Cooking Microenvironment and Health: A Cross-Sectional Study of Solid Fuels Users in Urban Slums in India

About half of the global population still depends on solid fuels for cooking and heating. Slum residents face a disproportionate risk to household air pollution (HAP) because of the dense population often residing in poorly ventilated houses. We conducted a cross-sectional study among solid fuel users to find out the association between 1) the cooking microenvironment and HAP related health symptoms and lung function 2) lung function (FEV1%pred) and shortness of breath among women. A total of 260 households were recruited. We found that leaks in the roof were significantly associated with higher odds of cough or cough while cooking, headache and burning eyes than no leaks in the roof. Dwelling type with an attached cooking area was significantly associated with higher odds of shortness of breath than dwelling type with cooking area within the living room. Objectively measured chronic obstruction of the lungs confirmed these observations. Interestingly, a higher FEV1%pred was associated with higher odds of shortness of breath. Our results indicate that people are less likely to experience HAP related symptoms when there is no or minimum exposure to outdoor air. Slums are complex settings where HAP cannot be addressed in isolation. Localized interventions such as, improved cookstoves in only a few slums may not considerably improve the ambient air quality, and thus, might not result in large health benefits for such densely-populated settings. We suggest housing structure improvements such as, completely closed walls and presence of windows for cross ventilation. Key words: [solid fuels, household air pollution, urban, slums, health].