth weight, acute
respiratory infections, and childhood mortality. This study examines the
association between household use of biofuels (wood, dung, and crop residues)
for cooking and heating and prevalence of anaemia and stunting in children.
Methods Data are from a 1998–99 national family health survey in India, which measured
height, weight, and blood haemoglobin of 29 768 children aged 0–35 months in
92 486 households. Multinomial logistic regression is used to estimate the effects
of biofuel use on prevalence of anaemia and stunting, controlling for exposure to
tobacco smoke, recent episodes of illness, maternal education and nutrition, and
other potentially confounding factors.
Results Analysis shows that prevalence of moderate-to-severe anaemia was significantly
higher among children in households using biofuels than among children in
households using cleaner fuels (RRR 5 1.58; 95% CI: 1.28, 1.94), independent
of other factors. Prevalence of severe stunting was also significantly higher
among children in biofuel-using households (RRR 5 1.84; 95% CI: 1.44, 2.36).
Thirty-one per cent of moderate-to-severe anaemia and 37% of severe stunting
among children aged 6–35 months in India may be attributable to exposure to
biofuel smoke. Effects on mild anaemia and moderate stunting were smaller, but
positive and statistically significant. Effects of exposure to tobacco smoke on
anaemia and stunting were small and not significant.
Conclusions The study provides a first evidence of the strong association between biofuel use
and risks of anaemia and stunting in children, suggesting that exposure to
biofuel smoke may contribute to chronic nutritional deficiencies