Increased risk of allergy associated with the use of kerosene fuel in the home

Allergic diseases are becoming increasingly prevalent in developing countries, consistent with an environmental etiology associated with affluence or urbanization. We have tested the hypothesis that the risk of allergy is increased by the use of non-biomass fuels (kerosene, gas or electricity) in the home, using data from a survey of the urban population of Iimma, Ethiopia. Questionnaire data on allergic symptoms, domestic fuel use and lifestyle factors were collected from 9844 adults and children, and allergen skin sensitization measured in a subsample of 2372. Use of any non-biomass fuel was reported by 959 individuals (10%), usually in combination with biomass fuel, and was significantly associated with an increased risk of allergic sensitization (age, sex and socioeconomic status adjusted odds ratio (95% confidence interval) = 1.78 [1.06 to 2.97]) and wheeze (1.56 [1.07 to 2.26]), rhinitis (2.06 [1.46 to 2.91]) and eczema (2.82 [1.61 to 4.96]) relative to use of biomass fuel only. These effects were predominantly due to kerosene, which was significantly related. to all outcomes, and gas, which was strongly related to allergic sensitization. Our findings suggest that domestic combustion of refined fossil fuels increases the risk of allergic sensitization and symptoms, and may have contributed to the increasing prevalence of allergic disease.