Effects of household and outdoor air pollution on respiratory health in non-smoking, non-occupationally exposed women in rural Odisha, India.

Abstract

Background: It is estimated that up to half of the world's population uses biomass fuel (wood, crop residues, animal dung and coal) for household energy purposes such as cooking, lighting and heating. Emissions from these sources lead to personal exposures to complex mixtures of air pollutants. As a result, a large proportion of women and children are exposed to high levels of air pollution. The short and long term effects of these exposures on the respiratory health of this population are not clearly understood. Aim: To conduct a surveillance of current practice and to examine the association between household use of biomass fuels and respiratory health outcomes among primary cooks. Methods: A population-based study in two villages more than 5 km away from the highway and a cross sectional survey in two villages within 100 meters of a major highway was conducted in the coastal district of Khorda in Odisha state. Nonsmoking and non-occupationally exposed women 18 year of age or older (n=405) completed a questionnaire on respiratory symptoms and illnesses and on use of cooking fuel. Results: Only 12% of households used liquid petroleum gas (LPG), while 35% used mixed fuel. At the time of the survey, 97%, 93% and 87% women used some form of biomass fuel, mosquito repellant, and incense sticks respectively. In this population, 37%, 24%, 22%, and 15% had cough, wheezing, shortness of breath, and physician diagnosed asthma respectively. In contrast to previous reports, proximity to a major highway appeared to have minimal impact, while use of mosquito repellant and biomass fuel showed a strong association with respiratory symptoms in a multiple regression analysis. Conclusions: Household use of high pollution cooking fuels may cause respiratory illness. Additional studies on a larger number of LPG users are underway to discern the effect of different exposures on respiratory health in similar settings. This study was funded in part by the Bhagabat Behera Memorial Student Ambassador Award to Asmi Panigrahi at the Asian Institute of Public Health, Bhubaneswar.