"This smoke will finish us": impacts of cooking with polluting fuels on air quality, health and education in three schools in Nairobi, Kenya

Links between cooking with polluting fuels (e.g., wood and charcoal), air pollution and health in domestic settings are well-established. However, few studies have been conducted in schools that rely on such fuels for catering. This study is the first investigation of air pollution, cooking, and health in schools in Nairobi, Kenya. We carried out an in-depth mixed-methods study in three schools (two primary schools and a college) in an informal settlement using wood and/or charcoal for catering. In each school, repeated 24-hour air pollution measurements (fine particulate matter (PM2.5) and carbon monoxide (CO)) were collected to assess concentrations in the main kitchen and a nearby classroom, in addition to personal exposure for the main cook. Surveys with catering staff collected data on perspectives on air pollution and health symptoms. Focus groups were conducted with catering staff, teachers and senior management to understand perceived impacts on health and the school environment. 24-hour levels of PM2.5 were found to surpass World Health Organization (WHO) interim target level 1 (IT-1) (35µg/m3) in all schools – with levels three times higher (107.6µg/m3) in classrooms, ten times higher (316.2µg/m3) in kitchens and nearly six times higher (200.9µg/m3) among cooks. Peak levels of pollution were closely linked to times of stove use, as concentrations doubled in classrooms and tripled in kitchens during cooking. Catering staff reported being concerned about their health, and reported experiencing wheezing, chest pains, eye irritation and headaches and attempted to avoid the smoke to reduce exposure. Disturbance to classes from cooking smoke was reported by teachers, with students reporting coughing and sneezing from exposure. Support is needed to enable clean cooking transitions in schools to create a healthy and safe learning environment.