Effect of Indoor Air Pollution on Acute Respiratory Infection among Children in India

Kumar Ashwani, Paul Kalosona


Indoor Air Pollution (IAP) has become a major concern in India in recent years because women and young children are highly exposed to smoke of various types of unclean fuels used for cooking and heating in the household result into risk of respiratory disorders among them. The paper aims to seek association between prevalence of acute respiratory infection (ARI) among children less than five years of age and use of cooking fuels in households of India. The analysis is based on 52,868 Children less than five years of age included in India's third National Family Health Survey conducted in 2005-2006. Effects of exposure to cooking smoke, determined by the type of fuel used for cooking such as biomass and solid fuels versus cleaner fuels, on the reported prevalence of ARI were estimated using multivariate logistic regression. Since the effects of cooking smoke are likely to be confounded with effects of tobacco smoking, age, and other such factors, the analysis was carried out after statistically controlling for such factors. The results indicate that Children under five years of age living in households using biomass and solid fuels have a significantly higher risk of ARI than those living in households using cleaner fuels (OR: 1.54; 95%CI: 1.38-1.72; p = .010). The findings have important program and policy implications for countries such as India, where large proportions of the population still rely on polluting biomass fuels for cooking and heating. Decreasing household biomass and solid fuel use and increasing use of improved stove technology may decrease the health effects of indoor air pollution. More epidemiological research with better measures of smoke exposure and clinical measures of ARI is needed to validate the findings.


fuel, indoor, ARI, Under five children, India

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Acharya D, Prasanna K.S., Nair S & Rao R. S. (2003). Acute respiratory infections in children: A community based longitudinal study in south India. Indian J Public Health, 47:7–13. [PubMed]

Barnes D. F., Openshaw K, Smith K. R. & Van der Plas R. (1993). The design and diffusion of improved cookstoves. World Bank Research Observer, 8(2):119–141.

Broor S, Pandey R.M., Ghosh M, Maitreyi R. S., Lodha R, Singhal T, et al. (2001) Risk factors for severe acute lower respiratory tract infection under-five children. Indian Pediatr, 38:1361–9. [PubMed]

Bruce, N., Perez-Padilla R. and Albalak R. (2000). Indoor air pollution in developing countries: a major environmental and public health challenge for the new millennium.∫ Bulletin of the World Health Organization 78 (9): 1078 ± 1092.

Desai, M. A., Mehta, S., & Smith, K. (2004). Indoor smoke from solid fuels Assessing the environmental burden of disease at national and local levels. Environmental Burden of Disease Series, (4), 675-740.

ENHIS, (2009). Proportion of children living homes using solid fuels. European Environmental and Health Information System. Fact sheet 3.6, December 2009, Code: rpg3_hous_ex3 Available from: http://www.euro.who.int/__data/assets/pdf_file/0006/97008/3.6.-Homes-with-solid-fuels-EDITED_layouted_V3.pdf?ua=1 accessed on 16 July 2014.

Ezzati M & Kammen D. M. (2001). Quantifying the effects of exposure to indoor air pollution from biomass combustion on acute respiratory infections in developing countries. Environmental Health Perspectives, 109(5):481–488

Global health risks. (2009) Mortality and burden of disease attributable to selected major risks. World Health Organization, Geneva. http://unstats.un.org/unsd/mi/pdf/mdg%20book.pdf

IIPS and ORC Macro. (2007). National Family Health Survey (NFHS-3), 2005-06: India. Mumbai: International Institute for Population Sciences.

Jain N, Lodha R & Kabra S. K. (2001). Upper respiratory tract infections. Indian J Pediatr, 68:1135–8. [PubMed]

Ladomenou F, Moschandreas J, Kafatos A, Tselentis Y & Galanakis E. (2010). Protective effect of exclusive breastfeeding against infections during infancy: A prospective study. Arch Dis Child, 95:1004–8. [PubMed]

Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., ... & Aryee, M. (2013). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet, 380(9859), 2224-2260.

Mehta S et al. (2006). Modelling household solid fuel use towards reporting of the Millennium Development Goal indicator. Energy for Sustainable Development, 10(3): 36–45 Available from: http://www.who.int/indoorair/mdg/esdmodellingsolidfueluse.pdf, accessed 17 July 2014.

Million Death Study Collaborators. (2010). Causes of neonatal and child mortality in India: a nationally representative mortality survey. The Lancet, 376 (9755), 1853-1860. Available from: (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61461-4/abstract ) accessed 18 July 2014.

Mishra, V. (2003) Effect of Indoor air pollution from Biomass Combution on prevalence of Asthma in the Elderly, Environ Health perspective, 111: 71-77.

RGI (2003). Report on Cause of Death in India 2001-03, Census Commissioner of India, Ministry of Home Affairs (MoHA), Government of India. Available from: http://www.cghr.org/wordpress/wp-content/uploads/Causes_of_death_2001-03.pdf accessed 20 July 2014.

RGI (2011). Provisional Population Total. Census Commissioner of India, Ministry of Home Affairs (MoHA), Government of India.

Savitha M. R., Nandeeshwara S. B., Kumar M. J., Ul-Haque F & Raju CK. (2007). Modifiable risk factors for acute lower respiratory tract infections. Indian J Pediatr, 74:477–82. [PubMed]

Smith K. R. (1987). Biofuels, air pollution, and health: a global review. New York, Plenum.

Smith K. R. (1989). The dialectics of improved stoves. Economic and Political Weekly, 24(10):517–522.

Smith KR, Mehta S, Feuz M. (2004). Indoor air pollution from household use of solid fuels. In: Ezzati M et al., eds. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. Geneva, World Health Organization.

Smith, K. R. & Mehta, S. (2003). The burden of disease from indoor air pollution in Developing countries: comparison of estimates, Int. J. Hyg. Environ. Health, 206: 279-289.

Smith, K. R. (2000). National burden of Disease in India from Indoor air pollution, Proceedings of the National Academy of Sciences of the United States of America, 97:13286-13293.

Subramanian, S. V., Subramanyam, M. A., Selvaraj, S., & Kawachi, I. (2009). Are self-reports of health and morbidities in developing countries misleading? Evidence from India. Social science & medicine, 68(2), 260-265.

UNDP. (2005). The Millennium Development Goals Report 2005. United Nations. Retrieved from

Vashishtha V. M. (2010). Current status of tuberculosis and acute respiratory infections in India: Much more needs to be done! Indian Pediatr, 47:88–9. [PubMed]

Wiley Online Library (2013). Handwashing and risk of respiratory infections: A quantitative systematic review-Rabie-2006- Tropical Medicine and International Health. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j. 1365-3156.2006.01568.x/pdf , accessed 11March 2014.

World Health Organization. (2006). Fuel for life: household energy and health, WHO, Geneva. Available from http://www.who.int/indoorair/publications/fuelforlife.pdf . html

World Health Organization. (2002). World Health Report: Reducing Risks, Promoting Healthy Life. Geneva, WHO.

World Health Organization. (2005). Indoor air pollution and health. WHO, Geneva, (Fact Sheet No 292) Available from: http://www.who.int/mediacentre/factsheets/fs292/en/index.html, accessed 17 July 2014).

World Health Organization. (2007). Indoor air pollution: national burden of disease estimates. WHO, Geneva. Available from http://www.who.int/indoorair/publications/indoor_air_national_burden_estimate_revised.pdf, accessed 17 July 2014).

DOI: http://dx.doi.org/10.12955/snsj.v10i2.885


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