Household use of biomass fuel, especially traditional stove is associated with childhood wheeze and eczema: a cross sectional study of rural communities in Kandy, Sri Lanka

Abstract

Background

Most households in low- and middle-income countries (LMICs) rely on biomass fuel for daily cooking. Studies investigating the association between early life exposure to household air pollution and health outcomes in children in LMICs are limited.

Objective

To investigate the effects of biomass fuel for cooking and different types of stoves on wheeze and allergies in children of rural Sri Lankan communities.

Methods

A cross-sectional study was conducted on 452 children aged 5 years and younger in Kandy, Sri Lanka. Mothers completed a questionnaire on the use of biomass fuel and respiratory and allergic outcomes in children. The associations between biomass fuel and outcomes were analyzed using logistic regression models, adjusting for potential confounders.

Results

Use of biomass fuel for cooking was associated with increased risk of childhood wheeze (aOR 2.29; 95% CI 1.04–5.08) and eczema (aOR 4.57; 95% CI 1.24–16.89) compared with households that used clean fuel (liquid petroleum gas (LPG), electricity and/or biogas). Among households that used biomass fuel, use of traditional biomass stoves was associated with a higher risk of childhood wheeze (aOR 2.95; 95% CI 1.19–7.33), allergic rhinitis (aOR 3.01; 95% CI 1.42–6.39), and eczema (aOR 7.39; 95% CI 1.70–32.06) compared with households that used clean stoves.

Conclusion

Children living in households that use biomass fuel, especially traditional biomass cookstoves, have a higher risk of wheeze and allergic diseases. Access to affordable clean energy sources that reduce air pollution may help improve the health of children in rural LMICs.

Supplemental data for this article is available online at at www.tandfonline.com/ijas .

Keywords:

• Household air pollution
• biomass fuel
• wheeze
• eczema
• rhinitis
• allergies
• children
• Sri Lanka
• low-middle-income country

Acknowledgements

We would like to acknowledge the support of the University of Peradenyia and National Institute of Fundamental Studies in Sri Lanka. We are thankful Provincial Director of Health Services, Kandy, the Medical Officer of Health in Udunuwara and Gampola for granting us permission to conduct research in these areas. We would like to thank all the data collectors for their hard work which was critical in completing fieldwork as well as the local midwife. We also thank Mr Sajith Priyankara and Mr Mahesh Senaratna for statistical support. We are thankful to all the people who lived in the communities we conducted data collection in. Finally, we would like to thank the University of Melbourne and Australian Federal Government for providing us with the New Colombo Plan for providing scholarships.

Disclosure statement

AJL and SCD hold an investigator-initiated grant from GlaxoSmithKline for unrelated research. SCD holds an investigator-initiated grant from AstraZeneca for unrelated research. AJL has received non-financial support from Primus Pharmaceuticals for unrelated research. All other authors declare no competing interests.

Funding

This work was supported by the New Colombo Plan Scholarship Program of Australian Federal Government.