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a Care of the Elderly,
Division of Medicine, Bristol University, b NHS R&D Support Unit, Frenchay
Healthcare Trust, c MRC
Environmental Epidemiology Unit, University of Southampton, d University
Medicine, University of Southampton
Correspondence to: Dr L Dow, Care of the Elderly, Frenchay Hospital, Bristol BS16 1LE, UK
Received 8 March 1999; Returned to authors 15 April 1999; Revised version received 16 June 1999; Accepted for publication 28 June 1999
BACKGROUND
Studies in
children and young women have indicated an increased risk of
respiratory illness in association with the use of domestic gas
appliances, possibly caused by oxides of nitrogen generated when gas is
burned. It is not known whether risks are similarly increased in older subjects.
METHODS
A
questionnaire about respiratory symptoms in the past year and potential
risk factors for respiratory disease was mailed to 6000 men and women
aged 65 years and older who were selected at random from the lists of
general practices in North Bristol, UK. Associations between symptoms
and the use of gas appliances were examined by logistic regression with
adjustment for age, sex, social class, and smoking habits.
RESULTS
Questionnaires
were completed by 4792 (80%) of those mailed. The most common symptoms
were exercise induced breathlessness, wheeze, or chest tightness
(51%); wheeze (27%); morning phlegm (20%); and daytime
breathlessness at rest (19%). In an analysis that included all
subjects only weak associations were found with use of gas appliances,
odds ratios all being 1.2 or less. The risks associated with use of a
gas hob tended to be higher in women, with odds ratios of 1.36 (95% CI
1.01 to 1.83) for wheeze and 1.33 (95% CI 0.56 to 3.17) for morning
chest tightness, but were lower than had been reported previously in
younger women.
CONCLUSION
The absence
of stronger associations cannot readily be explained by bias or
confounding. Gas cookers and fires are unlikely to be an important
cause of respiratory illness in the elderly. If they do cause such
illness, the largest risks are likely to be in women who use gas hobs.
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