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Cooking with Gas Can Harm Children: Cooking with gas stoves is associated with increased risk of childhood respiratory illnesses, including asthma Andee Krasner, MPH* and T Stephen Jones, MD, MPH Key Points Question Does cooking with a gas stove harm children's health? Findings In a systematic review of the literature, we found that cooking with natural gas increases nitrogen dioxide, degrades indoor air quality, and increases the risk of respiratory illnesses in children, including asthma. More than 30% of United States households cook with gas. In Massachusetts, many health workers and others do not know that cooking with gas is associated with increased risk of asthma. Meaning A public education campaign is needed to inform parents, health care providers, caregivers, and public health staff that cooking with gas can harm children. Abstract Importance Children spend more than 80% of their time indoors. Indoor air quality, even in industrial cities, has been shown to be worse than outdoor air quality. Objective To review published literature of the health impacts on children of cooking with a gas stove. Methods We searched PubMed for articles including U.S. populations using the search terms, "Gas Stoves" with a human -only filter. The search found 247 articles. We excluded articles for the following reasons: the main topic was burns; case studies of individual deaths; the study group was entirely outside the United States.; the study group was infants or adults. After applying these exclusions, we found ten studies, including two meta-analyses. Following our review, we searched for studies of the biological plausibility of nitrogen dioxide increasing the risk of respiratory illnesses in children, the health impacts of outdoor nitrogen dioxide, and interventions to reduce the harms of cooking with a gas stove. We informally asked health workers and others in Massachusetts if they knew about the negative health impacts of cooking with a gas stove. Results The ten articles documented an association between cooking with a gas stove and increased indoor nitrogen dioxide levels, and that nitrogen dioxide and cooking with gas were both associated with increased risk of respiratory illnesses, including asthma and more severe asthma. Most people we asked in Massachusetts did not know about the risks of cooking with a gas stove. Conclusions and Recommendations Cooking with gas can harm children by increasing their risk of respiratory illnesses, including asthma. Because at least a third of United States households cook with gas stoves, this risk is substantial. Reports show that indoor air pollution can be worse than outdoor air pollution. For children who are indoors more than 80% of the time, cooking with a gas stove is a largely unrecognized risk. We recommend a public education campaign to inform parents, health care providers, public health staff, and caregivers that cooking with a gas stove can harm children. h e e 1 MOMERSOUf Fri