Effect of cooking conditions on lung health in Kisinga Subcounty, Kasese district, Uganda
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It is estimated that around the world there is 11,000 deaths daily and nearly 4.3 million premature deaths per year because of the effects of unhealthy indoor air quality especially from wood fuel. The burning of wood fuels produces toxic compounds like Carbon monoxide (CO), Sulphur dioxide (SO2), Nitrogen dioxide (NO2), Carbon dioxide (CO2) gases and, most importantly, coarse and fine particulate matter which can infiltrate the airways, go deep into the lungs of those exposed to it and cause lung complications. While human health in developing countries is greatly affected by the use of wood fuels, information on pollutant exposures, specific health effects, control technologies and health interventions is much scarcer compared to developed countries. The study was conducted to assess the effect of cooking conditions on lung health, factors that influence exposure to pollutants. Factors that influence exposure studied were ventilation, cooking time, type of stove (two pot rocket Lorena and single pot shielded mud stoves. Measurements were made on 30 minutes basis for both before and during cooking using Multi-gas Monitor, Particle counter for PM2.5 and PM10. A health survey checklist was used to obtain respondents’ background information and exposure history. In addition, Lung function measurements including forced vital capacity FVC, forced expiratory volume in one second FEV1 and FEV1/FVC Ratio the amount of air you exhale in one second and the total amount of air you are able to exhale were assessed and compared using a Spirometric examination. There was a significant difference between IAQ studied for both before cooking and during cooking for all parameters measured (P<0.05) in all the three villages at different altitudes. It was found that PM2.5 gas concentrations in the traditional open fires exceeded baseline values by a large margin (on average by a factor of about ten to twenty times). The burning of wood fuel in poorly designed two pot rocket lorena and single pot shielded mud stoves during cooking, resulted in 24-hr mean concentrations that were ten or more times greater than what is recommended by the WHO on indoor air quality . Respondents with healthy lungs had a mean of FEV1% and FVC% of 98.8 (SD=16.7) and 104.5 (SD=16.2), and a mean ratio of FEV1/FVC of 0.81 (SD=0.08), greater than the threshold of 0.7, FEV1/FVC ratio below 0.7 was11.9% and FVC% and FEV1% predicted values were significantly lower among studied group. The mean hours spent cooking indoors is 4.7 (SD=1.5) vs 5.3 (SD=1.9). Hours spent cooking was the only factor associated with increased xii exposure to PM10 (P=0.008) with mean hours equal to 5.0 (SD=1.4) and 4.2 (SD=1.8). Ventilation was significantly associated with increased exposure to NO2 (P=0.005) and C0 (P=0.068. In conclusion, there were high levels of particulate matter and gas pollutions in most of the households beyond WHO permissible limits. Levels of pollutants were influenced by a number of factors which included: altitude, type of stove, wood species, kitchen ventilation and time spent cooking. In general, the exposure period was associated with risk of lung health effects in most households. Ensure that an improved energy-saving cook stove is part of the requirements for each household and other training institutions and create efficient energy-saving cook stove hubs in all trading centres in the district. Promote multi stakeholder participation in improved energy-saving cook stove projects so as to promote acceptance, ownership and behavioural change among the community. And rocket stove should be designed based on an elbow pipe, chimney of 1-2m high which further improves efficient burning and reducing smoke.