IJE Advance Access originally published online on April 22, 2004
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
International Journal of Epidemiology, Volume 33, Number 3, pp. 573-578
IJE vol.33 no.3 © International Epidemiological Association 2004; all rights reserved.
Environmental Epidemiology |
Household wood and charcoal smoke increases risk of otitis media in childhood in Maputo
1 Department of Community Health, Faculdade de Medicina UEM, Maputo, Mozambique
2 Laboratori de Bioestadística i d'Epidemiologia, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain
3 ENT-CHM, Faculdade de Medicina UEM, Maputo, Mozambique
4 Grups de Recerca d'Amèrica i d‘Àfrica Llatines (GRAAL)
Correspondence: Dr Miguel Martín, Laboratori de Bioestadística i d'Epidemiologia, Facultat de Medicina. Edifici M. Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès (Barcelona), Spain. E-mail: gaton2001{at}yahoo.es/Miquel.Martin{at}uab.es
Background This study examined the association of otitis media in children <6 years old and the exposure to wood and charcoal smoke, as well as to other risk factors, in Maputo.
Methods Case-control study. In all 750 children matched by sex and age were enrolled in a hospital-community study. Cases were gathered from among children visiting the Central Hospital of Maputo with otitis media and controls were recruited in the same village as the cases. Conditional logistic regression was performed to evaluate, simultaneously, the effect of each risk factor.
Results Cases were more likely to have been exposed to tobacco smoke (OR = 1.51), to wood (OR = 1.85) and charcoal (OR = 1.50) household smoke, to short term breastfeeding (OR = 1.47), and to live in overcrowded conditions (OR = 1.49). Multivariate analysis stratified by age groups (younger and older than 2 years) showed that cases were more likely to be exposed to wood and charcoal smoke than controls, regardless of age. Among children aged >2 years, Eustachian tube dysfunction was evident (OR = 3.06) particularly in those living in less overcrowded conditions.
Conclusions Findings of this study are consistent with earlier studies that have reported an association between parental smoking, short duration of breastfeeding, and Eustachian tube dysfunction. The association with wood and charcoal smoke indicates that there is a need to educate people regarding the avoidance of exposing their children to this environmental hazard.
Keywords Otitis media, Eustachian tube, wood smoke pollution, tobacco smoke pollution, overcrowding, breastfeeding, case-control studies
Accepted 13 November 2003