Household Air Pollution Exposure Research Articles

Household Air Pollution Interventions to Improve Health in Low- and Middle-Income Countries: An Official American Thoracic Society Research Statement.

Background: An estimated 3 billion people, largely in low- and middle-income countries, rely on unclean fuels for cooking, heating, and lighting to meet household energy needs. The resulting exposure to household air pollution (HAP) is a leading cause of pneumonia, chronic lung disease, and other adverse health effects. In the last decade, randomized controlled trials of clean cooking interventions to reduce HAP have been conducted. We aim to provide guidance on how to interpret the findings of these trials and how they should inform policy makers and practitioners.Methods: We assembled a multidisciplinary working group of international researchers, public health practitioners, and policymakers with expertise in household air pollution from within academia, the American Thoracic Society, funders, nongovernmental organizations, and global organizations, including the World Bank and the World Health Organization. We performed a literature search, convened four sessions via web conference, and developed consensus conclusions and recommendations via the Delphi method.Results: The committee reached consensus on 14 conclusions and recommendations. Although some trials using cleaner-burning biomass stoves or cleaner-cooking fuels have reduced HAP exposure, the committee was divided (with 55% saying no and 45% saying yes) on whether the studied interventions improved measured health outcomes.Conclusions: HAP is associated with adverse health effects in observational studies. However, it remains unclear which household energy interventions reduce exposure, improve health, can be scaled, and are sustainable. Researchers should engage with policy makers and practitioners working to scale cleaner energy solutions to understand and address their information needs.

IJCM_333A: Household Air Pollution Exposure and Autism Spectrum Disorder Outcomes in Children: Insights from the HAPIN India Study

Background: The global public health challenge of household air pollution, stemming from conventional cooking practices and the widespread use of solid fuels, is a critical concern. Exposure to indoor air pollutants has been associated with adverse health outcomes, particularly affecting vulnerable populations like pregnant women and young children. The Household Air Pollution and Neurodevelopment (HAPIN) study addresses this issue through a multicentric randomized controlled trial spanning four diverse countries: Guatemala, India, Peru, and Rwanda. Objectives: The study aims to evaluate the prevalence of autistic spectrum disorder among children residing in HAPIN study site of India. Methodology: A cross-sectional assessment for autism spectrum disorders within the HAPIN cohort was done.365 children aged 2 to 3 years were studied to explore the potential link between household air pollution and autism spectrum disorder (ASD). Household air quality, measuring PM2.5, CO, and black carbon, was assessed using established protocols. Neurodevelopmental outcomes, particularly ASD, was screened using the Modified Checklist for Autism in Toddlers (M-CHAT) in children aged 2 to 3 years, and screened positive children were evaluated by a psychiatrist to diagnose autism spectrum disorder using DSM-5 criteria. Results: There is significant association between exposure to air pollutants (PM2.5, CO, and black carbon) and the diagnosis of autism spectrum disorder (ASD), with a prevalence rate of 5.48%. Conclusion: ASD prevalence rate of 5.48%, underscore the global relevance of the impact of household air pollution on neurodevelopment. Urgent interventions are warranted to mitigate the risk of ASD, particularly for vulnerable populations like pregnant women and young children, emphasizing the imperative for cleaner cooking practices and improved indoor air quality.

Chronic household air pollution and exposure patterns among Himalayan nomads.

Household air pollution (HAP) is a major risk factor of non-communicable diseases, causing millions of premature deaths each year in developing nations. Populations living at high altitudes are particularly vulnerable to HAP and associated health outcomes. This study aims to explore the relationships between activity patterns, HAP, and an HAP biomarker among 100 Himalayan nomadic households during both cooking and heating-only periods. Household CO was monitored in 100 rural homes in Qinghai, China, at 3500 m on the Himalayan Plateau among Himalayan nomads. Carboxyhemoglobin (COHb) was used as a biomarker to assess exposure among 100 male and 100 female heads of household. Linear mixed-effects models were used to explore the relationship between COHb and activity patterns. Cooking periods were associated with 7 times higher household CO concentrations compared with heating periods (94 ± 56 ppm and 13 ± 11 ppm, respectively). Over the three-day biomarker-monitoring period in each house, 99% of subjects had at least one COHb measurement exceeding the WHO safety level of 2%. Cooking was associated with a 32% increase in COHb (p < 0.001). This study on household air pollution (HAP) in high-altitude regions provides important insights into the exposure patterns of nomadic households in Qinghai, China. The study found that cooking is the primary factor influencing acute carbon monoxide (CO) exposure among women, while heating alone is sufficient to elevate CO exposure above WHO guidelines. The results suggest that cooking-only interventions have the potential to reduce HAP exposure among women, but solutions for both cooking and heating may be required to reduce COHb to below WHO guidelines. This study's findings may inform future interventions for fuel and stove selection to reduce HAP and exposure among other populations.

