Household fuel use and severe asthma symptoms among preschool children in Gauteng province, South Africa : a cross-sectional study

Abstract

BACKGROUND : Household air pollution continues to be a major public health hazard due to the continued use of household fuel sources. Globally, approximately 4 million people die prematurely each year due to exposure to household air pollution sources. Children are more susceptible to health effects associated with air pollution because their immune systems and lungs are not fully developed. OBJECTIVE : The objective of the study was to investigate the association between household fuel use and current severe asthma symptoms among preschool children in Gauteng province, South Africa. METHODS : This was a cross-sectional study conducted in the City of Tshwane Metropolitan Municipality in Gauteng province, South Africa. A total of 1844 parents and guardians of preschool children completed the modified International Study of Asthma and Allergies in Childhood questionnaire. However, a total of four questionnaires were discarded due to incorrect completion. Therefore, a total of 1840 questionnaires were included in the data analysis. Data were analysed using multiple logistic regression analysis. RESULTS : The prevalence of current severe asthma symptoms was 15.4%. The use of gas for cooking or heating significantly increased the likelihood of current severe asthma symptoms among preschool children (OR=3.20;95% CI 2.08 to 4.91; p<0.001). The use of open fire sources (paraffin, wood or coal) increased the likelihood of severe asthma symptoms among preschool children by 87% (95% CI 0.98 to 3.55; p=0.057). CONCLUSION : The study observed that using gas and open fire sources for cooking or heating was associated with current severe asthma symptoms among preschool children in Gauteng, South Africa. Household air quality regulations should be developed to mitigate child exposure to household air pollution in the study setting.