The association between biomass fuel use for cooking and linear growth in young children in Bhaktapur, Nepal

Risk assessment of unclean cooking energy usage from the perspective of subjective wellbeing: The mediating role of perceived physical and mental health

Although outdoor air pollution has been associated with adverse health outcomes and decreased subjective welfare, there has been a lack of research investigating the potential risks associated with indoor unclean cooking energy usage from the perspective of subjective wellbeing. This paper systematically assesses the risks of unclean cooking fuel usage from the novel perspective of subjective welfare and examines the mediating role of perceived physical and mental health applying a large-scale nationally representative dataset. Analytical results demonstrate that the usage of unclean cooking energy has significantly negative impacts on subjective wellbeing, and this finding has been confirmed through various robustness tests. The mechanism behind this impact is that unclean cooking fuel usage reduces people's perceived physical and mental health status, which in turn decreases their subjective wellness. Furthermore, the negative consequences of using unclean cooking energy on subjective wellbeing are particularly pronounced among certain demographic groups, including older, lower educated, married individuals as well as those with lower economic status, uncovered by medical insurance and having less social capital. Findings of this study highlight the risks linked to unclean cooking energy usage, as evidenced in the negative impact on perceived health and subjective wellbeing. In light of the increasing focus on improving indoor environment as well as enhancing people's health and wellbeing, results of this paper emphasize the significance of promoting access to cleaner and healthier energy.

Impact of indoor Air Pollution on the Linear growth of children in Jimma, Ethiopia

BACKGROUND

Stunting in children is the term for reduced linear growth and development, which is frequently brought on by a persistently inadequate diet, recurrent infections and chronic diseases or poor health conditions. Apart from the classic covariates of stunting, which include diet and illness, the relative contribution of household air pollution to chronic nutrition conditions is least studied. Hence, this study is conducted to investigate the impact of household air pollution on the linear growth of under-five children in Jimma town, Ethiopia.

METHODS

A prospective cohort study was employed to collect data from 280 under-five children who lived in households using solid fuel (exposed group, n = 140) and clean fuel (unexposed group, n = 140). Height-for-age Z scores were compared in both groups over a 12-month follow-up period. The difference in differences estimators were used for comparison of changes in the height-for-age Z scores from baseline to end line in exposed and non-exposed groups. The independent effect of the use of solid fuels on height-for-age Z scores was analyzed through a multivariable linear regression model. Statistical Significances were declared at P < 0.05 and 95% CI level.

RESULTS

In an unadjusted model (Model 1), compared with the clean fuel type, the mean difference in the height-for-age Z score of children in households using solid fuel was lower by 0.54 (-0.54, 95% CI -0.97, -0.12, P = 0.011). The beta coefficient remained negative after adjusting for age and sex (Model 2 -0.543, 95% CI -1.373, -0.563) and sociodemographic variables (Model 3: -0.543, 95% CI -1.362, -0.575). In the final model (Model 4), which adjusted for wealth quantile, dietary practice, water, sanitation and hygiene status and household food insecurity access scale, the beta coefficient held the same and significant (beta: -0.543, 95% CI -1.357, -0.579, P < 0.001). Higher HAZ scores were observed among female child (β: = 0.48, 95%CI: 0.28, 0.69), Child with father attended higher education (β: = 0.304 95%CI: 0.304, 95% CI 0.19, 0.41) as compared to male gender and those who did not attend a formal education, respectively. In contrast, child living in households with poor hygiene practices had lower HAZ score (β: -0.226, 95% CI: -0.449, -0.003), P < 0.001.

CONCLUSIONS

Exposure to indoor air pollution was inversely related to linear growth. Furthermore, sex, educational status and hygiene were found relevant predictors of linear growth. In such a setting, there is a need to step up efforts to design and implement public education campaigns regarding the health risks associated with exposure to household air pollution. Promoting improvements to kitchen ventilation and the use of improved cooking stoves, which will help to mitigate the detrimental effects of indoor air pollution on child growth impairment and its long-term effects.

Household air pollution and childhood stunting in China: A prospective cohort study

Background

Exposure to air pollution, especially indoor air pollution, was associated with an increased risk of childhood stunting. However, few longitudinal studies have explored the long-term impacts of indoor air pollution from household solid fuel use on child growth. We aimed to investigate the association between household air pollution (HAP) from solid fuel use and childhood stunting in Chinese children.

