Cooking fuel and symptoms of chronic respiratory disease in ageing adults: Evidence from West Africa and North America

BackgroundThe combustion of solid fuels (e.g., wood, coal, and charcoal) for cooking fuel is widespread in low- and middle-income countries. The use of these fuels increases exposure to airborne pollutants which have been shown to increase the risk of disease and premature death, particularly among older individuals. Despite this, most studies examining this association come from India and China. Furthermore, few studies have examined this association among the elderly. This study aims to fill this gap by examining the association between household cooking fuel and chronic respiratory disease. MethodsWe analyzed data from Wave 2 of the World Health Organizations Study on Global Ageing and Adult Health. Our study sample consists of 7,253 adults aged 50+ from Mexico and Ghana. Logistic regression was conducted to study the association between chronic respiratory disease (measured by whether the participant reported having either (1) a medical diagnosis for chronic obstructive pulmonary disorder, chronic bronchitis, or emphysema, or (2) symptoms suggesting chronic lung infection), and the main cooking fuel used by the household. ResultsThe prevalence of chronic respiratory disease was 6.55% and 17.45% for Ghana and Mexico, respectively. 15.96%, and 22.47% of participants lived in households using solid fuels for cooking. Adjusting for covariates, solid fuel use was associated with 1.72 (95%CI: 1.07-2.79; p=0.026) times higher odds of chronic respiratory disease. Regional disparities were found, with individuals in Mexico and Ghana respectively having 1.70 (95%CI:1.01-2.89; p=0.049) and 3.40 (95%CI:1.50-7.72; p=0.004) higher adjusted odds for chronic respiratory disease. ConclusionsOur results confirm the association found between the use of solid fuels and increased chronic respiratory disease risk. These findings demonstrate the salience of improving access to clean cooking fuels and methods, especially for households in the sub-Saharan region, particularly, women. Policy interventions need to capture the unique needs of women to ensure that health outcomes from energy use are well-mitigated.