Epidemiological Profile of Tobacco Users at Tobacco Cessation Centre: An Indian Experience.

Objective. Tobacco consumption continues to rise in India with about 34.6% of adult population being tobacco users. This study was done to evaluate the epidemiological profile of the tobacco users presenting to a Tobacco Cessation Centre (TCC) in Delhi. Methods. This is a retrospective observational study of subjects seen over a period of 10 years (2001-2010) at TCC of Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India. Information from a structured questionnaire filled by all tobacco users was pooled and analysed. Results. Of a total of 4493 subjects seen in the TCC, 4370 (97.3%) were males. 2704 (60.2%) subjects were smokers and remaining were users of smokeless tobacco. The highest number of subjects attending the clinic was between the age of 31 to 40 years. The mean age of starting tobacco use was 21 years. 2518 subjects started tobacco use due to "peer group pressure", while family history of tobacco use was observed in 2912 subjects. 3065 number of subjects attending the clinic were without any co-morbidity. Conclusions. Most of the subjects started tobacco use at a young age between 11 to 20 years. Peer pressure was the most common reason for initiation (56%). Most of the subjects (68.2%) had no co-morbidity. The present study observed that tobacco users probably want to quit smoking not only because of the consequences of co-morbidities but also because of the realisation of later harmful effects of continuing smoking.

Indoor air pollution and asthma in children at Delhi, India.

INTRODUCTION: Several studies in developed countries have shown association between indoor air pollution and asthma in children. The present research was undertaken to study this association at Delhi, India. MATERIAL AND METHODS: This study took place at Delhi, capital of India. Eight locations based on the source of pollution such as industrial, residential and villages were included. Recording of the demographic profile and clinical examination of each child was conducted at their residence. Indoor SO2, NO2 and SPM (suspended particulate matter) levels were measured by using Handy Air Sampler (Low Volume Sampler). RESULTS: A total of 3104 children were examined of which 60.3% were male and 39.7% were female. 32.4% children were exposed to environmental tobacco smoke. 31.5 % children's families were using biomass fuels for cooking. History of respiratory symptoms included cough (43.9%), phlegm production (21.9%), shortness of breath (19.3%) and wheezing (14.0%). 7.9% children were diagnosed as having asthma, which was highest in industrial areas (11.8%), followed by residential (7.5%) and village areas (3.9%). The mean indoor SO2, NO2 and SPM levels were 4.28 ± 4.61 mg/m³, 26.70 ± 17.72 mg/m³ and 722.0 ± 457.6 mg/m³ respectively. Indoor SPM was the highest in industrial area followed by residential area and urban village area. Indoor SPM level was significantly (p < 0.001) higher in the asthmatic children's houses. CONCLUSION: This study suggests that industry plays an important role in increasing the concentration of indoor suspended particulate matter and occurrence of asthma in children in developing countries like India.

Impact of domestic air pollution from cooking fuel on respiratory allergies in children in India.

This study undertaken in India was aimed at identifying the effects of the indoor air pollutants SO2, NO2 and total suspended particulate mater (SPM) generated from fuel used for cooking on respiratory allergy in children in Delhi. A total of 3,456 children were examined (59.2% male and 40.8% female). Among these, 31.2% of the children's families were using biomass fuels for cooking and 68.8% were using liquefied petroleum gas. Levels of indoor SO2, NO2 and SPM, measured using a Handy Air Sampler (Low Volume Sampler), were 4.60 +/- 5.66 microg/m3, 30.70 +/- 23.95 microg/m3 and 705 +/- 441.6 microg/m3, respectively. The mean level of indoor SO2 was significantly higher (p = 0.016) for families using biomass fuels (coal, wood, cow dung cakes and kerosene) for cooking as compared to families using LP gas. The mean level of indoor NO2 for families using biomass fuels for cooking was significantly higher in I.T.O. (p = 0.003) and Janakpuri (p = 0.007), while indoor SPM was significantly higher in Ashok Vihar (p = 0.039) and I.T.O. (p = 0.001), when compared to families using LP gas. Diagnoses of asthma, rhinitis and upper respiratory tract infection (URTI) were made in 7.7%, 26.1% and 22.1% of children, respectively. Respiratory allergies in children, which included asthma, rhinitis and URTI, could be associated with both types of fuels (liquefied petroleum gas [LPG] and biomass) used for cooking in the different study areas. This study suggests that biomass fuels increased the concentrations of indoor air pollutants that cause asthma, rhinitis and URTI in children. LP gas smoke was also associated with respiratory allergy.

Indoor air pollution and respiratory function of children in Ashok Vihar, Delhi: an exposure-response study.

The objective of this study was to investigate the effects of indoor air pollution on respiratory function of children (aged 7-15 years). The study took place at Ashok Vihar, an urban locality in the northwest part of Delhi during the summer months of June and July 2004. The team did house visits. The questionnaire, administered at the house itself, asked about the history of smoking in the family, type of cooking fuel used, duration of cooking, ventilation and lighting at the cooking place, and other confounders. In total, 441 children (59% male, 41% female) between ages 7 and 15 years were considered for the study, and a detailed profile was collected. Clinical examination with special reference to respiratory system was done. Pulmonary function tests/peak expiratory flow rates of each child were measured. Indoor air pollutant (suspended particulate matter, SO(2), NO(2)) was measured, and the effect of these pollutants on the children's respiratory function was analyzed. The respiratory health profile suggests that children had cough, sputum production, shortness of breath, wheezing, common cold, and throat congestion. Indoor SO(2) , NO(2), and suspended particulate matter levels were high in houses where there was a family history of smoking. SO(2) level was significantly high according to occupancy per room. NO(2) and suspended particulate matter levels were significantly high in houses where children had respiratory problems. It is concluded that indoor air pollution had an association with respiratory function of children.

Association of indoor and outdoor air pollutant level with respiratory problems among children in an industrial area of Delhi, India.

The authors conducted this prospective study at the Shahdara industrial area of Delhi, India. They examined the effects of indoor and outdoor air pollutant levels on respiratory health in 394 children aged 7 to 15 years. The majority of children had a history of respiratory problems, including cough (62.7%), sputum production (24.4%), shortness of breath (32.0%), wheezing (25.6%), common cold (44.4%), and throat congestion (43.1%). The association of indoor and outdoor air pollutant levels showed that outdoor SO2 and NO2 was significantly higher than indoor SO2 and NO2 levels, whereas the mean indoor level of suspended particulate matter (SPM) was significantly higher than outdoor SPM level. Indoor SPM level also was significantly higher in homes of children with a history of respiratory illness than homes of children having no history of respiratory illness. Results suggest that both indoor and outdoor particulate exposure may be important risk factors in the development of respiratory illness in children.