Determinants of household air pollution exposure mitigating factors in urban Uganda

Abstract

Background/Aim: Urban slum populations in sub-Saharan Africa (SSA) can be subject to high levels of exposure to household air pollution (HAP) from domestic use of polluting fuels. We know very little, however, about the local determining factors that can mitigate or exacerbate exposure to HAP among SAS’s urban poor. Methods: Among urban households in Kampala, Uganda (N=1294), we administered cross-sectional surveys and used multivariable logistic regression to identify household, demographic and local contextual determinants that can mitigate or exacerbate exposure to HAP from cooking with polluting fuels. Results: Most households used solid fuels for cooking (93%). Multivariable logistic regression revealed that households whose children were indoors during cooking (OR=3.93), or who used a polluting fuel (kerosene lantern) for lighting the home (OR=2.56), had significantly (p<0.05) higher odds of never opening windows during cooking with solid fuels indoors. Significantly higher odds of cooking indoors with polluting fuels was observed for households that light their home with a polluting fuel (OR=2.00), report being very concerned about neighborhood traffic-related air pollution (OR=1.57), have higher educational attainment (OR=1.51), or who cook more meals per day (OR=1.47). Lower household income (OR=3.65), younger child age (OR=8.16), cooking in a structure separate from the main living area (OR=3.56), or younger age for those who perform cooking duties in the home, were all significantly associated with higher odds of keeping the child indoors during cooking with polluting fuels indoors. Conclusions: Multiple household and demographic characteristics, as well as local contextual factors, were strongly associated with factors that can either mitigate (e.g., children outdoors during cooking) or exacerbate (kerosene for lighting) exposures to HAP from polluting cooking fuels. Tailored and targeted HAP interventions in urban SSA slum populations are needed that are sensitive to local contextual (traffic-related air pollution), demographic (age and income), and exposure-mitigating factors.