Household air pollution and risk of pulmonary tuberculosis in HIV-Infected adults

BackgroundIn low- and middle-income countries countries, millions of deaths occur annually from household air pollution (HAP), pulmonary tuberculosis (PTB), and HIV-infection. However, it is unknown whether HAP influences PTB risk among people living with HIV-infection.MethodsWe conducted a case-control study among 1,277 HIV-infected adults in Bukavu, eastern Democratic Republic of Congo (February 2018 – March 2019). Cases had current or recent (<5y) PTB (positive sputum smear or Xpert MTB/RIF), controls had no PTB. Daily and lifetime HAP exposure were assessed by questionnaire and, in a random sub-sample (n=270), by 24-hour measurements of personal carbon monoxide (CO) at home. We used multivariable logistic regression to examine the associations between HAP and PTB.ResultsWe recruited 435 cases and 842 controls (median age 41 years, [IQR] 33-50; 76% female). Cases were more likely to be female than male (63% vs 37%). Participants reporting cooking for >3h/day and ≥2 times/day and ≥5 days/week were more likely to have PTB (aOR 1·36; 95%CI 1·06-1·75) than those spending less time in the kitchen. Time-weighted average 24h personal CO exposure was related dose-dependently with the likelihood of having PTB, with aOR 4·64 (95%CI 1·1-20·7) for the highest quintile [12·3-76·2 ppm] compared to the lowest quintile [0·1-1·9 ppm].ConclusionTime spent cooking and personal CO exposure were independently associated with increased risk of PTB among people living with HIV. Considering the high burden of TB-HIV coinfection in the region, effective interventions are required to decrease HAP exposure caused by cooking with biomass among people living with HIV, especially women.

Household air pollution exposure and risk of tuberculosis: a case–control study of women in Lilongwe, Malawi

IntroductionGlobally, 3–4 billion people rely on solid fuels for cooking, and 1 billion use kerosene to light their homes. While household air pollution (HAP) emitted from burning these fuels has...

Household air pollution could make children grow shorter in sub-Saharan Africa; but can households help stem the tide on their own?

Recently, there has been growing research interest in the influence of household air pollution on child health. Despite the increasing advocacy for households to switch from the use of polluting cooking fuels due to climate change and health-related concerns, the practice is still prevalent in Sub-Saharan Africa (SSA). The intensity of household air pollution exposure and its influence on child stunting and wasting of children is an important, but understudied, cause for public health concern. Identifying the health effects of polluting fuels, for instance, could stimulate a speedy transition to clean energy. This study, therefore, examines the association between the intensity of household air pollution exposure and child stunting and wasting of children using data from the most recent demographic and health surveys (DHS) from 33 countries in SSA using linear probability modeling. Results show that high levels of intensity of air pollution within households are associated with increased stunting probability of 2.9% − 3.2%. The findings highlight a potential negligible cost measure households can adopt to limit the intensity of pollution they are exposed to and consequently, to reduce the faltering growth in children.

Biomass smoke exposure and somatic growth among children: The RESPIRE and CRECER prospective cohort studies in rural Guatemala

