Effects of cooking smoke on prevalence of tuberculosis in India by Vinod Mishra, Robert D. Retherford, and Kirk R. Smith. East-West Center Working Papers, Population and Health Series, No. 92. October 1997. 28 pp.

Abstract

The effects of indoor air pollution on the risk of tuberculosis have not been studied previously. This study examines the effects of cooking smoke from biomass fuels on the prevalence of tuberculosis among persons age 30 years and older in India. The analysis is based on 173,520 persons age 30 and over covered in India's 1992-93 National Family Health Survey (NFHS). Logistic regression was used to estimate the effects of cooking smoke from biomass fuels (wood or dung) on the prevalence of active tuberculosis after controlling for a number of potentially confounding variables.

Persons living in households that primarily use biomass for cooking fuel have a considerably higher prevalence of active tuberculosis than persons living in households that use cleaner fuels (OR 3.81; 95% CI 2.95-4.93). This effect is reduced somewhat when availability of a separate kitchen, house type, indoor crowding, age, gender, urban/rural residence, education, religion, caste/tribe, and geographic region are statistically controlled (OR 2.75; 95% CI 2.07-3.67). Cooking smoke also has a large effect when the analysis is done separately for men (OR 2.59; 95% CI 1.84-3.64) and for women (OR 3.06; 95% CI 2.00-4.67) and separately for urban areas (OR 2.47; 95% CI 1.70-3.58) and for rural areas (OR 2.76; 95% CI 1.79-4.26).

This analysis indicates that, among persons age 30 years and older, 53 percent of the prevalence of active tuberculosis is attributable to cooking smoke. These results strongly suggest that the use of biomass fuels for cooking substantially increases the risk of tuberculosis in India.