Associations between exposure to landscape fire smoke and child mortality in low-income and middle-income countries: a matched case-control study
Tao Xue, Guannan Geng, Jiajianghui Li, Yiqun Han, Qian Guo, Frank J. Kelly, Martin J. Wooster, Huiyu Wang, Bahabaike Jiangtulu, Xiaoli Duan, Bin Wang, Tong Zhu
Abstract
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. METHODS: 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. FINDINGS: 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]). 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.