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Health Effects from Domestic Use of Gaseous and Liquid Fuels for Cooking and Heating in High, Middle and Low-Income Countries: A Systematic Review and Meta-Analysis
22 Pages Posted: 6 Apr 2023
More...Abstract
Background: Exposure to household air pollution from reliance on polluting fuels is a substantial public health burden. There is a global push for transition to clean fuels to address this burden. Systematically synthesizing evidence on the health impacts of liquid and gaseous fuel use is crucial to inform policies for clean household energy adoption at scale.
Methods: A systematic review and meta-analysis was conducted assessing health effects from cooking or heating with gas (natural gas, LPG and biogas) compared to polluting (e.g., wood, charcoal, kerosene) and clean (e.g., electricity) fuels.
Findings: Overall, 116 studies (215 effects estimates) met inclusion criteria for meta-analyses providing data for five grouped health outcomes. Compared to polluting fuels, use of gas significantly (p<0.05) reduced the risk of pneumonia (OR 0.56), wheeze, cough and breathlessness (OR 0.43, 0.44 and 0.40), chronic obstructive pulmonary disease (COPD) and bronchitis (OR 0.37 and 0.60), preterm birth and low birth weight (OR 0.66 and 0.70). Compared to electricity, use of gas significantly (p<0.05) increased the risk of pneumonia and COPD (OR 1.26 and 1.15) and slightly increased the risk of childhood asthma (OR 1.09; p=0.07) but significantly reduced the risk of bronchitis (OR 0.87). No association was found for adult asthma, wheeze, cough and breathlessness.
Interpretation: Switching from polluting to clean gaseous fuels for household energy significantly reduces the risk of key health outcomes that carry substantial morbidity and mortality. These findings are most relevant in lower-and-middle income countries where households have the greatest reliance on polluting fuels. Although gas was associated with a slightly higher risk of some negative health outcomes compared to electricity, clean gaseous fuels remain the best transitional option for countries where universal access to electricity for cooking/heating is not feasible in the near-term.
Funding: The review was commissioned by the World Health Organization.
Declaration of Interest: All authors declare no competing interests.
Keywords: review, meta-analysis, cooking, heating, indoor pollution, gas, LPG, alcohol, clean fuels, health effects, household
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