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Lack of an Association Between Household Air Pollution Exposure and Previous Pulmonary Tuberculosis

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Abstract

Context

Observational studies investigating household air pollution (HAP) exposure to biomass fuel smoke as a risk factor for pulmonary tuberculosis have reported inconsistent results.

Objective

To evaluate the association between HAP exposure and the prevalence of self-reported previous pulmonary tuberculosis.

Design

We analyzed pooled data including 12,592 individuals from five population-based studies conducted in Latin America, East Africa, and Southeast Asia from 2010 to 2015. We used multivariable logistic regression to model the association between HAP exposure and self-reported previous pulmonary tuberculosis adjusted for age, sex, tobacco smoking, body mass index, secondary education, site and country of residence.

Results

Mean age was 54.6 years (range of mean age across settings 43.8–59.6 years) and 48.6% were women (range of % women 38.3–54.5%). The proportion of participants reporting HAP exposure was 38.8% (range in % HAP exposure 0.48–99.4%). Prevalence of previous pulmonary tuberculosis was 2.7% (range of prevalence 0.6–6.9%). While participants with previous pulmonary tuberculosis had a lower pre-bronchodilator FEV1 (mean − 0.7 SDs, 95% CI − 0.92 to − 0.57), FVC (− 0.52 SDs, 95% CI − 0.69 to − 0.33) and FEV1/FVC (− 0.59 SDs, 95% CI − 0.76 to − 0.43) as compared to those who did not, we did not find an association between HAP exposure and previous pulmonary tuberculosis (adjusted odds ratio = 0.86; 95% CI 0.56–1.32).

Conclusions

There was no association between HAP exposure and self-reported previous pulmonary tuberculosis in five population-based studies conducted worldwide.

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Acknowledgements

We would like to thank Dr. Shakir Hossen for his independent review of the statistics and development of figures. These studies were sponsored and funded by the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institute of Health in the United States, under contracts HHSN268200900029C, HHSN268200900032C, and HHSN26820900033C. FRESH AIR Uganda was done by the University Medical Centre Groningen (Netherlands) in close collaboration with Makerere University (Uganda) and the Leiden University Medical Centre (Netherlands). It was funded by the International Primary Care Respiratory Group (UK), supported by an unrestricted grant from Mundipharma International. WC is additionally supported under UM1HL134590. TS was supported by a National Research Service Award through the National Institute of Environmental Health Sciences of the National Institutes of Health (1F32ES028577). AR was supported by the National Institutes of Health Office of the Director, Fogarty International Centre and National Heart, Blood, and Lung Institute through the International Clinical Research Fellows Program at Vanderbilt University (R24TW007988) and the American Relief and Recovery Act. RJ was supported by the Applied Research Collaboration South West Peninsula.

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Authors and Affiliations

  1. Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA

    Dennis Emuron, Trishul Siddharthan, Brooks Morgan, Suzanne L. Pollard, Matthew R. Grigsby, Dina Goodman & William Checkley

  2. Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, USA

    Dennis Emuron, Trishul Siddharthan, Brooks Morgan, Suzanne L. Pollard, Matthew R. Grigsby, Dina Goodman & William Checkley

  3. Initiative for Noncommunicable Diseases, Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh

    Muhammad Chowdhury

  4. Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina

    Adolfo Rubinstein, Vilma Irazola & Laura Gutierrez

  5. CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru

    J. Jaime Miranda & Antonio Bernabe-Ortiz

  6. Departamento de Medicina, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru

    J. Jaime Miranda

  7. School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada

    Dewan Alam

  8. Makerere Lung Institute, Makerere University, Kampala, Uganda

    Bruce Kirenga

  9. Faculty of Health, Plymouth University, Plymouth, UK

    Rupert Jones

  10. University of Groningen, University Medical Centre Groningen, Groningen, Netherlands

    Frederik van Gemert

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  1. Dennis Emuron
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Correspondence to William Checkley.

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Emuron, D., Siddharthan, T., Morgan, B. et al. Lack of an Association Between Household Air Pollution Exposure and Previous Pulmonary Tuberculosis. Lung 197, 793–801 (2019). https://doi.org/10.1007/s00408-019-00275-8

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  • DOI: https://doi.org/10.1007/s00408-019-00275-8

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