The burden of indoor pollution affecting women in South Asia is underrepresented in the media

People | Human Health

By Isabel Rowbotham, Co-Editor in Chief

Published September 19th, 2023

Inefficient cooking fuels can produce indoor pollution and may lead to pregnancy concerns, infertility and sterilisation for women. In South Asian countries such as India, Pakistan and Bangladesh, particularly in rural areas, this type of pollution poses a considerable threat to women's health.

India in particular has one of the highest air pollution levels in the world. Exposure to unhealthy levels of ambient particulate matter less than 2.5 micrometres in diameter (PM2.5) from fossil fuel and biomass emissions can contribute to various diseases.

In urban centres throughout South Asia, households typically enjoy access to gas supplies in their kitchens. However, in certain rural regions where cooking relies on alternative fuels, there exists a potential for the population to face health hazards. | Michael Parfitt

South Asian women at risk of pollution

Population growth is a contributing factor to this issue. A major source of pollution comes from household cookstoves and rural areas are more likely to use alternative fuels such as firewood, coal, charcoal, dung, crops, or straw. This is due to a lack of energy infrastructure, almost no electrification and a dilapidated network of gas pipelines that has struggled to keep up with population demand.

The use of these cooking biomass fuels poses a risk to women in India and various South-Asian countries. With 65% of people in India, 143 million in Pakistan (65%) and 100 million (60.6%) in Bangladesh living in rural areas, the health repercussions to the population are concerning, especially in the context of extreme and dry weather during the summer season.

A study published in 2022 aimed to analyse the impacts of biomass fuels on women's health, specifically pregnancy and sterilisation in Pakistan, India and Bangladesh. The study is particularly important given that most women in South Asia bear complete responsibility for cooking in their households.

‘…rural areas are more likely to use alternative fuels such as firewood, coal, charcoal, dung, crops, or straws.’

The use of inefficient cooking oils can have a direct impact on a person’s respiratory system, but other factors may be at play such as kitchen ventilation, and exposure to pollutants during other chores such as cleaning and cattle farming. Combine this with India’s crop burning, women and girls are the central victims of pollution exposure due to their spending more time indoors.

Another study on the effects of cooking oil exposure was carried out in southern Bangladesh. This study indicated that the potential for pollution was drastically reduced in areas with ventilation, and the practice of frying compared to boiling food further pointed to the use of biomass fuels for cooking using traditional mud stoves and gas stoves.

Ventilation in kitchen areas may help dissipate fumes from cooking that carry PAH pollutants..| Michael Parfitt

Moreover, a study into aerosols identified the air pollutants, particularly PM2.5, PM1, PM0.5 and PM0.1 derived from biomass fuel combustion, were significantly higher during cooking than non-cooking periods.

Air pollution may be affecting fertility

Sterilisation is a massive concern. According to Rochon M., ‘sterility usually refers to an inability to produce a live child, while infertility is the failure to conceive after one year without contraception.’ While air pollution may impact both, it may also lead to an increased risk of bearing children with birth defects as well as a variety of health problems and potential pregnancy termination.

The study found the use of biomass fuels as a causal factor for sterilisation in women. For terminated pregnancies, the difference between cooking in the house and cooking in a separate building was significant.

‘The study found the use of biomass fuels as a causal factor for sterilisation in women.’

The issue of infertility is a great source of anxiety and depression in women and a major source of cultural trauma. Stress plays a key role in infertility, as well as problems during pregnancy.

While this paints a terrifying picture for all those living in India and Southeast Asia, women in rural areas find themselves in particular danger. Women received more discrimination when receiving proper health care compared to their male counterparts, which are still rooted in health inequalities and are accentuated in rural areas.

Lung cancer is the main focus in air pollution prevention, however, its effects on women’s health such as fertility may cost us dearly. | Michael Parfitt

Why India may have the worst air pollution

India’s air pollution problem has been intrinsically linked to the monsoon season. Firstly, aerosols can indirectly affect precipitation formation by reducing the amount of solar radiation from reaching the Earth’s surface.

Previous research has shown that India’s location, the Indo-Gangetic Plain, is an aerosol ‘super hotspot’ for air pollution; this mechanism is guided by heavy aerosol loading adjacent to regions of abundant atmospheric moisture, i.e. oceans or tropical forests.

‘India’s air pollution problem has been intrinsically linked with the monsoon season.’

During the summer months, the aerosols from the Thar Desert and the Middle East deserts are at their highest concentrations and they combine with the atmospheric moisture during the pre-monsoon months.

An air pollution hotspot in India

Scientists have identified the ‘Gateway of Northeast’ India as the city of Siliguri, which is a major hotspot of air pollution in West Bengal, India. Again, climate conditions are closely linked to this phenomenon.

Additional research is needed in other indoor contaminant parameters such as PM10, formaldehyde, carbon monoxide and metals, to assess the health risks. | Michael Parfitt

The study pointed to a rise in the concentration of ammonia (NH3)- associated with vehicle air pollution in Siliguri city, despite other major air pollutants shown to be lowering. Levels of PM2.5 and PM10 were positively affected by the high temperature and humidity experienced. However, dry air with reduced humidity aggregates greater pollutants in urban environments, hence why winter has the highest concentrations of air pollutants.

Infertility has already been identified as a consequence of fossil fuel pollution by previous sources, and socioeconomic factors cannot be considered the sole factor in falling birth rates. Studies have shown pollutants have been reported in human tissues including blood, urine, semen, placenta and breast milk and a major course of endocrine disruption.

The burden of infertility should not fall on the shoulders of women. Countries like India are looking seriously into the topic of endocrine disruptors, but there is a long road ahead in this understudied area of research.

Featured Image: Michael Parfitt / @michaelparfittphoto

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