Solid fuel combustion exposure and respiratory health in children and adults in Europe, USA, Canada, Australia and New Zealand: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND/AIM: Epidemiological studies in low- and middle-income countries have shown a positive association between solid fuel (SF) burning exposure and adverse effects in children and adults. However, as the evidence is less clear in other countries, we investigated the associations between indoor and outdoor SF combustion (biomass and coal) and respiratory health in children and adults in studies conducted in Europe, North America, Australia, and New Zealand. METHODS: We performed 2 systematic reviews of epidemiological studies for children and adults. A meta-analysis was performed on the association between indoor wood burning exposure and respiratory outcomes in children only. Pooled relative risks (RRs) and 95% confidence intervals (CI) were calculated using random-effects models. RESULTS: We identified 74 articles conducted in children. The RR for indoor wood exposure was 0.90 (95%CI 0.77-1.05) for asthma, 1.11 (95%CI 0.88, 1.41) for lower respiratory infection and 1.11 (95%CI 0.85, 1.44) for upper respiratory infection. No association was found with wheeze and cough risk. Inconsistent and limited results were found considering other respiratory outcomes. Results from studies evaluating exposure to outdoor emissions derived from indoor SF combustion were limited. Among 34 articles identified in adults, positive associations were found between indoor SF combustion exposure and lung cancer and COPD risk, although based on limited studies. Inconsistent results were found considering other respiratory outcomes. Exposure to residential coal burning was associated with an increased risk of adverse respiratory effects. The introduction of measures to reduce SF use showed an improvement in air quality resulting in a reduction of adverse respiratory effects. CONCLUSIONS: Exposure to SF burning was associated with some adverse respiratory effects in children and adults. However, due to limited number of studies for each outcome and several limitations, additional and better studies in high-income countries are needed. KEYWORDS Epidemiology; Respiratory disease; Solid fuels; Systematic review.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".