, Volume 197, Issue 6, pp 793–801 | Cite as

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

  • Dennis Emuron
  • Trishul Siddharthan
  • Brooks Morgan
  • Suzanne L. Pollard
  • Matthew R. Grigsby
  • Dina Goodman
  • Muhammad Chowdhury
  • Adolfo Rubinstein
  • Vilma Irazola
  • Laura Gutierrez
  • J. Jaime Miranda
  • Antonio Bernabe-Ortiz
  • Dewan Alam
  • Bruce Kirenga
  • Rupert Jones
  • Frederik van Gemert
  • William CheckleyEmail author



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


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


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.


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).


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


Biomass fuel Tuberculosis burden Cross-sectional study 



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.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Dennis Emuron
    • 1
    • 2
  • Trishul Siddharthan
    • 1
    • 2
  • Brooks Morgan
    • 1
    • 2
  • Suzanne L. Pollard
    • 1
    • 2
  • Matthew R. Grigsby
    • 1
    • 2
  • Dina Goodman
    • 1
    • 2
  • Muhammad Chowdhury
    • 3
  • Adolfo Rubinstein
    • 4
  • Vilma Irazola
    • 4
  • Laura Gutierrez
    • 4
  • J. Jaime Miranda
    • 5
    • 6
  • Antonio Bernabe-Ortiz
    • 5
  • Dewan Alam
    • 7
  • Bruce Kirenga
    • 8
  • Rupert Jones
    • 9
  • Frederik van Gemert
    • 10
  • William Checkley
    • 1
    • 2
    Email author
  1. 1.Division of Pulmonary and Critical Care, School of MedicineJohns Hopkins UniversityBaltimoreUSA
  2. 2.Center for Global Non-Communicable Disease Research and Training, School of MedicineJohns Hopkins UniversityBaltimoreUSA
  3. 3.Initiative for Noncommunicable DiseasesHealth Systems and Population Studies Division, icddr,bDhakaBangladesh
  4. 4.Institute for Clinical Effectiveness and Health PolicyBuenos AiresArgentina
  5. 5.CRONICAS Centre of Excellence in Chronic DiseasesUniversidad Peruana Cayetano HerediaLimaPeru
  6. 6.Departamento de Medicina, Facultad de MedicinaUniversidad Peruana Cayetano HerediaLimaPeru
  7. 7.School of Kinesiology and Health Science, Faculty of HealthYork UniversityTorontoCanada
  8. 8.Makerere Lung InstituteMakerere UniversityKampalaUganda
  9. 9.Faculty of Health, Plymouth UniversityPlymouthUK
  10. 10.University of Groningen, University Medical Centre GroningenGroningenNetherlands

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