Abstract
Objectives
Three billion people use biomass fuel for cooking and heating globally. We assessed the association between acute coronary syndromes (ACS) and use of biomass fuel for cooking.
Methods
We conducted a case–control study among women living in defined areas that were served by two tertiary care hospitals. A total of 364 women admitted to cardiac care units with ACS were compared with 727 controls, individually matched for age, who were inpatients at the same hospitals with a miscellany of diagnoses. Exposure to biomass fuel and other risk factors was ascertained through a questionnaire and assessed by conditional logistic regression.
Results
After adjustment, risk of ACS was elevated in women who had ever used biomass for cooking. In comparison with never users, the odds ratio for those who currently cooked with biomass was 4.8 (95% confidence interval 1.7, 13.8). However, among those who had ever used biomass, there was no decline in risk with time since last exposure.
Conclusions
The study found increased risk of ACS from use of biomass for cooking. However, full benefits from interventions may not accrue in short term.
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Acknowledgements
We thank Dr. Syeda Sana for her help in enabling data collection at the two participating hospitals, and Dr. Asif Aziz Sahito who interpreted ECGs. We are grateful also to Professor Keith Palmer and Professor M. Masood Kadir for their advice on various aspects of the study.
Funding
The funding agency had no role in design, conduct or interpretation of results of the study. This research was supported by a fellowship from the Colt Foundation for the conduct of a Ph.D. by Professor Zafar Fatmi. Dr. Ambreen Sahito was not supported by any grant. Professor David Coggon and Dr. Georgia Ntani were supported by funding from the UK Medical Research Council (MRC_MC_UU_12011/5).ax.
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Fatmi, Z., Sahito, A., Ntani, G. et al. Acute coronary syndrome and use of biomass fuel among women in rural Pakistan: a case–control study. Int J Public Health 65, 149–157 (2020). https://doi.org/10.1007/s00038-020-01339-w
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DOI: https://doi.org/10.1007/s00038-020-01339-w