BackgroundCooking-related biomass smoke is a major source of household air pollution (HAP) and an important health hazard. Prior studies identified associations between HAP exposure and childhood stunting; less is known for underweight and wasting. Few studies had personal HAP measurements. Methods557 households in rural Guatemala were enrolled in the CRECER study, the follow-up study of the RESPIRE randomized intervention trial. They were assigned to three groups that received chimney stoves at different ages of the study children. Multiple personal carbon monoxide (CO) exposure measurements were used as proxies for HAP exposures. Children’s heights and weights were measured from 24 to 60 months of age. Height-for-age z-score (HAZ), weight-for-age z-score (WAZ), and weight-for-height z-score (WHZ) were calculated based on the World Health Organization’s Multicentre Growth Reference Study. HAZ, WAZ, and WHZ below −2 were classified as stunting, underweight, and wasting, respectively. Generalized linear models and mixed effects models were applied. Results541 children had valid anthropometric data, among whom 488 (90.2 %) were stunted, 192 (35.5 %) were underweight, and 2 (0.3 %) were wasted. A 1 ppm higher average CO exposure was associated with a 0.21 lower HAZ (95 % CI: 0.17–0.25), a 0.13 lower WAZ (95 % CI: 0.10–0.17) and a 0.06 lower WHZ (95 % CI: 0.02–0.10).The associations for HAZ were stronger among boys (coefficient = −0.29, 95 % CI: −0.35 – −0.22) than among girls (coefficient = −0.15, 95 % CI: −0.20 – −0.10). A 1 ppm-year higher cumulative CO exposure was associated with a higher risk of moderate stunting among boys (OR = 1.27, 95 % CI: 1.05-1.59), but not among girls. DiscussionIn this rural Guatemalan population, higher HAP exposure was associated with lower HAZ and WAZ. The associations between HAP and HAZ/stunting were stronger among boys. Reducing HAP might benefit childhood somatic growth in rural populations of low-income countries.

Association of household solid fuel use and long-term exposure to ambient air pollution with estimated 10-year high cardiovascular disease risk among postmenopausal women

This study aimed to explore the separate and joint effects of long-term ambient air pollution and household air pollution exposure on 10-year high cardiovascular disease (CVD) risk among postmenopausal women. A total of 4679 postmenopausal women from the China Health and Retirement Longitudinal Study (CHARLS) were included in this study. Information of fuel type was collected by standard questionnaires and use of solid fuel was considered as a proxy for household air pollution. Data of ambient air pollutants (PM1, PM2.5, PM10, SO2, NO2, CO, O3) were obtained from the ChinaHighAirPollutants (CHAP) datasets. Logistic regression models were performed to assess the separate and joint effects of long-term exposure to ambient air pollution and use of solid fuel on 10-year high CVD risk. We found use of solid fuel and its duration and ambient air pollutants (PM1, PM2.5, PM10, SO2, NO2) were all positively associated with 10-year high CVD risk among postmenopausal women (P < 0.05). Compared to those used clean fuel and exposed to low ambient air pollution levels, odds ratios (ORs) and 95% confidence intervals (CIs) for participants using solid fuels and exposed to high ambient air pollution levels (PM1, PM2.5, PM10, SO2, NO2, CO, O3) were 1.66 (1.35, 2.05), 1.66 (1.35, 2.04), 1.49 (1.22, 1.83), 1.28 (1.05, 1.57), 1.67 (1.34, 2.07), 1.28 (1.04, 1.57), 1.46 (1.18, 1.80), respectively. Moreover, significant additive interactions of solid fuel use with PM1 and PM2.5 on 10-year high CVD risk were observed, with approximately 18% and 23% of 10-year high risk of CVD attributable to the interaction. Overall, indoor and outdoor air pollution had separate and joint effects on 10-year high CVD risk among postmenopausal women. Therefore, simultaneously improving indoor and outdoor air quality are of great importance and could have a joint impact on prevention of CVD and improved health among postmenopausal women.

Health perceptions of smart meter liquefied petroleum gas users in Nairobi's Informal Settlement

Introduction : Household air pollution (HAP) from cooking with polluting fuels increases the risk of developing respiratory diseases. The use of a smart-meter liquefied petroleum gas (LPG); Pay-as-you-go (PAYG) model that eliminates cost barriers may increase the use of LPG, reduce HAP exposure, and lower the burden of respiratory diseases. Lack of awareness of the effects of HAP is a barrier to the exclusive use of LPG. This cross-sectional study examined smart meter users' awareness of air quality and perception of health risks associated with HAP among PAYG customers in Mukuru informal settlement, Nairobi Kenya.&#x0D; Materials and Methods : The study targeted household customers who have been cooking with PAYG LPG for at least two years. Surveys (n=330) and focus group discussions (FGDs) (n=32) participants were selected using multistage and purposive sampling techniques respectively. Quantitative and qualitative data were descriptively and thematically analyzed using STATA and NVIVO respectively.&#x0D; Results : The majority, who cooked with no separate kitchen room 147(60%) were worried about kitchen smoke (p-value=0.038). Also, 129(65%) of those who used smart meter LPG with other polluting fuels (p-value =0.021), and most 79(63%) who had experienced respiratory symptoms were concerned about kitchen smoke (p-value&lt;0.05). Results further revealed participants' overall low awareness of indoor/outdoor pollution and little concern about respiratory health risks associated with HAP, due to a focus on more immediate issues, like; food security. The motivation to use LPG was more linked to economic considerations than health benefits.&#x0D; Conclusion/Recommendation : Results highlighted the potential for the smart-meter LPG (PAYG) model for exclusive adoption of LPG especially in the informal settlement and recommended the need to create awareness of the negative effects of HAP.

