Background

Poor housing conditions, such as poor building materials and weak structures as well as high levels of indoor air pollution, are important risk factors for a broad range of diseases, including acute respiratory infections (ARI). In mining areas, research on the determinants of respiratory health predominantly focuses on exposures to outdoor air pollutants deriving from mining operations. However, mining projects also influence the socioeconomic status of households, which, in turn, affect housing quality and individual behaviors and, thus, housing quality and levels of indoor air pollution. In this study, we aimed to determine how proximity to an industrial mining project impacts housing quality, sources of indoor air pollution, and prevalence of ARI.

Methods

We merged data from 131 Demographic and Health Surveys (DHS) with georeferenced data on mining projects in sub-Saharan Africa (SSA) to determine associations between housing quality, indoor air pollution sources, and child respiratory health. Spatial differences in selected indicators were explored using descriptive cross-sectional analyses. Furthermore, we applied a quasi-experimental difference-in-differences (DiD) approach using generalized linear mixed-effects models to compare temporal changes in household and child health indicators at different operational phases of mining projects and as a function of distance to mines.

Results

For cross-sectional analyses, data of 183,466 households and 141,384 children from 27 countries in SSA were used, while 41,648 households and 34,406 children from 23 SSA countries were included in the DiD analyses. The increase in the share of houses being built from finished building materials after mine opening was more than 4-fold higher (odds ratio (OR): 4.32, 95% confidence interval (CI): 2.98–6.24) in close proximity to mining sites (i.e., ≤ 10 km) compared to areas further away (i.e., 10–50 km). However, these benefits were not equally distributed across socioeconomic strata, with considerably weaker effects observed among poorer households. Increases in indoor tobacco smoking rates in close proximity to operating mines were twice as high as in comparison areas (OR: 2.06, 95% CI: 1.15–3.68). The cross-sectional analyses revealed that traditional cooking fuels (e.g., charcoal, dung, and wood) were less frequently used (OR: 0.27, 95% CI: 0.23–0.31) in areas located in close proximity to mines than in comparison areas. Overall, no statistically significant association between mining operations and the prevalence of symptoms related to ARI in children under the age of 5 years was observed (OR: 0.78, 95% CI: 0.29–2.07).

Conclusions

Mines impact known risk factors for ARI through diverse pathways. The absence of significant changes in ARI symptoms among children is likely the result of counteracting effects between improvements in housing infrastructure and increased exposures to air pollutants from outdoor sources and tobacco smoking. For mining projects to unfold their full potential for community development, we recommend that impact assessments move beyond the mere appraisal of mining-related pollution emissions and try to include a more comprehensive set of pathways through which mines can affect ARI in exposed communities.

中文翻译：

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采矿社区儿童的住房条件和呼吸健康：撒哈拉以南非洲27个国家的数据分析

背景

恶劣的住房条件，例如不良的建筑材料和薄弱的结构，以及高水平的室内空气污染，是导致包括急性呼吸道感染（ARI）在内的多种疾病的重要危险因素。在矿区，有关呼吸健康决定因素的研究主要集中在暴露于采矿作业产生的室外空气污染物中。但是，采矿项目也会影响家庭的社会经济状况，进而影响住房质量和个人行为，进而影响住房质量和室内空气污染水平。在这项研究中，我们旨在确定离工业采矿项目的距离如何影响住房质量，室内空气污染源以及ARI的患病率。

方法

我们将131个人口与健康调查（DHS）的数据与有关撒哈拉以南非洲（SSA）采矿项目的地理参考数据进行了合并，以确定住房质量，室内空气污染源和儿童呼吸健康之间的关联。使用描述性横截面分析探索选定指标的空间差异。此外，我们使用准线性实验的差异化方法（DiD），使用广义线性混合效应模型来比较采矿项目不同运营阶段的家庭和儿童健康指标随时间的变化以及距离矿山距离的函数。

结果

对于横断面分析，使用了来自SSA的27个国家的183,466户家庭和141,384个孩子的数据，而DiD分析中包括了来自23个SSA的41,648户家庭和34,406个孩子的数据。靠近矿区的矿山建成后，用完工的建筑材料建造房屋的比例增加了4倍以上（赔率（OR）：4.32，95％置信区间（CI）：2.98–6.24） （即，≤10 km）与更远的区域（即，10–50 km）相比。但是，这些收益在社会经济各阶层之间分布不均，在较贫穷的家庭中观察到的影响要弱得多。靠近运营矿场的室内吸烟率的增加是比较区域的两倍（OR：2.06，95％CI：1.15-3.68）。横截面分析表明，与比较区相比，在靠近矿井的地区，传统烹调燃料（例如木炭，粪便和木材）的使用频率较低（OR：0.27，95％CI：0.23-0.31）。总体而言，未观察到5岁以下儿童的采矿活动与ARI相关症状的患病率之间有统计学意义的关联（OR：0.78，95％CI：0.29–2.07）。

结论

地雷通过多种途径影响ARI的已知危险因素。儿童ARI症状没有明显变化可能是抵消住房基础设施与增加室外空气污染和吸烟对空气污染物的暴露之间的影响的结果。为使采矿项目发挥其社区发展的全部潜力，我们建议影响评估不仅要评估与采矿相关的污染排放，还应尝试包括一套更全面的途径，使矿山可以通过这些途径来影响裸露社区的ARI。