Role of poverty in fuel choice and exposure to indoor air pollution in Pakistan

Nasir, Zaheer Ahmad; Murtaza, Fowad; Colbeck, I.

doi:10.1080/1943815x.2015.1005105

Cited by 30 publications

(31 citation statements)

References 6 publications

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“…The study found urban children were at slightly higher risk of death than children from rural areas, which was similar to previous similar studies in Bangladesh and Indonesia [24, 25]; despite the fact that the majority of the households in rural Pakistan rely on solids fuels mainly due to the unavailability of better alternatives [44, 45]. An intervention study in Pakistan investigating indoor particulate matter (PM) concentrations in developing countries reported that PM was considerably higher in urban kitchens as rural kitchens were more ventilated than urban ones [46].…”

Section: Discussionsupporting

confidence: 89%

Household air pollution from use of cooking fuel and under-five mortality: The role of breastfeeding status and kitchen location in Pakistan

2017

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Household air pollution (HAP) mainly from cooking fuel is one of the major causes of respiratory illness and deaths among young children in low and middle-income countries like Pakistan. This study investigates for the first time the association between HAP from cooking fuel and under-five mortality using the 2013 Pakistan Demographic and Health Survey (PDHS) data. Multi-level logistic regression models were used to examine the association between HAP and under-five mortality in a total of 11,507 living children across four age-groups (neonatal aged 0–28 days, post-neonatal aged 1–11 months, child aged 12–59 months and under-five aged 0–59 months). Use of cooking fuel was weakly associated with total under-five mortality (OR = 1.22, 95%CI = 0.92–1.64, P = 0.170), with stronger associations evident for sub-group analyses of children aged 12–59 months (OR = 1.98, 95%CI = 0.75–5.25, P = 0.169). Strong associations between use of cooking fuel and mortality were evident (ORs >5) in those aged 12–59 months for households without a separate kitchen using polluting fuels, and in children whose mother never breastfed. The results of this study suggest that HAP from cooking fuel is associated with a modest increase in the risk of death among children under five years of age in Pakistan, but particularly in those aged 12–59 months, and those living in poorer socioeconomic conditions. To reduce exposure to cooking fuel which is a preventable determinant of under-five mortality in Pakistan, the challenge remains to promote behavioural interventions such as breastfeeding in infancy period, keeping young children away from the cooking area, and improvements in housing and kitchen design.

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Section: Discussionsupporting

confidence: 89%

Household air pollution from use of cooking fuel and under-five mortality: The role of breastfeeding status and kitchen location in Pakistan

2017

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“…Recent Global Burden of Disease analysis indicated that poverty was the single largest contributor to childhood illness in sub-Saharan Africa25 though any association between poverty, education, family size, sanitation and fuel use is complex. In recent work in Pakistan, Nasir et al showed multiple inter-related pathways 26. In Ram et al ’s study in Bangladesh in children aged under 5 years with pneumonia where comparable proportions to our study lived in households using gas (85% vs 86% in Karachi) suggested that improved ventilation and the reduction of overcrowding were the single largest preventable determinants of illness.…”

Section: Discussionsupporting

confidence: 73%

Recurrence of WHO-defined fast breathing pneumonia among infants, its occurrence and predictors in Pakistan: a nested case–control analysis

et al. 2020

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ObjectivesStudies in low-income and middle-income countries have shown an adverse association between environmental exposures including poverty. There is little literature from South Asia. We aimed to test the associations between housing, indoor air pollution and children’s respiratory health and recurrent fast breathing pneumonia in a poor urban setting in Pakistan.SettingPrimary health centres in a periurban slum in Karachi, Pakistan.MethodsNested matched case–control study within a non-inferiority randomised controlled trial of fast breathing pneumonia (Randomised Trial of Amoxicillin vs Placebo for Pneumonia (RETAPP)) in periurban slums of Karachi, Pakistan. Cases were children aged 2–60 months enrolled in RETAPP with fast breathing pneumonia who presented again with fast breathing between 8 weeks and 12 months after full recovery. Controls, selected in a 2:1 ratio, were age-matched participants who did not represent. Multivariable conditional logistic regression analysis was undertaken to explore associations with potentially modifiable environmental predictors including housing type, indoor air quality, exposure to tobacco smoke, outdoor pollution, household crowding, water and sanitation quality, nutritional status, immunisation completeness, breast feeding and airways hyperactivity.ResultsFast breathing recurred in 151 (3.7%) of children out of the total (4003) enrolled in the trial. Poor-quality housing of either katcha or mixed type strongly predicted recurrence with adjusted matched ORs 2.43 (95% CI 1.02 to 5.80) and 2.44 (1.11 to 5.38), respectively. Poor air quality, cooking fuel, inadequate ventilation, nutritional status, water, sanitation and hygiene (WASH) index, wheeze at first presentation and group of initial trial assignment were not independently predictive of recurrence.ConclusionPoor-quality housing independently predicted recurrence of fast breathing pneumonia.Trial registration numberNCT02372461

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“…This divulges that a 1% change in HH income would decrease the probability of using agricultural crop waste and increase the possibility of using wood for the purpose of cooking. However, [37] divulging that low-income households are highly exposed to indoor air pollution because of using unclean fuel for cooking. Likewise, the coefficient of building type was positively and negatively significant for gas, kerosene, wood and animal dung, respectively.…”

Section: Health Effects On Different Sitesmentioning

confidence: 99%

Perceived Health Risks of Exposure to Indoor Air Pollution from Cooking Fuels in Sindh, Pakistan

Rajper¹,

Nazir²,

Ullah³

et al. 2020

Pol. J. Environ. Stud.

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About 50% of the world's low-income population uses biomass fuel as their primary source for cooking [1], while the usage is even higher in developing countries. The burning of biomass fuel emits pollutants into the air, which are detrimental to human health. Some of those pollutants are suspended particulate matter, carbon monoxide, polyaromatic hydrocarbons, formaldehyde, and volatile organic compounds [2]. These pollutants can cause many health diseases in humans, specifically respiratory problems such as chronic bronchitis [3] and bronchial asthma, and can cause tuberculosis and abnormalities in newborns [4, 5]. The use of solid fuels for cooking in rural areas of developing countries cannot be denied because it is used in many forms such as coal, charcoal, wood, straw, dung cakes, and agricultural crop residues [3]. Furthermore, due to limited alternative sources of fuel in rural areas of Pakistan people are heavily relying on solid fuel for cooking. Mostly women and children

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Role of poverty in fuel choice and exposure to indoor air pollution in Pakistan

Cited by 30 publications

References 6 publications

Household air pollution from use of cooking fuel and under-five mortality: The role of breastfeeding status and kitchen location in Pakistan

Household air pollution from use of cooking fuel and under-five mortality: The role of breastfeeding status and kitchen location in Pakistan

Recurrence of WHO-defined fast breathing pneumonia among infants, its occurrence and predictors in Pakistan: a nested case–control analysis

Perceived Health Risks of Exposure to Indoor Air Pollution from Cooking Fuels in Sindh, Pakistan

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