Household Air Pollution and Child Lung Function: The Ghana Randomized Air Pollution and Health Study.

Rationale: The impact of a household air pollution (HAP) stove intervention on child lung function has been poorly described. Objectives: To assess the effect of a HAP stove intervention for infants prenatally to age 1 on, and exposure-response associations with, lung function at child age 4. Methods: The Ghana Randomized Air Pollution and Health Study randomized pregnant women to liquefied petroleum gas (LPG), improved biomass, or open-fire (control) stove conditions through child age 1. We quantified HAP exposure by repeated maternal and child personal carbon monoxide (CO) exposure measurements. Children performed oscillometry, an effort-independent lung function measurement, at age 4. We examined associations between Ghana Randomized Air Pollution and Health Study stove assignment and prenatal and infant CO measurements and oscillometry using generalized linear regression models. We used reverse distributed lag models to examine time-varying associations between prenatal CO and oscillometry. Measurements and Main Results: The primary oscillometry measure was reactance at 5 Hz, X5, a measure of elastic and inertial lung properties. Secondary measures included total, large airway, and small airway resistance at 5 Hz, 20 Hz, and the difference in resistance at 5 Hz and 20 Hz (R5, R20, and R5-20, respectively); area of reactance (AX); and resonant frequency. Of the 683 children who attended the lung function visit, 567 (83%) performed acceptable oscillometry. A total of 221, 106, and 240 children were from the LPG, improved biomass, and control arms, respectively. Compared with control, the improved biomass stove condition was associated with lower reactance at 5 Hz (X5 z-score: β = -0.25; 95% confidence interval [CI] = -0.39, -0.11), higher large airway resistance (R20 z-score: β = 0.34; 95% CI = 0.23, 0.44), and higher AX (AX z-score: β = 0.16; 95% CI = 0.06, 0.26), which is suggestive of overall worse lung function. The LPG stove condition was associated with higher X5 (X5 score: β = 0.16; 95% CI = 0.01, 0.31) and lower small airway resistance (R5-20 z-score: β = -0.15; 95% CI = -0.30, 0.0), which is suggestive of better small airway function. Higher average prenatal CO exposure was associated with higher R5 and R20, and distributed lag models identified sensitive windows of exposure between CO and X5, R5, R20, and R5-20. Conclusions: These data support the importance of prenatal HAP exposure on child lung function. Clinical trial registered with www.clinicaltrials.gov (NCT01335490).

Estimating personal exposures to household air pollution and plastic garbage burning among adolescent girls in Jalapa, Guatemala

Waste collection services are uncommon in rural areas of low-resource countries, causing waste accumulation and subsequent dumping and burning of garbage. Air pollution from household garbage burning, including plastics, has been observed in Jalapa, Guatemala in addition to household air pollution (HAP) from cooking. Adolescent girls often help with these cooking and household tasks, but little is known about their exposures. We characterized 24-h exposures to HAP and household garbage burning in adolescent girls by measuring fine particulate matter (PM2.5), black carbon (BC), urinary biomarkers of polycyclic aromatic hydrocarbons (PAHs), bisphenol A (BPA), and phthalates. We recruited 60 girls between 13 and 17 years of age who helped with cooking activities and lived with participants of the Household Air Pollution Intervention Network (HAPIN) trial. We recruited n = 30 girls each from the control (wood-burning stove) and intervention (liquefied petroleum gas stove) arms. We also measured real-time kitchen concentrations of BC in 20 homes (33%). PM2.5 and BC were measured in n = 21 control and n = 20 intervention participants. Median concentrations of personal PM2.5 and BC and kitchen BC were lower (p < 0.05) in the intervention arm by 87%, 80%, and 85%, respectively. PAH metabolite concentrations were lower (p < 0.001) for all nine metabolites in intervention (n = 26) compared to control participants (n = 29). Urinary BPA concentrations were 66% higher in participants who reported using cosmetics (p = 0.02), and phthalate concentrations were 63% higher in participants who had reported using hair products during the sample period (p = 0.05). Our results suggest that gas stoves can reduce HAP exposures among adolescents who are not primary cooks at home. Biomarkers of plastic exposure were not associated with intervention status, but some were elevated compared to age- and sex-matched participants of the National Health and Nutrition Examination Survey (NHANES).

