Abstract
Background: Considering the respiratory health risk of exposure to biomass cooking fuel emissions, this study was conducted to elucidate the relationship between cooking fuel choices and declined pulmonary function in rural and urban population in the Copperbelt Province of Zambia. Methods: We carried out a cross-sectional study of 1,170 healthy nonsmoking pregnant women from Masaiti and Ndola predominantly using biomass fuel for cooking. Questionnaire based data was acquired along with standardized measures of lung function. MIR Spirobank G (Italy) was used in spirometry based on American Thoracic Standards. Results: The present study found that over two thirds (69.2%) of pregnant women in the study population use biomass for cooking and only 12.4 % use electricity only. Declined lung function was found to be statistically significantly associated with cooking fuel choices (p – value 0.005) and a weak association was observed with gravida at a p-value of 0.056. Pregnant women using crop residues as cooking fuel were two times more likely to have a declined lung function [AOR 2.33 (1.27, 4.30)] compared with pregnant women using mixed fuel type (biomass and electricity) and those using electricity only were 57% less likely to have a declined lung function [AOD 0.43 (0.26, 0.69)]. Conclusion: Use of biomass for cooking among pregnant women is a strong determinant of declined lung function. Interventions to improve maternal respiratory health outcomes in Zambia and other countries in sub-Saharan Africa should involve making cleaner cooking fuel energy options available and accessible by ordinary women from both rural and urban areas.
Highlights
In developing countries, use of fuels such as wood, dung and crop residue is estimated in as many as 70% of households [1,2] or in more than 3 billion people worldwide according to other researchers[3]
According to Chidumayo et al and Indaba Agricultural Policy Research Institute (IAPRI), charcoal is widely used in urban Zambia as a source of cooking fuel, either on its own or in combination with electricity, it’s further been observed that even among electrified households, charcoal is commonly used in combination with electricity, more than electricity only, an indication of pervasive fuel stacking, rather than fuel switching [4,5]
Compared to the urban areas, rural areas recorded the highest level of biomass use, an observation that is comparable with most sub-Saharan African countries where previous studies indicate consistent results of high level of solid fuel use for cooking especially in the rural areas when compared with the urban areas [22,23]
Summary
Use of fuels such as wood, dung and crop residue is estimated in as many as 70% of households [1,2] or in more than 3 billion people worldwide according to other researchers[3]. Periodic and longtime exposure to solid fuel emissions may lead to various types of adverse health outcomes such as chronic bronchitis, increase in the risk of tuberculosis, respiratory failure and cor pulmonale [8] It is for this reason that biomass use for cooking and heating houses has been implicated in respiratory function disorders and pulmonary diseases due to emissions from incomplete combustion in usually poorly ventilated houses. The cheaper cooking fuel options in any context are generally less efficient cooking fuels, emit more smoke, and are the ones used by groups of people with the most poorly designed houses Fuels such as propane, liquid petroleum gas (LPG), or ethanol usually burn very cleanly, but remain too expensive for many households. Considering the respiratory health risk of exposure to biomass cooking fuel emissions, this study was conducted to elucidate the relationship between cooking fuel choices and declined pulmonary function in rural and urban population in the Copperbelt Province of Zambia
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