Cooking fuel use and respiratory health of women and children in rural Ballabgarh, Haryana.

Background: Household air pollution arising from combustion of unclean fuels during cooking activities causes serious respiratory health effects. This study investigated patterns of household cooking fuel use and its effect on respiratory health status of women and children.

Methods: A cross-sectional study was conducted in rural households of Ballabgarh, Haryana during December 2019 to January 2020 among 18-45 years old women and their children having age between 6 and 59 months. A total of 450 households were selected using simple random sampling. Cooking fuel use was categorised as unclean (Wood, dung cakes, crop residues) and clean (LPG and electricity). The classification of mixed fuel use (predominantly unclean or clean) was based upon duration of unclean fuel use ≥ 2.5 h per day. The clinical history and physical examination was done using a semi-structured questionnaire. Assessment of respiratory health status of women participants was done using peak expiratory flow meter and presence of pneumonia in children was evaluated as per Integrated Management of Neonatal and Childhood Illnesses (IMNCI) guidelines.

Results: Overall use of unclean cooking fuels was predominant in 59.6% of households and 71.8% of households had mixed fuel use. Only clean fuel use was in 11.3% of households. Nasal stuffiness, breathing difficulty and cough were observed among 13.1%, 10.5% and 8.5% among women while the common respiratory symptoms in children were cough (27.8%) and runny nose (22.9%). As compared to clean fuels, women using unclean fuels were more likely to have any respiratory symptom (aOR 3.0, 95% CI: 1.5-6.0) and impaired pulmonary functions (adjusted OR 1.9, 95% CI: 1.2-2.9). Cooking fuel use was not associated with respiratory symptoms and presence of pneumonia in children living in the households.

Conclusion: Cooking with unclean fuel continues to be prevalent in the households of rural Ballabgarh and adversely affects the respiratory health of women indicating strengthening of initiatives promoting clean fuel use.