Quantifying national household air pollution (HAP) exposure to PM2.5 in rural and urban areas

According to WHO (World Health Organization), in 2020, 14% of people in global urban areas relied on polluting solid fuels and technologies, compared with 52% of the rural population. The health impacts of such inequality are massive. It was estimated that 3.2 million premature deaths per year (2020), particularly in low-income and middle-income countries due to household air pollution (HAP). Several studies provide estimates of the exposure to fine particulate matter (PM2.5) from household air pollution (HAP-PM2.5) for users of different fuel/cookstove types in rural and urban areas. However, hardly any studies estimate the population-weighted exposure to HAP-PM2.5 at the global scale. A Bayesian hierarchical model was developed to estimate PM2.5 exposure coefficients and their uncertainties for an annual average of HAP-PM2.5 personal exposure. The predicted HAP-PM2.5 exposure at the user level was used to estimate the national-level exposure for the population living in urban and rural areas. The results suggest that switching from polluting solid fuels (biomass, charcoal, coal) to cleaner fuels (gas and electricity) for heating and cooking can potentially reduce the national-level HAP-PM2.5 personal exposure on average by 53%. However, there exists a significant disparity between rural and urban areas, partly reflecting inequality in energy access. More specifically, switching from polluting solid fuels for heating and cooking to cleaner fuels can reduce the personal exposure to HAP-PM2.5 in rural areas by 54% and in urban areas by 38%. The study indicates that increased access to clean fuels and improved stove interventions are needed to achieve the goals of universal energy access and equality between urban and rural areas.

Assessment of Household Air Pollution Exposure in Kampala Capital City, Uganda

Assessment of Household Air Pollution Exposure in Kampala Capital City, Uganda

Pregnant women’s perception on the health effects of household air pollution in Rural Butajira, Ethiopia: a phenomenological qualitative study

BackgroundHousehold air pollution is the major public health problem in developing countries. Pregnant women spent the majority of their time at home and are the most affected population by household air pollution. Exploring the perception of pregnant women on adverse health effects is important to enhance the mitigation strategies. Therefore, this study aim to explore the pregnant women’s perceptions about health effects of household air pollution in rural Butajira, Ethiopia.MethodsA phenomenological qualitative study design was conducted among 15 selected pregnant women. All interviews were carried out at the participants´ house and audio-recorded while housing and cooking conditions were observed and appropriate notes were taken for each. The collected data were transcribed verbatim and translated into the English language. Then, the data were imported into Open code software to manage the overall data coding processes and analyzed thematically.ResultsStudy participants perceived that respiratory problems such as coughing, sneezing and asthma and eye problem were the major health problem caused by household air pollution among pregnant women. Study participants also mentioned asphyxiated, abortion, reduces weight, and hydrocephalus was caused by household air pollution on the foetus. Study participants perceived that financial inability, spouse negligence, autonomy and knowledge level of the women were the barriers to tackling household air pollution. Study participant also suggested that opening the door and window; using improved cookstove and reduce workload were the perceived solution for household air pollution.ConclusionsThis study explores pregnant women’s perceptions on health effects of household air pollution. The finding of this study was important to deliver suitable intervention strategies to mitigate household air pollution. Therefore, educating the women on way of mitigating household air pollution, improving existing structure of the house and minimize the time to stay in the kitchen is important to mitigate household air pollution exposure.

