Objective: To examine whether indoor coal combustion for heating, which releases pollutants into the air, affects early childhood growth. Design:Aprospective longitudinal study,withgrowthmeasurements extracted frommedical records of the children's well-child care visits at age 36 months.Data were compiled fromself-administered questionnairesandmedical records, both completed at 2 time points: delivery and follow-up. Setting: Teplice and Prachatice districts in the Czech Republic. Participants: A total of 1133 children followed from birth to age 36 months. Main Exposure: Maternally reported use of coal for heating. Main Outcome Measure: The z score for height for age and sex at age 36 months. Results: Adjusted for covariates, indoor coal use was significantly associated with a lower z score for height for age and sex at age 36 months (z score=-0.37; 95% confidence interval, -0.60 to -0.14). This finding translates into a reduction in height of about 1.34 cm (95% confidence interval, 0.51 to 2.16) for boys and 1.30 cm (95% confidence interval, 0.50 to 2.10) for girls raised in homes that used coal. The association between coal use and height was modified by postnatal cigarette smoke exposure. Conclusions: Pollution from indoor coal use may impair early childhood skeletal growth to age 36 months. Because a significant proportion of the world population still uses coal indoors, the finding has public health consequences.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health