Open Access Research article

Atopic dermatitis and indoor use of energy sources in cooking and heating appliances

Ana M Vicedo-Cabrera1*, Luís García-Marcos2, Agustín Llopis-González13, Ángel López-Silvarrey-Varela4, Izaskun Miner-Canflanca5, José Batlles-Garrido6, Alfredo Blanco-Quiros7, Rosa María Busquets-Monge8, Carlos Díaz-Vazquez9, Carlos González-Díaz10, Antonio Martínez-Gimeno11, Francisco Guillén-Grima12, Alberto Arnedo-Pena13 and María Morales-Suárez-Varela1143

Author affiliations

1 Unit of Public Health, Hygiene and Environmental care, Department of Preventive Medicine, University of Valencia, Valencia, Spain

2 Pulmology and Allergy Units, Virgen de la Arrixaca Children’s University Hospital, Murcia, Spain

3 CIBER - Epidemiology and Public Health, Madrid, Spain

4 Foundation María José Jove, A Coruña, Madrid, Spain

5 Department of Paediatrics, Donostia Hospital, San Sebastián, Spain

6 Department of Paediatrics, Torrecárdenas Hospital, Almería, Spain

7 Department of Paediatrics, University of Valladolid, Valladolid, Spain

8 Department of Paediatrics, del Mar Hospital, Barcelona, Spain

9 Health Centre of Moreda, Health Service of Principado de Asturias, Madrid, Spain

10 Department of Paediatrics, Basurto Hospital, Bilbao, Spain

11 Department of Paediatric Pneumo-Allergy, 12 de Octubre Children’s Hospital, Madrid, Spain

12 Section of Epidemiology, Centre of Public Health, Regional Ministry of Health, Castellón, Castellón, Spain

13 Department of Health Sciences, Public University of Navarre, Navarre, Spain

14 Centre for Public Health Research (CSISP), Valencia, Spain

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Citation and License

BMC Public Health 2012, 12:890  doi:10.1186/1471-2458-12-890

Published: 22 October 2012



Atopic dermatitis (AD) prevalence has considerably increased worldwide in recent years. Studying indoor environments is particularly relevant, especially in industrialised countries where many people spend 80% of their time at home, particularly children. This study is aimed to identify the potential association between AD and the energy source (biomass, gas and electricity) used for cooking and domestic heating in a Spanish schoolchildren population.


As part of the ISAAC (International Study of Asthma and Allergies in Childhood) phase III study, a cross-sectional population-based survey was conducted with 21,355 6-to-7-year-old children from 8 Spanish ISAAC centres. AD prevalence, environmental risk factors and the use of domestic heating/cooking devices were assessed using the validated ISAAC questionnaire. Crude and adjusted odds ratios (cOR, aOR) and 95% confidence intervals (CIs) were obtained. A logistic regression analysis was performed (Chi-square test, p-value < 0.05).


It was found that the use of biomass systems gave the highest cORs, but only electric cookers showed a significant cOR of 1.14 (95% CI: 1.01-1.27). When the geographical area and the mother’s educational level were included in the logistic model, the obtained aOR values differed moderately from the initial cORs. Electric heating was the only type which obtained a significant aOR (1.13; 95% CI: 1.00-1.27). Finally, the model with all selected confounding variables (sex, BMI, number of siblings, mother’s educational level, smoking habits of parents, truck traffic and geographical area), showed aOR values which were very similar to those obtained in the previous adjusted logistic analysis. None of the results was statistically significant, but the use of electric heating showed an aOR close to significance (1.14; 95% CI: 0.99-1.31).


In our study population, no statistically significant associations were found between the type of indoor energy sources used and the presence of AD.

Atopic dermatitis; Electricity; Gas; Biomass; Indoor; Children