Method

The longitudinal data from the Chinese Family Panel Study over 2010-2018 were included in this study with a total of 6,013 children aged 0-15 years enrolled at baseline. Exposure to HAP was measured as solid fuel use for cooking, while solid fuel was defined as coal and firewood/straw according to the questionnaire survey. Stunting was defined as-2SD below the height-for-age z-score (HAZ) of the reference children. Logistic regression and Cox proportional hazards models with time-varying exposures were employed to estimate the association between childhood stunting and HAP exposure.

Results

At baseline, children with exposure to HAP from combusting solid fuels had a relatively higher risk of stunting [OR (95%CI): 1.42 (1.24-1.63)]. Among children without stunning at baseline, those living in households with solid fuel use had a higher stunting risk over an 8-year follow-up [HR (95%CI): 2.05 (1.64-2.57)]. The risk of childhood stunting was increased for those with HAP exposure from firewood/straw combustion or with longer exposure duration [HR (95%CI): 2.21 (1.74-2.79) and 3.01 (2.23-4.08), respectively]. Meanwhile, this risk was significantly decreased among children from households switching from solid fuels to clean fuels [HR (95%CI): 0.53 (0.39-0.70)]. Solid fuel use was suggested to be a mediator of the relationship between poor socioeconomic factors (i.e., household income and parental education level) and childhood stunning, with a mediation effect ranging from 11.25 to 14.26%.

Conclusions

HAP exposure from solid fuel use was associated with childhood stunting. Poor parental education and low household income might be socioeconomic factors contributing to solid fuel use. Therefore, household energy policies to facilitate access to clean fuels are urgently needed, especially for low-income and low-educated households.

Assessing exposure to household air pollution in children under five: A scoping review

Understanding the differences in the approaches used to assess household air pollution (HAP) is crucial for evaluating HAP-related health effects and interpreting the effectiveness of stove-fuel interventions. Our review aims to understand how exposure to HAP from solid fuels was measured in epidemiological studies in children under five. We conducted a search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Global Health Library, Web of Science, and CINAHL to identify English-language research articles published between January 1, 2000 and April 30, 2022. Two researchers applied the inclusion and exclusion criteria independently. Study region, type of measurement, study design, health outcomes, and other key characteristics were extracted from each article and analyzed descriptively. Our search strategy yielded 2229 records, of which 185 articles were included. A large proportion was published between 2018 and 2022 (42.1%), applied a cross-sectional study design (47.6%), and took place in low- or lower middle-income countries. Most studies (130/185, 70.3%) assessed HAP using questionnaires/interviews, most frequently posing questions on cooking fuel type, followed by household ventilation and cooking location. Cooking frequency/duration and children's location while cooking was less commonly considered. About 28.6% (53/185) used monitors, but the application of personal portable samplers was limited (particulate matter [PM]: 12/40, 30.0%; carbon monoxide [CO]: 13/34, 38.2%). Few studies used biomarkers or modeling approaches to estimate HAP exposure among children under five. More studies that report household and behavioral characteristics and children's location while cooking, apply personal exposure samplers, and perform biomarker analysis are needed to advance our understandings of HAP exposure among infants and young children, who are particularly susceptible to HAP-related health effects.

Impact of the COVID-19 pandemic on daily life and worry among mothers in Bhaktapur, Nepal

The COVID-19 pandemic has affected many aspects of daily life worldwide, but the impact may be higher for impoverished populations. The main aim of this study is to describe the impact of the COVID-19 pandemic on different aspects of daily life in mothers in Nepal. We included 493 mothers of children aged 54-71 months participating in a randomized controlled trial on vitamin B12 supplementation. Mothers answered questions regarding the exposure and impact of the pandemic on their daily lives, and pandemic-related worries and sleep problems. We examined the extent to which worry, and sleep problems differed between mothers according to their exposure to COVID-19, socioeconomic status, and previous symptoms of depression. The mean age (SD) of the mothers was 32.3 (4.6) years and 54% had education below the secondary level. Of the mothers, 5.4% had either been exposed to someone who had tested positive or who had a family member with COVID-19. One-third of the participants responded that the pandemic had affected their economic situation, employment, and family life to a great deal. Both mothers and fathers with educational levels above 10 years or households with higher socioeconomic status had significantly higher average worry scores (maternal p = 0.020 and paternal p = 0.005). Mothers with a history of symptoms of depression had significantly more worry-related sleep problems during the pandemic (p = 0.020) than those without a history of depressive symptoms. Our study underlines the negative impact of the COVID-19 pandemic on diverse aspects of everyday life of mothers in Nepal.