TY  - JOUR
PY  - 2021//
TI  - Associations between exposure to landscape fire smoke and child mortality in low-income and middle-income countries: a matched case-control study
JO  - Lancet. Planetary health
A1  - Xue, Tao
A1  - Geng, Guannan
A1  - Li, Jiajianghui
A1  - Han, Yiqun
A1  - Guo, Qian
A1  - Kelly, Frank J.
A1  - Wooster, Martin J.
A1  - Wang, Huiyu
A1  - Jiangtulu, Bahabaike
A1  - Duan, Xiaoli
A1  - Wang, Bin
A1  - Zhu, Tong
SP  - e588
EP  - e598
VL  - 5
IS  - 9
N2  - BACKGROUND: The prevalence of landscape fires has increased, particularly in low-income and middle-income countries (LMICs). We aimed to assess the impact of exposure to landscape fire smoke (LFS) on the health of children. <br><br>METHODS: We conducted a sibling-matched case-control study and selected 552 155 children (aged <18 years) from Demographic and Health Surveys in 55 LMICs from 2000 to 2014. Each deceased child was matched with their sibling(s). The exposure indicators were fire-sourced PM(2·5) and dry-matter emissions. We associated these exposure indicators with child mortality using conditional regressions, and derived an exposure-response function using a non-linear model. Based on the association, we quantified the global burden of fire-attributable child deaths in LMICs from 2000 to 2014. <br><br>FINDINGS: Each 1 μg/m(3) increment of fire-sourced PM(2·5) was associated with a 2·31% (95% CI 1·50-3·13) increased risk of child mortality. The association was robust to different models. The exposure-response function was superlinear and suggested per-unit exposure to larger fires was more toxic. Based on our non-linear exposure-response function, we estimated that between 2000 and 2014, the five countries with the largest number of child deaths associated with fire-sourced PM(2·5) were Nigeria (164 000 [126 000 to 209 000] annual deaths), Democratic Republic of the Congo (126 000 [95% CI 114 000 to 139 000] annual deaths), India (65 900 [-22 200 to 147 000] annual deaths), Uganda (30 200 [24 500 to 36 300] annual deaths), and Indonesia (28 900 [19 100 to 38 400]). <br><br>INTERPRETATION: Exposure to landscape fire smoke contributes substantially to the global burden of child mortality. FUNDING: National Natural Science Foundation of China, Ministry of Science and Technology of China, Peking University, UK National Institute for Health Research Health Protection Research Unit, Leverhulme Center for Wildfires, Environment and Society, and National Environment Research Council National Capability funding to National Centre for Earth Observation and Energy Foundation.<p />  <p>Language: en</p>
LA  - en
SN  - 2542-5196
UR  - http://dx.doi.org/10.1016/S2542-5196(21)00153-4
ID  - ref1
ER  -