1
|
Pan H, Jarvis D, Potts J, Casas L, Nowak D, Heinrich J, Aymerich JG, Urrutia I, Martinez-Moratalla J, Gullón JA, Pereira-Vega A, Raherison C, Chanoine S, Demoly P, Leynaert B, Gislason T, Probst N, Abramson MJ, Jõgi R, Norbäck D, Sigsgaard T, Olivieri M, Svanes C, Fuertes E. Gas cooking indoors and respiratory symptoms in the ECRHS cohort. Int J Hyg Environ Health 2024; 256:114310. [PMID: 38183794 DOI: 10.1016/j.ijheh.2023.114310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Gas cooking is an important source of indoor air pollutants, and there is some limited evidence that it might adversely be associated with respiratory health. Using repeated cross-sectional data from the multi-centre international European Community Respiratory Health Survey, we assessed whether adults using gas cookers have increased risk of respiratory symptoms compared to those using electric cookers and tested whether there was effect modification by a priori selected factors. METHODS Data on respiratory symptoms and gas cooking were collected from participants at 26-55 and 38-67 years (median time between examinations 11.4 years) from interviewer-led questionnaires. Repeated associations between gas cooking (versus electric) and respiratory symptoms were estimated using multivariable mixed-effects logistic regression models adjusted for age, sex, study arm, smoking status, education level, and included random intercepts for participants within study centres. Analyses were repeated using a 3-level variable for type of cooker and gas source. Effect modification by ventilation habits, cooking duration, sex, age atopy, asthma, and study arm were examined. RESULTS The sample included 4337 adults (43.7% males) from 19 centres in 9 countries. Gas cooking increased the risk of "shortness of breath whilst at rest" (OR = 1.38; 95%CI: 1.06-1.79) and "wheeze with breathlessness" (1.32; 1.00-1.74). For several other symptoms, effect estimates were larger in those who used both gas hobs and ovens, had a bottled gas source and cooked for over 60 min per day. Stratifying results by sex and age found stronger associations in females and younger adults. CONCLUSION This multi-centre international study, using repeat data, suggested using gas cookers in the home was more strongly associated than electric cookers with certain respiratory symptoms in adults. As gas cooking is common, these results may play an important role in population respiratory health.
Collapse
Affiliation(s)
- Holly Pan
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Debbie Jarvis
- National Heart and Lung Institute, Imperial College London, London, UK; MRC Centre for Environment & Health, London, UK
| | - James Potts
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Lidia Casas
- Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Germany
| | - Judith Garcia Aymerich
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Isabel Urrutia
- Respiratory Department, Galdakao Hospital, OSI Barrualde-Galdakao, Biscay, Spain
| | - Jesus Martinez-Moratalla
- Servicio de Neumología del Complejo Hospitalario Universitario de Albacete. (CHUA) Albacete, Spain; Servicio de Salud de Castilla - La Mancha (SESCAM), Spain; Facultad de Medicina de Albacete. Universidad de Castilla - La Mancha, Albacete, Spain
| | | | | | | | | | - Pascal Demoly
- University Hospital of Montpellier, IDESP, Univ Montpellier - Inserm, Montpellier, France
| | - Bénédicte Leynaert
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Center for Epidemiology and Population Health (CESP), Integrative Respiratory Epidemiology Team, 94807, Villejuif, France; Landspitali University Hospital, Department of Sleep, Reykjavik Iceland
| | - Thorarinn Gislason
- University of Iceland, Medical Faculty, Reykjavik, Iceland; Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Dan Norbäck
- Occupational and Environmental Medicine, Department of Medical Science, University Hospital, Uppsala University, 75237, Uppsala, Sweden
| | - Torben Sigsgaard
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Mario Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, Policlinico "G. Rossi", Verona, Italy; Center for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Elaine Fuertes
- National Heart and Lung Institute, Imperial College London, London, UK; MRC Centre for Environment & Health, London, UK.
| |
Collapse
|
2
|
Leynaert B, Bousquet J, Henry C, Liard R, Neukirch F. Is bronchial hyperresponsiveness more frequent in women than in men? A population-based study. Am J Respir Crit Care Med 1997; 156:1413-20. [PMID: 9372654 DOI: 10.1164/ajrccm.156.5.9701060] [Citation(s) in RCA: 147] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
To test the hypothesis that a greater proportion of women than men react to methacholine challenge and investigate the possible reasons for any differences observed, we recruited 495 subjects 20 to 44 yr of age (50.9% male) in Paris and 304 subjects (51.3% male) in Montpellier (France), as part of the European Community Respiratory Health Survey. The proportion of responders (PD20 < or = 4 mg methacholine) was 33.7% in women and 11.9% in men (odds ratio = 3.8; 95% confidence interval = 2.4-6.0) in Paris and 43.2% in women and 29.5% in men (odds ratio = 1.8; 95% confidence interval = 1.1-2.9) in Montpellier. These differences could not be explained by asthma, respiratory symptoms, atopy, or lung function parameters. In stepwise logistic regressions including sex, asthma, and asthma-like symptoms, nasal allergies, atopy, baseline FEV1, FEV1%pred, FVC, and FEV1%FVC, the odds-ratios for the effect of female sex on PD20 < or = 4 mg methacholine were 5.2 (3.0-9.0) in Paris and 2.2 (1.2-3.8) in Montpellier. Reacting to low doses of methacholine (PD20 < or = 0.5 mg) was associated with asthma and atopy in both men and women. In contrast, reacting to doses between 0.5 and 4 mg was associated with asthma and atopy only in men and with heavy tobacco consumption only in women. We conclude that the excess of hyperresponsiveness in women is not due to their having smaller lung size or airway caliber than men and may be related to a greater susceptibility to smoking.
Collapse
|