Investigation of Ocular Disease and Household Fuel Use in Kaski District, Nepal

尼泊尔卡斯基地区眼部疾病和家庭燃料使用情况调查

• 批准号: 9146347
• 负责人: MICHAEL N BATES
• 金额: $ 47.8万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-30 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9146347
• 关键词: Affect; Age; Age related macular degeneration; Air Pollution; Animals; Biomass; Blindness; Burn injury; Carbon Monoxide; Cardiovascular Diseases; Case-Control Studies; Cataract; Charcoal; Child; Chronic; Chronic Obstructive Airway Disease; Coal; Confidence Intervals; Cornea; Cost-Benefit Analysis; Cross-Sectional Studies; Crystalline Lens; Data; Data Collection; Developing Countries; Diagnosis; Disease; Ensure; Epidemiologic Studies; Exposure to; Eye; Eye diseases; Female; Fire - disasters; Formaldehyde; Funding; Health; Health Policy; Heating; High Prevalence; Hospitals; Household; Household Air Pollution; Infection; International Agencies; Intervention; Investigation; Keratoconjunctivitis Sicca; Kerosene; Life; Lighting; Link; Liquid substance; Macular degeneration; Malignant neoplasm of lung; Monitor; Naphthalene; National Institute of Environmental Health Sciences; Nepal; Odds Ratio; Ophthalmic examination and evaluation; Outcome Measure; Pain; Particulate Matter; Pneumonia; Policies; Public Health; Reactive Oxygen Species; Recording of previous events; Research Infrastructure; Research Personnel; Rest; Risk Factors; Source; Statistical Data Interpretation; Surgeon; Teaching Hospitals; Testing; Tissues; Tobacco smoking; Trachoma; Training; United States National Institutes of Health; Visual impairment; Visually Impaired Persons; Woman; Wood material; World Health Organization; aged; ambient air pollution; base; biomass fuel; blind; cigarette smoking; clay; combustion product; cooking; eye dryness; high risk; lens; ocular pain; policy implication; pollutant; solid fuel

 DESCRIPTION (provided by applicant): Solid fuels (coal and biomass) are used for cooking and heating by approximately 3 billion people worldwide-- almost all in the developing world. Kerosene is also widely used for cooking and lighting. These fuels emit into the kitchen high concentrations of pollutants, including particulate matter, carbon monoxide and other organic compounds known to affect the eye, such as formaldehyde and naphthalene. Usually, women doing the cooking are the most exposed. There is evidence linking solid fuels to a wide range of health effects, but the impact on eye diseases has not been extensively investigated. Virtually no studies have investigated kerosene use and eye disease. In every part of the world, females are at higher risk of eye disease at all ages. About 90% of visually impaired and blind people lived in developing countries. These two closely related ocular disease studies, which focus on cataract of the lens and age-related macular degeneration (AMD), the first and third most common causes of blindness in the world, and dry eye disease, a major cause of pain and discomfort, take advantage of the established infrastructure, including offices, vehicles and trained field staff, and prior data collection-household cooking, heating and lighting appliance use, and air pollution monitoring data--of an earlier NIH-funded epidemiologic study of TB and indoor fuel use, in Pokhara, Nepal. The ocular disease studies are a cross-sectional study investigating cataract and dry eye disease, and a case-control study investigating AMD. In the cross-sectional study, women, aged 40-70 years, from TB study households, chosen on the basis of their cooking, heating and lighting appliance use, will be transported to the Manipal Teaching Hospital in Pokhara, where they will receive a free and comprehensive eye examination. Slit-lamp photos of the crystalline lens will be taken and tests done for dry eye disease. Separately, a case-control study of AMD diagnosed in women attending the hospital will be carried out. Statistical analysis in both studies will focus on examining associations between household fuel uses, for cooking, heating and lighting, and the ocular outcome measures. Together, these will comprise the most comprehensive investigation ever of these potentially causal relationships. Results will have implications for policy and for health interventions. In particular, if evidence is produced that kerosene is a risk factor for eye diseas, then this will strengthen arguments for not treating kerosene as a clean fuel alternative to biomass, as is currently the policy of some international agencies, including WHO. The studies will provide data for reworking cost-benefit analyses of replacing biomass stoves and fuel-based lighting sources with alternatives, such as LPG stoves or electric lighting.

 描述（由适用提供）：全球约有30亿人使用固体燃料（煤炭和生物量），几乎所有人都在发展中国家。煤油也广泛用于烹饪和照明。这些燃料会散发到厨房中的高浓度污染物，包括颗粒物，一氧化碳和其他已知会影响眼睛的有机化合物，例如甲醛和萘。通常，做烹饪的妇女是最暴露的。有证据将固体燃料与广泛的健康影响联系起来，但对眼病的影响尚未得到广泛的研究。几乎没有研究研究煤油使用和眼科疾病。在世界各地，女性在所有年龄段的眼睛疾病风险都更高。大约90％的视力障碍和盲人生活在发展中国家。这两项密切相关的眼部疾病研究，重点是镜头和年龄相关的黄斑变性（AMD），这是世界上第一个和第三大常见的失明原因，以及干眼症，是疼痛和不适的主要原因，利用了既定的基础设施，包括既定的基础设施，包括办公室，车辆和培训式培养机，以及供应型供应型供应型供应型供应，以及供应型供应型供应，并供应供应型供应型暖气，并置于供应型供应室，供应医院，供应医院，供您供应，并置于供应厂，供应医院，供应型供应厂，并置于供应式暖气，并获得了供应型暖气，并置于了供应式暖气，并利用NIH资助的TB和室内燃料使用的流行病学研究，位于尼泊尔Pokhara。眼科疾病研究是一项研究白内障和干眼症的横断面研究，以及一项研究AMD的病例对照研究。在横截面研究中，根据TB研究家庭的40至70岁妇女，根据烹饪，供暖和照明设备的使用选择，将被运送到Pokhara的Manipal教学医院，在那里她们将接受免费且全面的眼睛检查。将拍摄晶体镜头的狭缝灯光照片，并为干眼病进行测试。另外，将对在医院诊断出的AMD进行的病例对照研究将进行。两项研究中的统计分析都将侧重于研究家庭燃料使用，烹饪，供暖和照明以及眼睛结果指标之间的关联。共同完成了这些潜在因果关系有史以来最全面的调查。结果将对政策和健康干预措施产生影响。特别是，如果有证据表明煤油是眼部疾病的危险因素，那么这将加强没有将煤油视为生物量的清洁燃料替代品的争论，就像目前某些国际机构（包括谁）的政策一样。这些研究将提供用于重新加工成本效益分析的数据，该分析以替代诸如LPG炉灶或电动照明等替代的替代生物质炉灶和基于燃料的照明源。