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Where there’s smoke… there’s tuberculosis
  1. Stephen Gordon,
  2. Jamie Rylance
  1. Dr Stephen Gordon, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; sbgordon{at}

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Recent observations have demonstrated precisely the increased life expectancy associated with clean environmental air in the USA.1 This dramatic health benefit has been achieved at levels of pollution very much lower than those found indoors in underdeveloped countries. Traditional cooking fires using biomass (organic material) fuel are inefficient and the smoke levels measured in poorly ventilated homes are often 100 times that regarded as dangerous in the affluent industrial world. High levels of indoor air pollution have been associated in epidemiological studies with upper and lower respiratory tract acute infections (ALRIs), chronic obstructive pulmonary disease (COPD) and lung cancer.2 There has been less evidence to support an association of indoor air pollution with biomass fuel use and tuberculosis, and so the report by Kolappan and Subramani (see page 705) in …

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