Association Between Solid Cooking Fuels and Respiratory Disease Across Socio-Demographic Groups in India

Assessment of the association between health problems and cooking fuel type, and barriers towards clean cooking among rural household people in Bangladesh

BACKGROUND

In low- and middle-income countries, households mainly use solid fuels like wood, charcoal, dung, agricultural residues, and coal for cooking. This poses significant public health concerns due to the emission of harmful particles and gases. To address these issues and support Sustainable Development Goals (SDGs), adopting cleaner cooking fuels like electricity and gas are acknowledged as a viable solution. However, access to these cleaner fuels is limited, especially in rural areas.

METHODS

This study conducted a face-to-face survey with 1240 individuals in rural Bangladesh to explore the link between health issues and cooking fuel type, as well as barriers to transitioning to clean cooking. Using a convenient sampling technique across four divisions/regions, the survey gathered socio-demographic and health data, along with information on clean cooking barriers through a semi-structured questionnaire. Binary and multivariable logistic regression analyses were then employed to identify significant associations between cooking fuel type and health problems.

RESULTS

The study revealed that a majority of participants (73.3%) relied on solid fuel for cooking. The use of solid fuel was significantly correlated with factors such as lower education levels, reduced family income, location of residence, and the experience of health issues such as cough, chest pressure while breathing, eye discomfort, diabetes, asthma, and allergies. Economic challenges emerged as the foremost obstacle to the adoption of clean cooking, accompanied by other contributing factors.

CONCLUSION

The use of solid fuel in rural Bangladeshi households poses substantial health risks, correlating with respiratory, eye, cardiovascular, and metabolic issues. Lower education and income levels, along with specific residential locations, were associated with higher solid fuel usage. Economic challenges emerged as the primary obstacle to adopting clean cooking practices. These findings emphasize the need for implementing strategies to promote clean cooking, address barriers, and contribute to achieving Sustainable Development Goal targets for health and sustainable energy access in Bangladesh.

Performance evaluation of national healthcare systems in the prevention and treatment of non-communicable diseases in sub-Saharan Africa

BACKGROUND

Non-communicable diseases (NCDs) remain a major public health concern globally, threatening the achievement of sustainable development goal 3.4 (SDG 3.4), which seeks to reduce premature NCD-related deaths by one-third by 2030. According to the World Health Organization (WHO), improving the efficiency of NCD spending (i.e., maximizing the impact of every dollar spent on NCDs) is one of the strategic approaches for achieving SDG target 3.4. This study aims to assess the efficiency and productivity of NCDs spending in 34 sub-Saharan African (SSA) countries from 2015 to 2019.

METHODS

The study employed the data envelopment analysis (DEA) double-bootstrap truncated and Tobit regressions, one-stage stochastic frontier analysis (SFA) model, the Malmquist productivity index (MPI), and spatial autocorrelation analysis to estimate NCDs spending efficiency, identify the context-specific environmental factors that influence NCDs spending efficiency, evaluate total productivity change and identify its components, and assess the spatial interdependence of the efficiency scores.

RESULTS

The estimated average DEA bias-corrected NCD spending efficiency score was 87.3% (95% CI: 86.2-88.5). Additionally, smoking per capita, solid fuel pollution, alcohol use, governance quality, urbanization, GDP per capita, external funding for NCDs, and private domestic funding for NCDs healthcare services were found to be significantly associated with NCDs spending efficiency. The study also revealed a decline of 3.2% in the MPI, driven by a 10.6% technical regress. Although all countries registered growth in efficiency, except for the Central Africa Republic and DR Congo, the growth in efficiency was overshadowed by the decline in technical change. Global Moran's I test indicated the existence of significant positive spatial autocorrelation in the efficiency of NCDs spending across SSA countries.

CONCLUSION

The study underscores the importance of efficient use of resources in NCDs treatment and prevention and increased investment in NCDs research and development in achieving the SDG target 3.4.

Trends of ischemic heart disease mortality attributable to household air pollution during 1990-2019 in China and India: an age-period-cohort analysis

Cardiovascular diseases (CVD) caused by household air pollution (HAP) have sparked widespread concern globally in the recent decade. Meanwhile, increased ischemic heart disease (IHD) mortality has been the leading cause of worldwide CVD deaths. Both China and India experienced a high IHD burden and high exposure to HAP. The present study aimed to estimate and compare the long-term trends of HAP-attributable IHD mortality in the two countries. The data of this study were extracted from the Global Burden of Diseases (GBD) Study 2019. The age-period-cohort (APC) analysis was utilized to estimate the independent trends of the age, period, and cohort effects from 1990 to 2019. The age-standardized mortality rates (ASMRs) of HAP-attributable IHD have fallen faster in China than in India for both sexes. The local drift and net drift values were < 0 for all age groups in both countries. The age effects in both countries and sexes increased with time, suggesting age is a risk factor for IHD; conversely, period and cohort effects in China demonstrated a faster decline in both genders than in India. It indicated that China has been more successful than India in decreasing HAP-attributable IHD mortality.

Health damage to housewives by contaminants emitted from coal combustion in the Chinese countryside: focusing on day-to-day cooking

PURPOSE

The study aimed to estimate the health damage and find out the main exposure pathways of housewives posed by polycyclic aromatic hydrocarbons (PAHs) and heavy metals (HMs) from coal combustion in rural areas of China.

METHODS

We obtained the concentrations of 16 PAHs and 8 HMs from published literatures and the Monte Carlo simulation was used to process and analysis the data. Sensitivity analysis was also applied to clear parameter uncertainty and the health damage of housewives was quantitatively evaluated by loss of life expectancy.

RESULTS

Housewives' carcinogenic risks from PAHs exposure were in descending order of inhalation > ingestion > dermal contact, while exposed to HMs were ingestion > dermal contact > inhalation. The carcinogenic risks from PAHs primarily originated from benzo[a]pyrene (BaP), dibenz[ah]anthracene (DahA) and benzo[b]fluorathene (BbF). For HMs, arsenic posed the highest carcinogenic risk to housewives, with a contribution of 92.98%. In addition, the life expectancy loss of housewives exposed to PAHs was 469.04 min from inhalation and 51.82 min for HMs from ingestion.

CONCLUSION

Through a comprehensive assessment of the health risks in housewives exposed to emissions from coal combustion, we can gain insight into the hazards from PAHs and HMs in housewives, and take measures to reduce their exposure risks.

Advances in asthma genetics

While asthma has a strong genetic component, our current ability to systematically understand and predict asthma risk remains low, despite over a hundred genetic associations. The reasons for this unfilled gap range from technical limitations of current approaches to fundamental deficiencies in the way we understand asthma. These are discussed in the context of genomic advances.

Air pollution and chronic obstructive pulmonary disease

There is considerable epidemiological evidence indicating that air pollution has adverse effects on human health and is closely related to respiratory diseases, including chronic obstructive pulmonary disease (COPD). These effects, which can be divided into short- and long-term effects, can manifest as an exacerbation of existing symptoms, impaired lung function, and increased hospitalization and mortality rates. Long-term exposure to air with a high concentration of pollutants may also increase the incidence of COPD. The combined effects of different pollutants may become more complex in the future; hence, there is a need for more intensive research on specific at-risk populations, and formulating corresponding protective strategies is crucial. We aimed to review the epidemiological evidence on the effect of air pollution on COPD, the possible pathophysiological mechanisms underlying this effect, as well as protective measures against the effects of air pollutants in patients with COPD.