Household Air Pollution from Cooking in Madagascar: Effects of Wood Smoke Exposure on Respiratory Health

Abstract

Background: Approximately 3.8 million people die annually from illnesses caused by household air pollution (HAP). Cooking related HAP is the second leading cause of disease in Madagascar. Our exploratory study aims to examine the effect of cooking fuel smoke exposure on lung function and respiratory symptoms.Methods: A cross-sectional study was conducted in Mandena, Madagascar from 2016 through 2018. Adults aged ≥18 years completed a survey on respiratory symptoms and cooking habits and performed spirometry for FEV1 and FEV6 values. Results: Of the 140 participants, 95 individuals were included in the multiple regression model. Being the primary cooks was significantly associated with decreasing FEV1 (-0.30; 95% CI: -0.57, -0.04) and FEV6 (-0.32, 95% CI: -0.57,-0.06). Cooking indoors significantly decreases FEV6 compared to cooking outdoors (-0.26, 95% CI: -0.50,-0.03). Conclusion: Reduced lung function and increased respiratory disease are most common among primary cooks. Reduced lung function was associated with cooking indoors. Further studies are essential to investigate HAP’s effect on Madagascar communities.