Household Fuel Use for Heating and Cooking and Respiratory Health in a Low-Income, South African Coastal Community.

Sikhumbuzo Buthelezi,Angela Mathee,Candice Webster,Caradee Wright,Thandi Kapwata,Bianca Wernecke

doi:10.3390/ijerph16040550

Abstract

In low-income communities, non-electric fuel sources are typically the main cause of Household Air Pollution (HAP). In Umlazi, a South African coastal, informal settlement, households use electric- and non-electric (coal, wood, gas, paraffin) energy sources for cooking and heating. The study aimed to determine whether respiratory ill health status varied by fuel type use. Using a questionnaire, respondents reported on a range of socio-demographic characteristics, dwelling type, energy use for cooking and heating as well as respiratory health symptoms. Multivariate Poisson regression was used to obtain the adjusted Odds Ratios (ORs) for the effects of electric and non-electric energy sources on prevalence of respiratory infections considering potential confounding factors. Among the 245 households that participated, Upper Respiratory Tract Infections (URTI, n = 27) were prevalent in respondents who used non-electric sources compared to electric sources for heating and cooking. There were statistically significant effects of non-electric sources for heating (adjusted OR = 3.6, 95% CI (confidence interval): 1.2–10.1, p < 0.05) and cooking (adjusted OR = 2.9, 95% CI: 1.1–7.9, p < 0.05) on prevalence of URTIs. There was a statistically significant effect of electric sources for heating (adjusted OR = 2.7, 95% CI: 1.1–6.4, p < 0.05) on prevalence of Lower Respiratory Tract Infections (LRTIs) but no evidence for relations between non-electric sources for heating and LRTIs, and electric or non-electric fuel use type for cooking and LRTIs. Energy switching, mixing or stacking could be common in these households that likely made use of multiple energy sources during a typical month depending on access to and availability of electricity, funds to pay for the energy source as well as other socio-economic or cultural factors. The importance of behaviour and social determinants of health in relation to HAP is emphasized.

Highlights

Human respiratory health is adversely affected by the use of polluting fuels such as coal, wood and paraffin for cooking and indoor space heating [1]
The type of fuel used often determines the nature of the health outcomes, for example, biomass smoke exposure has been associated with an increased risk of chronic bronchitis and chronic obstructive pulmonary disease (COPD), and around 15% of those experiencing long-term exposure to wood smoke suffer from COPD [2,3]
Despite the small sample size, we found some differences in respiratory health status in a coastal, low-income community in KwaZulu-Natal according to type of fuel

Summary

Introduction

Human respiratory health is adversely affected by the use of polluting fuels such as coal, wood and paraffin ( known as kerosene) for cooking and indoor space heating [1]. HAP has been associated with increased risk of suffering stroke, ischaemic heart disease, chronic obstructive pulmonary disease (COPD) and lung cancer [1,2]. The type of fuel used often determines the nature of the health outcomes, for example, biomass smoke exposure has been associated with an increased risk of chronic bronchitis and COPD, and around 15% of those experiencing long-term exposure to wood smoke suffer from COPD [2,3]. Though considered a cleaner fuel than coal or wood, exposure to fumes created by burning paraffin has been shown to impair lung function and increase asthma [4]

Objectives

Methods

Results

Discussion

Conclusion