Ecological study on household air pollution exposure and prevalent chronic disease in the elderly

Older people spend most of their time indoors. Limited evidence demonstrates that exposure to indoor air pollutants might be related to chronic complications. This study aimed to estimate the correlation between household air pollution (HAP)'s long-term exposure and the prevalence of elevated hypertension, diabetes mellitus (DM), obesity, and low-density lipoprotein (LDL) cholesterol. From the Global Burden disease dataset, we extracted HAP, hypertension, DM, body mass index, and LDL cholesterol data from Iran from 1990 to 2019 to males and females in people over 50 years. We present APC and AAPC and their confidence intervals using Joinpoint Software statistical software. R software examined the correlation between HAP and hypertension, DM2, Obesity, and high LDL cholesterol. Our finding showed a significant and positive correlation between HAP exposure and prevalence of high low-density lipoprotein cholesterol (p ≤ 0.001, r = 0.70), high systolic blood pressure (p ≤ 0.001, r = 0.63), and high body mass index (p ≤ 0.001, r = 0.57), and DM2 (p ≤ 0.001, r = 0.38). The analysis results also illustrated a positive correlation between indoor air pollution and smoking (p ≤ 0.001, r = 0.92). HAP exposure might be a risk factor for elevated blood pressure, DM, obesity, and LDL cholesterol and, consequently, more serious health problems. According to our results, smoking is one of the sources of HAP. However, ecological studies cannot fully support causal relationships, and this article deals only with Iran. Our findings should be corroborated in personal exposure and biomonitoring approach studies.

Environmental exposures and adverse pregnancy outcomes in Ethiopia: A systematic review and meta-analysis.

Maternal exposures to environmental hazards during pregnancy are key determinants of birth outcomes that affect health, cognitive and economic status later in life. In Ethiopia, various epidemiological evidences have suggested associations between environmental exposures such as household air pollution, cigarette smoking, and pesticide exposure and pregnancy outcomes such as low birth weight, preterm birth, and birth defects. This review aimed at generating summarized evidence on the association between maternal exposure to environmental factors (household air pollution, cigarette smoking, and pesticide) and pregnancy outcomes (birth weight, preterm birth, and birth defects) in Ethiopia. A systematic literature search was performed using PubMed, Google Scholar, and the Cochrane Library databases. All observational study designs were eligible for inclusion in the review. Quality assessment was conducted using the Newcastle-Ottawa Scale (NOS) quality assessment tools adopted for case-control and cross-sectional studies. The random-effects model was applied in computing the pooled estimates and their corresponding 95% confidence interval (CI). Funnel and Doi plots were used for detecting the potential publication bias. All statistical analyses were performed using comprehensive meta-analysis (CMA 2.0) and MetaXL version 5.3 software. The pooled estimates revealed that prenatal biomass fuel use increased the risk of giving a low birth weight baby by twofold (OR = 2.10, 95% CI: 1.33-3.31), and has no separate kitchen increases the risk of having low birth weight baby nearly by two and half times (OR = 2.48, 95% CI: 1.25-4.92). Overall, using biomass fuel as the main energy source for cooking and /or having no separate kitchen from the main house is 2.37 times more likely to give low birth weight babies (OR = 2.37, 95% CI: 1.58-3.53). Active cigarette smoker women were 4 times (OR = 4.11, 95% CI: 2.82-5.89) more prone to have low birth weight babies than nonsmokers; and passive smoker women were 2.6 times (OR = 2.63, 95% CI: 1.09-6.35) more risked to give low birth weight babies. It was also estimated that active cigarette smoker women were nearly 4 times (OR = 3.90, 95% CI: 2.36-6.45) more likely to give preterm birth babies. Pesticide exposure during pregnancy also increases the risk of the birth defect 4 times (OR = 4.44, 95% CI: 2.61-7.57) compared with non-exposed pregnant women. Household air pollution from biomass fuel use, active and passive cigarette smoking, and pesticide exposures are significantly associated environmental risk factors for low birth weight, preterm birth, and birth defects in Ethiopia. Therefore, Pregnant and lactating women should be aware of these environmental hazards during pregnancy. Promoting clean energy and improved and efficient stoves at the household level will help to reduce household air pollution-related adverse health effects. PROSPERO 2022: CRD42022337140.

Two years’ exclusive use of liquefied petroleum gas (LPG) for cooking reduced household air pollution exposure among rural Bangladeshi women

Two years’ exclusive use of liquefied petroleum gas (LPG) for cooking reduced household air pollution exposure among rural Bangladeshi women

Household Polluting Fuel Use and Frailty among Older Adults in Rural China: The Moderating Role of Healthy Lifestyle Behaviors.

