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Household fuels, low birth weight, and neonatal death in India: the separate impacts of biomass, kerosene, and coal
Authors: Epstein MB, Bates MN, Arora NK, Balakrishnan K, Jack DW, Smith KR.
Source: International Journal of Hygiene and Environmental Health, 216(5):523-32. doi: 10.1016/j.ijheh.2012.12.006. Epub 2013 Jan 21.
Topic(s): Birth weight
Environment and natural resources
Household solid fuel use
Neonatal mortality
Country: Asia
Published: AUG 2013
Abstract: We examined the impact of maternal use of different household cooking fuels in India on low birth weight (LBW < 2500 g), and neonatal mortality (death within 28 days of birth). Using cross-sectional data from India's National Family Health Survey (NFHS-3), we separately analyzed the prevalence of these two outcomes in households utilizing three types of high-pollution fuels for cooking – biomass, coal, and kerosene – using low-pollution fuels (gas and biogas) as the comparison “control” group. Taking socioeconomic and child-specific factors into account, we employed logistic regression to examine the impact of fuel use on fetal and infant health. The results indicate that household use of high-pollution fuels is significantly associated with increased odds of LBW and neonatal death. Compared to households using cleaner fuels (in which the mean birth weight is 2901 g), the primary use of coal, kerosene, and biomass fuels is associated with significant decreases in mean birth weight (of -110 g for coal, -107 g for kerosene, and -78 g for biomass). Kerosene and biomass fuel use are also associated with increased risk of LBW (p < 0.05). Results suggest that increased risk of neonatal death is strongly associated with household use of coal (OR 18.54; 95% CI: 6.31–54.45), and perhaps with kerosene (OR 2.30; 95% CI: 0.95–5.55). Biomass is associated with increased risk of neonatal death among infants born to women with no more than primary education (OR 7.56; 95% CI: 2.40–23.80). These results are consistent with a growing literature showing health impacts of household air pollution from these fuels. Keywords • Indoor air pollution; • Household air pollution; • NFHS-3; • Solid fuel