The association of household particulate-bound metal concentrations and tuberculosis in women and children in Pune, India

OPS 35: Health effects of indoor air pollution in LMIC countries, Room 411, Floor 4, August 27, 2019, 1:30 PM - 3:00 PM Background/Aim: Particulate-based heavy metal exposure is a known risk factor for respiratory and other disease, however has yet to be associated with tuberculosis (TB). We assessed the association of metals in household particulate matter and TB in women and children in Pune, India. Methods: A case-control study was conducted among adult women and child index TB cases and healthy controls matched on geography, age, and sex. Household concentrations of particulate matter less than 2.5 microns (PM2.5) were collected at the primary cookstove for a period of 24 hours and analyzed for chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), molybdenum (Mo), cadmium (Cd), tin (Sn), antimony (Sb), and lead (Pb). Results: A total of 134 individuals in 74 matched pairs were included in this analysis (54 children and 80 adults). The median (IQR) concentration of PM2.5 was 161 (96, 272). Median metal concentrations ranged from 0.36 – 4.65 ng/m3 for Cr, Co, Ni, As, Mo, Cd, Sn, and Sb, from 14.43 – 15.35 ng/m3 for Mn and Cu, and from 49.16 – 128.47 ng/m3 for Pb, Zn, and Fe. Median concentration values were higher among TB cases as compared to controls for Cr, Co, As, Sn, Sb, and Pb, however these differences were not statistically significant. No significant difference between metal concentrations was seen for type of fuel use in the home. Mn, Fe, Ni, Cu, Zn, As, Cd, Sn, Sb, and Pb were all statistically significantly higher in the winter months as compared to non-winter months (p < 0.05). Conclusions: In this small matched case-control study we did not find any significant association between PM2.5-bound metal concentrations and TB or household fuels. Metal concentrations were significantly higher in winter months, which are associated with higher TB incidence.