This study worked to investigate the effect of household polluting fuel use (HPFU), as an indicator of household air pollution exposure, on frailty among older adults in rural China. Additionally, this study aimed to examine the moderating effect of healthy lifestyle behaviors on the aforementioned association. This study employed cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, which conducted nationally representative sampling of older adults from 23 provinces in mainland China. The frailty index was calculated using 38 baseline variables that assessed health deficits through questionnaire surveys and health examinations. A total of 4535 older adults aged 65 years and above were included in our study, among whom, 1780 reported using polluting fuels as their primary household cooking fuel. The results of regression analyses and multiple robustness checks indicated a significant increase in the frailty index due to HPFU. This environmental health threat was more profound among women, illiterate individuals, and low-economic-status groups. Moreover, healthy dietary and social activities had significant moderating effects on the association between HPFU and frailty. HPFU can be regarded as a risk factor for frailty among older adults in rural China, with its effects exhibiting socio-economic disparities. The adoption of healthy lifestyle behaviors can alleviate the frailty associated with HPFU. Our findings underscore the significance of using clean fuels and improving household air quality for healthy aging in rural China.

Deepened socioeconomic inequality in clean cooking fuel use in India from 2005-2006 to 2015–2016

Uptake of clean cooking fuels (CCF), such as liquefied petroleum gas (LPG), in place of traditional cooking fuels such as wood, charcoal, and kerosene can improve public health by reducing household air pollution exposures. Though studies have cross-sectionally examined socioeconomic determinants of cooking fuel adoption, little is known about socioeconomic disparities in CCF use over time. Data from the third (2005–06) and fourth (2015–16) rounds of the National Family Health Survey covering 109,041 and 601,509 households, respectively, were used to examine inequities in CCF use in India. While CCF use in India increased nationally from 25% in 2005–06 to 44% in 2015–16, the adoption of CCF varied widely across states and socio-economic groups. Approximately 2% of households in the poorest wealth quintile gained access to LPG during the study period, compared with an increase of 10% or more among households in the middle or richer wealth quintiles; the LPG access gap between the low (0.2%) and middle class (19.2%) was 19% in 2005–06 and nearly doubled to 35% (2.5% vs. 37.4%, respectively) in 2015–16. At the state level, there was a four-fold difference in the uptake of CCF over the two survey periods. The use of CCF increased by less than 10% in Himachal Pradesh, Bihar, Assam, Manipur, Mizoram, and Meghalaya as compared to the increases of at least 30% in Tamil Nadu (42%), undivided Andhra Pradesh (34%), and Kerala (30%). Further, in wealthier states (Delhi, Goa, Punjab, Haryana, Tamil Nadu, Kerala, and undivided Andhra Pradesh), CCF use increased by more than 20% among the poorest individuals compared with less than 1% among the poorest families in lower income states (Tripura, Meghalaya, Madhya Pradesh, Jharkhand, Chhattisgarh, Bihar). To promote a more equitable clean energy transition, poorer and rural Indian households should be prioritized for CCF promotion programs.

The Effect of Household Air Pollution Exposure on the Incidence of Acute Respiratory Infection in Children Under Five in Asia: A Meta-Analysis

ASIA is a continent with many people who still have and use biomass or solid fuel use (SFU) for cooking and various household air pollution. Previous research has mentioned the negative effects of household air pollution on the incidence of acute respiratory infections in children under 5 years. Acute respiratory diseases have even become the cause of at least 4 million deaths of children under 5 years old every year in the world. The meta-analysis aimed to estimate the correlation between household air pollution and the incidence of acute respiratory infections in children under five in ASIA. This study was a meta-analysis. Primary data is taken through the electronic databases such as: PubMed, Science Direct, Web of Science, Springer Link and Cochrane Database. By using the search keywords "Household air pollution AND acute respiratory tract infections AND adjusted odds ratio", "indoor air pollution AND acute respiratory tract infections AND adjusted odds ratio", and "paparan asap rumah tangga DAN ISPA DAN adjusted odds ratio". Articles taken between 2013-2023. Statistical analysis was performed using the RevMan 5.3. 7 articles qualified for quantitatively analysis. The exposure of household air pollution can increases the risk of acute respiratory infections 3 times in children under five and statistically significant (OR 3.36; 95% CI: 2.96 – 3.81; p value &lt; 0.001). Exposureto household air pollution is a significant risk factor for the incidence of acute respiratory infections in children under 5 years.&#x0D;