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

Context: Observational studies investigating household air pollution (HAP) exposure to biomass fuel smoke as a risk factor for pulmonary tuberculosis have reported inconsistent results. Objective: To evaluate the association between HAP exposure and the prevalence of self-reported previous pulmonary tuberculosis. Design: 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. Results: 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). Conclusions: There was no association between HAP exposure and self-reported previous pulmonary tuberculosis in five population-based studies conducted worldwide.