Effects of cooking fuel sources on the respiratory health of children: evidence from the Annual Health Survey, Uttar Pradesh, India

Objectives: India is predominantly a rural country, where more than two-thirds of the population live in rural areas. The majority of the rural population use crop residue, firewood, and dung cake as cooking fuel sources. Combustion of these fuels emits life-threatening pollutants that contaminate the household environment, which can have serious health consequences, especially for young children. This study examines the use of cooking fuel sources and their association with acute respiratory infections (ARIs) in children aged 0-59 months. Study design: This study used data from the second update of the Annual Health Survey (2012-13). The prevalence rate was measured in terms of the number of children per 1000 children suffering from ARIs. Bivariate analysis was used to Wanalyze the use of different cooking fuels (in percentage) and the prevalence of ARIs in Uttar Pradesh. Methods: District-level variations in the cooking fuels used were assessed by simple bivariate analysis for all districts of Uttar Pradesh. A logistic regression was used to examine the association of household environment and pollutants with ARIs. Results: In total, 89 per 1000 children suffered from ARIs in Uttar Pradesh. Infants (0-11 months) were significantly more likely to suffer from ARIs than older children (12-59 months). Households using dung cake for cooking and kerosene and other oils for lighting were found to have significantly higher odds for ARIs (odds ratio [OR]: 1.21; 95% confidence interval [CI]: 1.17-1.25 and OR: 1.07; 95% CI: 1.05-1.10, respectively). A considerable interdistrict difference was observed in the cooking fuel used and the prevalence of ARIs among children aged 0-59 months. Conclusions: The type of cooking fuel and lighting source used were found to be significant predictors of ARIs among children aged 0-59 months. These results highlight the need for targeted efforts for the provision of clean cooking fuels (liquid petroleum gas/biogas/electricity) and for the improvement in knowledge and awareness of ARIs and exposure to cooking and lighting pollution. (c) 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.