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Consequences of household air pollution on child survival: evidence from demographic and health surveys in 47 countries
Authors: Lauren B. Kleimola, Archana B. Patel, Jitesh A. Borkar, and Patricia L. Hibberd
Source: International Journal of Occupational and Environmental Health, 6:2049396715Y0000000007; DOI:
Topic(s): Childhood mortality
Environmental health
Household solid fuel use
Country: More than one region
  Multiple Regions
Published: APR 2015
Abstract: Background: Over one-third of the world's population is exposed to household air pollution (HAP) from cooking with solid fuels. The magnitude of the effect of exposure to HAP on all-cause child mortality when kerosene is removed from the clean fuel group is not known, as kerosene's harmful effects have only recently been recognized. It is important to assess to the risks of exposure to HAP during the neonatal and post-neonatal periods separately as effects during the neonatal period are likely closely related to in utero exposure and during the post-neonatal period are more likely related to direct exposure of the child. Objectives: To quantify the separate effects of solid fuels and kerosene on all-cause child mortality in the neonatal and post-neonatal periods. Methods: We used Demographic and Health Surveys from 47 countries to study the risk of neonatal (0–28?days) and child (from 29?days to 59?months) mortality in homes cooking with solid fuels or kerosene versus clean fuels. We calculated adjusted relative risks (aRR) using Poisson regression models. Results: The aRR of neonatal and child mortality in households exposed to solid fuels were 1.24 (95% CI: 1.14, 1.34) and 1.21 (95% CI: 1.12, 1.30), respectively, and the aRR for neonatal and child mortality in households exposed to kerosene were 1.34 (95% CI: 1.18, 1.52) and 1.12 (95% CI: 0.99, 1.27), controlling for individual, household, and country-level predictors of mortality. Conclusions: Kerosene should not be classified as a clean fuel and the neonatal period is a high-risk period for mortality from exposure to solid fuels and kerosene.